Biomedical subjects

M Salvati

Publications and source records attributed to M Salvati.

At least 55 records · Page 3Linked to original sources

PubMed1998

Chronic subdural haematoma: a possible relationship with tamoxifen.

Five patients operated on between 6 months and 7 years earlier for breast cancer were surgically treated for chronic subdural haematoma. This unusual association may be explained on the basis of known factors such as coagulative impairment subsequent to chemotherapy, a degree of cerebral atrophy or mild trauma. On the other hand, since four of the patients were taking antioestrogen therapy to control the disease, it is speculated that the oestrogenic properties of tamoxifen may have contributed to subdural bleeding.

Aged↗

PubMed1998

Long-term survival in patients with supratentorial glioblastoma.

The authors report 11 patients with cerebral glioblastoma who lived at least 5 years after their initial diagnosis. There were 6 female and 5 male; the mean age was 39 years (range 24-55 years). All patients were treated surgically and postoperatively received whole-brain radiotherapy and chemotherapy. Five patients (45%) presented local recurrences after an average interval of 3.9 years from treatment. At average follow-up of 9 years (range 5-14 years), 7 patients (64%) were alive after an average interval of 8.1 years; 4 patients (36%) died from local relapse. Survival was influenced by patient age and, to a lesser degree, by treatment. A review of the literature, together with our own series, suggest that death from recurrence disease is unusual in glioblastoma patients who survive more than 5 years.

Adult↗

PubMed1998

Actinomycosis of the central nervous system: surgical treatment of three cases.

Three cases of actinomycotic brain infection are described, 2 of which manifested as cerebral abscess, the third as epidural empyema. Complete resolution of the infection was always achieved by means of surgical treatment and prolonged antibiotic therapy. The cases reported emphasize the importance of a combined approach in the treatment of this unusual cause of brain infection.

Actinomycosis↗

PubMed1998

Epithelioid schwannoma of the ulnar nerve. Some clinical observations.

The authors describe one case of purely epithelioid schwannoma of the ulnar nerve and discuss the therapeutic management. A 44 year-old man was referred to us for a fusiform, movable mass in the left ulnar nerve and was removed by a wide en bloc excision. Intraoperative nerve action potentials were performed both prior to and following excision of the lesion. Histologically, the tumor was composed of round or polygonal cells arranged in necrotic clusters and anastomosing cords. There were areas of spindle cells. The epithelioid cells were round with abundant cytoplasm. Mitoses were frequent. S100 protein immunoreactivity was present diffusely in tumor cells (both nuclear and cytoplasmic), whereas cytokeratin, NSE, and anti-melanoma reactions gave negative results. After a 13 months, the patient's neurological conditions are excellent and there are no signs of either recurrence or metastasis.

Adult↗

PubMed1998

Metastatic spinal cord compression. Clinical remarks.

BACKGROUND: Metastatic compression of the spinal cord is a frequent occurrence throughout the evolution of neoplastic disease. Possible clinical-diagnostic strategies and therapeutic management of this pathology are discussed in terms of survival and quality of life. METHODS: The study includes 59 patients (40 males and 19 females, with an average age of 48.4 years) with metastatic spinal compression treated surgically in our centre (in some cases with stabilization of the spinal segment involved). RESULTS: In 40 cases the localization of the primary tumor was known when the patient was admitted. The segment involved was the dorsal one in 41 cases. The most frequent type of tumor was pulmonary carcinoma in males and breast carcinoma in females. Average survival was 5.3 months. Treatment integrated by stabilization improved the quality of life in comparison to laminectomy alone. Survival was also influenced by the histological type and site of the primary tumor. CONCLUSIONS: Surgical treatment not only prolongs survival but, above-all, guarantees a satisfactory quality of life.

Adult↗

PubMed1998

[Therapeutic considerations in solitary cerebral metastases from uterine carcinoma].

Brain metastases from endometrial carcinoma rarely involve the nervous system and are solitary in exceptional cases (< 1% of cases). Two cases of solitary cerebral metastasis from endometrial carcinoma are described. Two patients, submitted to the therapeutic protocol established for endometrial carcinoma, underwent surgery, radiotherapy and chemotherapy for solitary cerebral metastasis after at average interval of 18 months. Average survival was 46 months and death was due to progression of the systemic disease. An examination of our cases and those described in the literature has shown that, although these metastasis do not respond well to therapeutic treatment, a better outcome may be achieved by combined treatment consisting of surgery, radiotherapy and chemotherapy.

Brain Neoplasms↗

PubMed1997

Idiopathic normal-pressure hydrocephalus in adults: result of shunting correlated with clinical findings in 18 patients and review of the literature.

The authors describe their findings in a study aimed at identifying clinical-prognostic factors in treatment of idiopathic normal-pressure hydrocephalus. The study comprised 18 adult patients submitted to surgery for ventriculo-peritoneal shunting. The findings that emerged from this series of patients were compared with those reported for the 381 published cases. In our group of 18 patients, average age was 65 years and the average duration of clinical history was 47 months (median 18 months). Follow-up ranged from 3 to 5 years (median 4.2 years): 12 patients improved (9 completely) and 6 presented stable neurological deficits. The factors that had a statistically significant influence on outcome were a short clinical history (less than 6 months) (p = 0.05) and a clinical onset without dementia (p = 0.03). Patients with medium-grade preoperative ventricular enlargement always made a complete functional recovery after surgery (p = 0.2).

Adult↗

PubMed1997

Central neurocytoma: clinical features of 8 cases.

The authors report 8 cases of central neurocytoma with a minimum follow-up of 3 years. Five patients were males and 3 females with average age of 21 years. All patients underwent surgical removal of tumor, and radiotherapy was delivered to 2 of the 3 patients in whom removal had been partial. At an average follow-up of 5 years, all patients are alive and none of them has presented signs of recurrence or progression of the disease. Some typical clinical and histological features of this tumor are pointed out.

Adolescent↗

PubMed1997

Osteoblastoma of the calvaria: report of two cases diagnosed with MRI and clinical review.

The authors describe 2 cases of osteoblastoma of the calvaria and review the clinical features of the 28 cases reported in the world literature. Benign osteoblastoma is a rare tumor that effects young patients, most frequently at temporal level. On the basis of its neuroradiological appearance, it is difficult to formulate a differential diagnosis against other osteoblastic tumors or against osteoid osteoma. In only a few cases MRI findings are reported. In our cases, MRI was more effective than CT scans and radiographs for evaluating the intracranial and intraosseous extension of the tumor. The definitive diagnosis was obtained by combining the histopathological features of the tumor with the clinical and radiological data. The prognosis of this tumor is very good regardless of the type of treatment performed, although both relapse and, more rarely, malignant tumor evolution are possible.

Adult↗

PubMed1997

Radiation-induced sarcoma of the skull: report of two cases.

The authors describe two cases of sarcomas of the skull following cranial irradiation in patients treated for other neoplasms, acute lymphatic leukemia, and astrocytoma, respectively. The patients (one man and one woman: mean age 24.5 years) developed sarcomas within the irradiated field after a mean latency period of 11.5 years. Histologically, the tumor proved to be a fibrosarcoma. Despite aggressive surgery and other therapy, the survival of the patients was short (10 and 8 months, respectively). The pathological and clinical aspects of this unusual complication are analyzed with reference to 41 cases taken from the world literature.

Adult↗

PubMed1997

Solitary cerebral metastasis from tumor of the testis: some observations about treatment in two cases.

The authors describe two cases of solitary cerebral metastasis from non-seminatous germ cell tumors of the testis: in the first case, the histology was teratocarcinoma; in the second, it was embryonal carcinoma. Both patients underwent surgery, whole-brain radiotherapy and chemotherapy, and are still alive and disease-free after respectively 42 and 72 months. Although systemic metastasis from tumors of the testis are relatively common, they rarely involve the nervous system. A review of our cases and those reported in the literature shows that the outcome in these patients can be improved by the combined surgical, radiological and chemotherapeutic treatment of the metastasis.

Adult↗

PubMed1997

Multicentric and multifocal primary cerebral tumours. Methods of diagnosis and treatment.

Forty patients with multifocal and multicentric cerebral tumours were retrospectively studied. The patients were divided into two groups: ten patients with multicentric tumours (group A), and 30 patients with multifocal tumours. As far as their preoperative clinical history and the incidence of the various symptoms and signs are concerned, there were no significant differences between the two groups. CT permitted a correct diagnosis in 90% of the cases. All of the patients underwent the removal of the tumour(s) and received radiotherapy; 30 patients also received chemotherapy. In group A, nine patients died and one was lost to follow-up one year after treatment; the average survival was ten months from the appearance of the multicentric tumour. In group B, 29 patients died and one is still alive two years after treatment; the average survival was six months. We consider the problems of diagnosis and the long-term follow-up of patients.

Adult↗

PubMed1997

Rathke's cleft cyst: a clinical and radiographic review.

We report the case of a 62-year-old woman, who had a 4-year history of progressive visual acuity deficit. On neurological examination, visual acuity was 5/20 in the right and 4/20 in the left eye. A hormonal study revealed hypophyseal hypofunction. CT and MRI scans showed an intra-suprasellar cystic lesion, hyperintense in T1 and hyperintense in T2-weighted sequences. At surgery, the cyst wall was opened and the cavity placed in communication with the subarachnoid space. Histological examination showed a Rathke's cleft cyst. After four years of follow-up the patient's visual deficit remained unchanged, whereas the results of the hormonal assays were normal. An MRI scan confirmed the absence of the cyst. We review 216 reported cases of Rathke's cyst and discuss its pathogenesis, clinical features and treatment.

Cysts↗

PubMed1997

Primary spinal epidural non-Hodgkin's lymphomas in childhood: a review of 6 cases.

We report a retrospective study regarding 6 children with primary epidural non-Hodgkin's lymphomas and analyse the factors influencing prognosis with emphasis on treatment. Four patients were females and 2 males. The neurological condition of patients was assessed pre- and postoperatively according to Shaw's classification for neurological disability. All patients were submitted to surgery, radiotherapy and chemotherapy. Histologically, the tumour proved to be a high-grade non-Hodgkin's lymphoma in all cases. At follow-up, all patients are alive after a median interval of 52 months (range 24-72 months). This study showed that the outcome of patients depends on the gravity of pre-operative deficits whereas the survival is influenced by the type of treatment.

Adolescent↗

PubMed1997

Malignant supratentorial astrocytomas of late childhood. Our experience with 25 cases.

The authors present 25 patients ranging in age from 8 to 16 years who had malignant supratentorial astrocytomas. This type of lesion represents one of the most important and statistically significant causes of morbidity and mortality in late childhood. Compared to adult malignant supratentorial astrocytomas, these lesions seem to show a better survival rate. The reason is unknown. The authors present their experience regarding the importance of radical removal and histology for a better prognosis.

Adolescent↗

PubMed1997

High-dose radiation-induced meningiomas.

BACKGROUND: Numerous neoplasms within the CNS have been reported as radiogenic in origin; radiation-induced meningiomas are at least five times more numerous than gliomas or sarcomas in the world literature. METHODS: The authors review 10 cases of cerebral meningiomas following high-dose radiotherapy in patients operated for neoplasm of the nervous system. The pathologic and clinical aspects of this unusual complication are analyzed in all cases in the world literature. RESULTS: There is a female predominance (F-M ratio: 3:2) and the patients are young (mean age: 33.1 years; median: 29 years). The average latency period is 14.4 years (range: 9-21 years). The first disease is acute lymphocytic leukemia (ALL) in 40% of cases. Radiation induced meningiomas are atypical in four cases. Recurrence was observed in one case without malignant transformation. CONCLUSION: High-dose radiation-induced meningiomas have the following characteristics: (1) children appear particularly sensitive to the development of this tumor; (2) there is a female predominance, otherwise than is observed in low-dose meningioma; (3) these tumors present a peak frequency in the third decade of life; and (4) frequently, these tumors are atypical and recur. Finally, it is essential that every new case be reported to throw light on this particular pathologic correlation with its many grey areas.

Adolescent↗

PubMed1997

Prognostic factors in intramedullary astrocytomas.

This report presents a retrospective prognostic study of 65 patients with intramedullary astrocytoma surgically treated between 1953 and 1990. Median survival and statistical survival at 5 years were assessed in relation to clinical, histological and therapeutic factors for each patient. Results showed that factors positively influencing the prognosis are low histological grade of the tumour and good pre- and post-operative general conditions. Among the grade II astrocytomas, the fibrillary and protoplasmatic types presented longer survival times regardless of the type of removal performed. In anaplastic astrocytomas the simultaneous presence of certain morphological features indicative of higher malignancy negatively influenced survival. The degree of resection did not influence average survival within each histological grade.

Adolescent↗

PubMed1997

Recurrence from filum terminale ependymoma 42 years after 'total' removal and radiotherapy.

The authors describe the unusual case of a patient requiring reoperation for ependymoma of the filum terminale after a symptom-free period of 42 years: treatment of the primary tumor consisted of macroscopically complete surgical excision and postoperative radiotherapy. This case brings to light some interesting observations: a late recurrence, as in the case reported here, appears to be rare especially if the tumor presents in adult age; the long preoperative clinical history (26 months) and the initial aspect of the tumor that infiltrated 2 caudal roots, removed together with the tumor, may have been factors correlated with the risk of recurrence: postoperative radiotherapy may have helped to delay clinical manifestation of the recurrence. Ependymomas of the filum terminale may clinically recur even after complete removal. The latest clinical recurrence described in the literature occurred after 26 years.

Adult↗