Months Of Evolution Research Articles

Carcinoma da Tiroide: Diagnóstico em exame de Saúde de Medicina do Trabalho e Aptidão ao Trabalho por Turnos

Introduction Thyroid carcinomas include a wide spectrum of lesions. The well-differentiated subtype, 90% of all thyroid cancers, is associated with an excellent prognosis. Several risk factors are described. The most important environmental factor is exposure to ionizing radiation, although shift work is proposed as a prominent factor. The common clinical presentation of thyroid carcinoma is a thyroid nodule detected by the patient or imaging tests. Case Report This is a 25-year-old nurse who came to the occupational health service with complaints of enlarged cervical nodes. She denied prominent personal background. She had a palpable mass in the thyroid and right supraclavicular region and dysphonia with six to nine months of evolution. She underwent cervical ultrasound with biopsy that revealed papillary thyroid carcinoma with lymph node metastasis. She had surgery and radioactive iodine treatment. In occupational health, she was conditioned to shift work. Discussion Surgical removal and radioactive iodine treatment cures more than 90% of localized and well-differentiated thyroid carcinomas. Well-differentiated thyroid carcinoma with metastases is associated with a 90% ten-year survival if there is good iodine supply and the tumor goes into remission after treatment. A relationship between circadian cycle dysfunction and thyroid carcinoma is proposed, so it is important to decide the ability to work at night in the follow-up period of the disease. Conclusion The relevance of the case arises with the aim of alerting to the advantages of an Occupational Health service and its ability to provide a timely and rapid response to various pathologies of the working population with important health gains. This case also offers a rationale for the management and time of shift work avoidance in the post-diagnosis of thyroid carcinoma. Keywords: thyroid carcinoma; shift work; occupational medicine; occupational health.

Secondary Gerstmann syndrome, a case report

IntroductionGerstmann syndrome is a rare neurological disorder that consist primarily of 4 neuropsychological signs that include acalculia (impairment in performing calcultaions), digital agnosia (dificulty discriminating their own fingers), agraphia (impairment or dificulty to write by hand); and left-right disorientation (impairment of distinguishing left from right.ObjectivesPresentation of a case report of a patient with Gertsmann syndrome secondary to breast cancer metastasis.MethodsWe analyze the case of a 79 years-old female with a history of breast cancer in remission, with a severe depressive episode of 8 months of evolution, dysphoria, apathy, decrease in the ability to carry out basic activities of daily life, acute personality changes and sleep disruption. 15 days previous to the first examination the patient suffers gait disturbances, falling from her own height, memory impairment, suicide ideation and nomination aphasia.ResultsAt the examination we encounter digital agnosia, acalculia, agraphia, right-left disorientation, right hemiparesis. MRI are taken founding 3 tumor lesions in the left and right frontal lobe, 2 solid lesions with a necrotic appearance in the right parietal lobe, one of them in the angular gyrus of the parietal cortex. CT scan found a solid tumor-like lesion in the left pulmonary apex. CA-125 antigen 429.5 U/mL. She was sent to continue her treatment with oncology, receiving radiotherapy.ConclusionsThe psychiatric abnormalities secondary to Gerstmann syndrome make the relatives of this patient seek psychiatric care, requiring multidisciplinary work to reach an accurate diagnosis. Gerstmann syndrome is a rare neurological condition that can mimic lots of other clinical pictures.DisclosureNo significant relationships.

Hypertriglyceridemia induced by aripiprazol: about a clinical case

Introduction41 years-old man diagnosed of schizophrenia and peripheral spondyloarthropathy HLA-B27 (-) in treatment with methotrexate. Psychiatric background: First psychotic episode at 18, with no further medical monitoring. In 2018 he underwent a new episode consisting in auditory hallucinations, delusional ideas and clinophilia of months of evolution. He was sent to a Psychiatric Rehabilitation Unit and prescribed aripiprazole 20mg. The routine blood analysis revealed triglycerides level of 414mg/dL, with previous normal levels (123 mg/dL), without no other cause to justify it.ObjectivesTo study the relationship between aripiprazole treatment and acute hypertriglyceridemia.MethodsA clinical case is presented and available bibliography about the relation between aripiprazole and acute hypertriglyceridemia is reviewed.ResultsHypertriglyceridemia was confirmed in the second analysis, so we concluded it was due to the start of aripiprazole, after rejecting other potential causes. Aripiprazole was replaced by cariprazine 3mg because of its similar profile. The analysis was repeated after a month and the normalization of the triglyceridemia (159mg/dL) was verified, while cholesterol levels remain stable. Moreover, the patient experienced an improvement in akathisia and sedation.ConclusionsAlthough metabolic impact is not expected with aripiprazole, after reviewing the bibliography we have found a clinical trial and a case series that described this adverse effect. Our case highlights the importance of closely monitoring of patients in whom an antipsychotic treatment is started due to the high mortality and morbidity related to cardiovascular diseases.DisclosureNo significant relationships.

De-prescribing strategy in a case of Delirium in the elderly

Introduction Iatrogenic factors, such as polypharmacy and prescription cascade, are some of the main causes of delirium in the elderly. We present a case of delirium of months of evolution that improved after applying a pharmacological de-prescription strategy.ObjectivesTo report a case and review the available literature on the concepts of prescription cascade and de-prescription in delirium in the elderly.MethodsA 92-year-old woman with a history of cerebrovascular accidents and no psychiatric history or dementia was admitted to a psychogeriatric clinic due to disorientation, delusions of harm and gait apraxia. Several months earlier she had required admission to the general hospital for agitation. In view of the suspicion of delirium, an exhaustive examination and complementary tests were performed, including a neuropsychological assessment and a brain scan (Image 1).ResultsThe patient had previously received multiple high-dose psychotropic drugs (Gabapentin, trazodone, Zolpidem, Quetiapine), which had reduced the agitation but had not resolved the problem. Organic causes were treated in a multidisciplinary team (pressure ulcers), together with a gradual tapering of medication. Although underlying vascular dementia was diagnosed, the patient’s gait and cognitive status improved, with a significant impact on her autonomy and quality of life.ConclusionsDespite an extensive literature on the subject, delirium in the elderly remains an under-diagnosed medical condition, especially the hypoactive subtype, just as cascade prescribing remains common. It is important to raise awareness among specialists in training to prevent and diagnose it.DisclosureNo significant relationships.

Interposition Arthroplasty in Untreated Chronic Dislocation of the Elbow.

Objective:To describe the clinical outcomes of interposition arthroplasty with transposition of the medial epicondyle to the coronoid process and articulated external fixation in patients with untreated chronic dislocation of the elbow.Methods:Fourteen consecutive patients diagnosed with untreated chronic elbow dislocation performed a complete radiological and physical examination. The same surgeon treated all patients with a same technique. Passive mobilization started immediately in addition to the vigorous care of the surgical wound and surrounding skin.Results:A total of 14 patients were treated, with a mean age of 31 years, with the nondominant side being the most affected (65%). In the immediate postoperative period, the initial Mayo Elbow Performance Score was 60 pts. In all cases, the distraction from the articulated fixator was removed, and there was an average of 16 pts improvement at the time of removal. A hinged elbow orthosis was placed for 4 weeks starting strengthening and obtained radiographic integration of the neocoronoids; ranges of motion of flexion 122°, extension −6°, and pronosupination 70°, without data of any direction instability.Conclusion:Considering that this is one of the longest series with a follow-up of more than 60 months of evolution in our patients, the result is completely satisfactory, achieving the objective of a minimum range of motion of 100° in addition to elbow stability.

Esguince lateral de tobillo con necrosis cutánea no yatrogénica. Presentación de un caso y revisión de los sistemas de clasificación.

Lateral ankle sprain is a frequent injury that heals quickly with correct treatment. We present a case with rare complications, unrelated to inadequate orthopedic treatment. In addition, the study is completed by conducting a review of the literature with the different systems used to classify this type of injury. A 49-year-old male athlete with a lateral ankle sprain while practicing basketball who presented significant edema, which progressed to anterolateral skin necrosis in 2 weeks. After scarectomy, he presented a deep wound with exposure of the capsulo-ligamentous structures, turning the injury into an open one. He associated a complete injury of the superficial peroneal nerve. Outpatient cures were startedwith associated negative pressure therapy, healing the wound after 4 months of evolution, returning to sports practice at 8 months.

Evaluation and Multidisciplinary Treatment of a Patient with Temporomandibular Disorder

Demonstrate that patients with signs and symptoms of the temporomandibular joint, prior to orthodontic treatment, should be treated multidisciplinary A 31-year-old female, a student at the Mexican Center for Stomatology, with a personal and family health history and orthodontic treatment who came to the clinic for presenting symptoms of pain in the face over the region of the bilateral temporomandibular joint, with alterations of the function, which radiated to the neck and back of several months of evolution. The clinical findings presented by the patient were: wear on the upper anterior teeth. The pain map diagnostic index was used, photographs of the face, whole body from the front and sides, panoramic radiography, lateral skull, anteroposterior and spine, articulated models in semi-adjustable articulator, this facilitated us to diagnose joint disorders. The proposed treatment was multidisciplinary treatment: Neuro-muscular rehabilitation and the use of physical agents, massage therapy, Kinesiology and manual therapy. The multidisciplinary treatment of occlusal guard by stomatology and the combination of physical agents, Kinesiology and manual therapy by physiotherapy, demonstrated excellent results with the disappearance of the symptoms in the patient, improved her expectations. Giving you a better quality of life.

Metástasis aislada en ganglios paraaórticos en adenocarcinoma de endometrio. Reporte de un caso

The presence of metastases in para-aortic nodes is one of the most important prognostic factors for endometrial cancer, and it may be the only site of metastatic disease, the probability of which in the absence of metastases in pelvic nodes is remote. We describe a case of a 69-year-old patient who consulted for postmenopausal bleeding of 3 months of evolution with a result of an endometrial biopsy that reported moderately differentiated endometrioid adenocarcinoma. After carrying out extension studies, she was taken to staging surgery plus resection of the para-aortic lymph node plastron; with favorable postoperative evolution. Para-aortic lymph node metastasis was the only site of extrauterine disease, therefore this pattern of lymphatic dissemination without involvement of the pelvic nodes must be taken into account in order to determine the strategies for the management of patients. Keywords: Endometrial cancer, Paraaortic lymph Nodes, Pelvic lymph nodes, Isolated metastasis.

Dual Glomerular Lesion in Hiv Patient

HIV-associated nephropathy (HIVAN), the classic kidney disease associated with HIV infection, was first described in 1984 as a complication of AIDS although HIVAN may also occur in patients with less advanced HIV infection or following acute seroconversion Histologically, HIVAN is a collapsing form of focal segmental glomerulosclerosis (FSGS) accompanied by microcystic tubular dilatation and interstitial inflammation. HIV-immune complex kidney disease (HIVICK). Other immune complex diseases may also occur in HIV-infected patients, including IgA nephropathy and postinfectious glomerulonephritis, and are best diagnosed as those specific entities The pathophysiological mechanism of HIVAN injury is mediated by direct infection of renal epithelial cells by HIV, expression of intrarenal viral genes, and dysregulation of host genes by modulating cell differentiation and the cell cycle. In contrast, kidney disease by HIV immune complexes (HIVICK) involves a different immune mechanism with antibody deposits within glomerular structures. Both entities progressively present different degrees of proteinuria and progressive decrease in the glomerular filtration rate, depending on the commitment or histology suffered by the patient. In this case reports patient with clinical picture of 3 months of evolution of temporo-spatial disorientation and alteration of the state of consciousness associated with hyperthermia. We perform neuroimaging without alterations, a lumbar puncture performed with evidence of an infectious process by coconuts + in the GRAM of the cerebrospinal fluid, normochromic normocytic anemia and renal failure, sub nephrotic proteinuria, glomerular hematuria, HIV positive, recount of normal CD4, renal biopsy with diagnosis of immune-mediated glomerulonephritis (IgG and C3), in the immunofluorescence (HIVICK) and with membrano pattern proliferative and in two glomeruli focal segmental sclerosis collapsing variant (HIVAN)is observed.

Evaluation of Three Models of Follow-up of Patients with Cervical Cytological Abnormalities in a Peruvian’s Largest Teaching Women’s Hospital

Introduction: The follow-up of squamous intraepithelial lesions (SIL) allows us to understand their progression and regression, however squamous cell atypia (ASC) can generate confusing follow-up results. We aimed to describe the evolution of ASC and SIL during cyto-histopathological follow-up in a tertiary-care hospital. Materials and methods: we conducted a retrospective study during 2016 in 156 Papanicolaou test (PAP) results under three models: 1) with ≥1 PAP and biopsies, 2) 1 PAP followed by ≥1 biopsy, and 3) ≥1 PAP and a confirmatory biopsy. Progression was defined as ASCUS to low-grade SIL (LSIL) or higher, and LSIL to high-grade SIL (HSIL) or higher; and regression as HSIL to LSIL or lower; and LSIL to ASCUS or lower. Results: In PAP, 57 (36.5%) cases were ASC and in histopathology 56 (39.9%) cases of grade 1 cervical intraepithelial neoplasia. Twenty-nine (18.6%) results were followed: 8 (27.6%), 17 (58.6%), and 4 (13.8%) with models 1, 2, and 3, respectively. The progression of the lesions was reported in ~50% for models 2 and 3. ASCUS was the main cytological finding that indicated biopsies, and for all models, the mean progression and regression time was 4 and 3.1 months, respectively. Conclusions: The follow-up of cytological alterations in three models showed progression of lesions in half of the cases analyzed with a time of four months of evolution; ASCUS was the main finding that indicated histopathological study.

HEPATIC MANIFESTATIONS OF INFECTIOUS DISEASES. PRESENTATION OF CLINICAL CASE

There are infectious diseases that produce alterations in liver function tests and histology, through the activation, by endotoxins and other agents of the innate immunity pathway. This work aims to review the hepatic manifestations of diseases such as dengue and brucellosis in the pediatric age by means of clinical cases. Case 1: 17-year-old male with a history of travel to an endemic area and family members positive for dengue. Fever, myalgias, arthralgias, arthralgias and headache. On admission with leukocytes 6.93 thousand, platelets 189 thousand and positive IgG and IgM antibodies for dengue fever. Physical examination with hepatodynia and petechiae in the pelvic limbs. In control biochemistry with leukopenia and moderate thrombocytopenia, as well as alterations in liver function (Table 1). Ultrasound of the liver with data of acute inflammatory process. Seven days after admission, with clinical and biochemical improvement, it was decided the discharge of the patient. Caso 2: male, four years nine months old, with symptoms of 1 month of evolution characterized by fever, hyporexia and general malaise. Physical examination with icteric-pale color, hepatomegaly of 3 × 5 × 7 cm and splenomegaly of 4 cm. Paraclinical tests showed anemia, leukopenia and mild-moderate thrombocytopenia, hypertransaminasemia, cholestasis and TTP prolongation (Table 2) with positive rose bengal, hepatic USG with hepatomegaly and echogenicity changes, for which he was sent to the third level of care. The mechanisms of liver injury can be divided into four pathways: vascular, toxic, immune and hormonal. In infections, the immune pathway is the cause of liver damage, being activated by endotoxins, leading to inflammatory infiltration, the release of cytokines, reactive oxygen species and necrosis. In dengue infection, liver injury manifests with hypertransaminasemia, with a peak between the seventh and ninth day, progressive decrease and normalization between 2 to 8 weeks. Hepatic involvement in brucellosis can occur in the acute or chronic phase of the disease. In the acute phase, establishing a non-specific granulomatous hepatitis, increasing in 63% of the cases the liver function tests. The functions of the liver and the relationships it establishes with other organs may favor its injury during some infectious pathologies, being at this level one of the first manifestations in the context of an infectious disease, ruling out, in both cases, liver pathology by hepatotropic virus, metabolic, autoimmune and anatomical cause. The authors declare that there is no conflict of interest.

Case Report: Cutaneous Leishmaniasis

Cutaneous leishmaniasis is a parasitic disease caused by over more than 20 Leishmania species, in both tropical and subtropical regions. There are three main forms of the disease: visceral leishmaniasis (VL), Cutaneous Leishmaniasis (CL) and Mucocutaneous Leishmaniasis (MCL), Leishmania braziliensis predominates in Guatemala. We present a case study of a 15-year-old female patient, referred from the Jutiapa hospital for presenting a lesion in the right ear of 3 months of evolution. When interviewing the patient, she mentions that several months ago she presented a "wheal" on her ear after being bitten by a mosquito, which turned red, grew and then she saw it open and form an ulcer with scabs on the ear. surface, which is not painful. The Giemsa-stained rub revealed the presence of Leishman bodies and the biopsy revealed amastigotes within the histiocytes, thus confirming the initial diagnosis of cutaneous Leishmaniasis. Due to the above, treatment with glucantime was started at a dose of 20mg/kg for 20 days, which improved the condition and resolved it. The patient's sister had the same condition, which was confirmed using the same techniques and is treated with what also resolves it. It is important to take cutaneous leishmania into account as a differential diagnosis in patients who present painless ulcers despite not being in a precisely endemic area.

Oral squamous cell carcinoma: General aspects and case reports

Introduction: Of the malignant tumors of the oral cavity, 90% of them are oral squamous cell carcinomas, with a predilection to develop in the tongue and floor of the mouth being the most common sites. It is a lethal and disfiguring disease with an increase in its incidence, especially in the young population. Case Report: We present the case of 2 patients of different gender, who attended a check-up due to the presence of a lesion on the right lateral edge of the tongue, with a time of 1 and 6 months of evolution; with different risk factors. When performing the inspection for the neck area, adenopathies were palpated in both patients. Incisional biopsies were performed for histopathological study through which the diagnosis of squamous cell carcinoma (OSCC) was obtained. Conclusion: The timely detection of oral cancer and premalignant lesions is a vital issue for the patient's prognosis. Due to the high incidence of OSCC, the dental community is invited to detect, manage, refer and/or diagnose this pathology, for the benefit of the patient.

Giant Fibrothecoma of the Ovary in a Young Patient a Case Report

Fibrothecomas are benign ovarian stromal tumors, they are rare tumors of gonadal stromal cell origin that represent 3-4% of all ovarian tumors. It commonly occurs in post-menopausal women. The clinical presentation is often nonspecific, whereas patients more frequently present with a pelvic mass, metrorrhagia, and pelvic pain. We present a 35-year-old patient, nulli-pregnant, with no personal or family pathological history, who attended a medical consultation for presenting progressive abdominal distention of 6 months of evolution in addition to abdominal pain in the last 2 months type colic which increased during her menstrual periods concomitantly alteration in your defecatory habits. Abdominal ultrasound was performed, finding a solid intrapelvic mass of approximately 14x10x10 cm in diameter of probable left ovarian origin, free fluid in the Douglas space, compression and displacement of intestinal loops and bladder. The patient underwent surgery and an exploratory laparotomy was performed, finding a pelvic tumor adhered to the tube and left ovary, in addition to ascites fluid in the abdominal cavity, complete resection of the tumor, ovary and left salpingue was performed.

Carcinoma metaplásico de mama con diferenciación liposarcomatosa pleomórfica: reporte de un caso

Metaplastic breast carcinoma is a heterogeneous group of invasive carcinomas that can manifest a wide morphological spectrum, which generates difficulties in its diagnóstico. We present the case of a 27-year-old young adult, with no pathological history, who consulted for a large mass in the right breast of 12 months of evolution. Macroscopically, a yellowish lobulated tumor with areas of necrosis was observed. Microscopically, it presented two histological patterns: the first composed of epithelioid cells with atypical nuclei, pleomorphic and with figures of mitosis. The second by pleomorphic lipoblasts immersed in a sarcomatous background. The second case reported in the literature of a metaplastic carcinoma with pleomorphic liposarcomatous differentiation is presented, emphasizing the macroscopic, histological, immunohistochemical approach and its differential diagnoses.

Superficial temporal artery pseudoaneurysm as cause of refractory headache

Case presentation: A 36-year-old male presented with moderate, progressive headache, in the left temporal region, irradiating to the ipsilateral frontal region, with several months of evolution, refractory to analgesic medication, including opioids. He reported a closed traumatic brain injury (TBI) 5 years before in a motorcycle collision with an automobile, without a helmet. At the physical examination, it was possible to verify a pulsatile mass measuring 1.5 cm in diameter, with fremitus, in the left temporal region. The magnetic resonance imaging scan presented a round lesion, encapsulated, on the course of the superficial temporal artery (STA). The digital subtraction angiography confirmed the diagnosis of STA pseudoaneurysm. A surgical resection of the aneurysm was performed, leading to the complete resolution of the headache. Discussion: The STA pseudoaneurysm is a rare condition, representing less than 1% of aneurysms, usually presenting as a late complication of TBI. The majority of cases are asymptomatic, although focal symptoms and even bleeding may occur. The presentation with a chronic refractory headache is exceptional. Its treatment is indicated for local symptom resolution, aesthetic purposes, and rupture prevention, done by clipping and resection of the pseudoaneurysm. Conclusion: Even though unusual, the awareness of this condition is important for the etiological diagnosis of a persistent temporal headache in a patient with a history of TBI.

Diverticulitis perforada causante de fascitis necrotizante de miembro inferior

Mujer de 59 años, con antecedentes de diverticulosis de colon, que acude por dolor en la región inguinal y en el miembro inferior izquierdo de dos meses de evolución.
 En una primera instancia, la paciente se presentó con clínica de sepsis y se objetivó un eritema en el miembro inferior izquierdo, asociado a celulitis y crepitación subcutánea.
 La TC mostraba una colección hidroaérea en psoas y retroperitoneal que asciende hasta la cavidad abdominal hallándose una diverticulitis perforada. El tratamiento quirúrgico se basó en el drenaje de la colección retroperitoneal y sigmoidectomía, seguido de una fasciotomía, desbridamiento y lavado del muslo.
 La perforación de un divertículo puede formar un absceso intraperitoneal desarrollando una peritonitis o un absceso retroperitoneal, derivando en una translocación bacteriana hacia la extremidad inferior, debido a la comunicación existente en el anillo crural, generando una fascitis necrotizante del miembro.

Tubo-Ovarian Inguinal Hernia with Ruptured Bleeding Follicle: A Case Report

Introduction: Hernias are abnormal protrusions of any abdominal-pelvic or fat organ, which are produced by a defect in the abdominal wall, the most frequent are inguinal hernias and their content is generally of the omentum or intestinal loops, the presence of pelvic organs is very infrequent and the majority of cases described are in children under five years of age. Objective: To analyze the entity in connection with a case of a patient with a tubo-ovarian inguinal hernia. Clinical case: The case of a 34-year-old female patient is presented, who was under follow-up by the gynecology service due to the presence of a left ovarian cyst, with symptoms of pain in the left iliac fossa for more than 6 months of evolution. which is performed an ultrasound, which reports left inguinal hernia for what is electively scheduled by the general surgery service, when performing the herniorrhaphy incarcerated hernia with left ovary with bleeding follicle and fallopian tube is evidenced. Conclusions: These types of findings are infrequent, documented in the literature with a global incidence of Tubo-ovarian inguinal hernias ranging from 0-8-4.4%, however it is worth clarifying that these studies are in infant patients, so its presentation in adults associated with a hemorrhagic follicle is anecdotal as in this case.

Mucormicosis rinocerebral e infeccin por SARS-CoV-2. Revisión de caso clínico e imagenológico en un paciente con diabetes mellitus mal controlada

The clinical case of a 52-year-old man is presented, with a pathological history of type 2 diabetes mellitus and systemic arterial hypertension, the two with 3 years of evolution and metabolically decompensated for 8 months of evolution. He started with symptoms suggestive of SARS-CoV-2, which evolved in 2 weeks with increased dyspnea, fever, and left eye edema, for which he received in-hospital management. Control studies were performed, including computed tomography of the chest and skull, the first CO-RADS 5 report (very high suspicion of SARS-CoV-2 infection) with a severity scale due to severe extension; the second reported pneumocephalus in the left temporal fossa, left ocular infectious process, which conditioned proptosis, left intraorbital emphysema with involvement of the optic nerve and erosion of adjacent bone structures, as well as emphysema to the left masticatory space. During his stay, he presented an acute infectious process in the maxillary region, left eye and palate, for which mucormycosis pathology was suspected, and treatment with intravenous amphotericin was started. He required intensive therapy management and surgical intervention derived from the extension of the infection, which affected the brain tissue and generated complications and the death of the patient. Mucormycosis is a low prevalence and rapidly progressive disease caused by fungi of the Mucoraceae family of the Mucorales order. It is the fastest evolving fatal fungal disease in humans. For this reason, timely detection and treatment is of utmost importance for the survival of those affected by this agent. Keywords: Rhinocerebral mucormycosis; SARS-CoV-2 infection; COVID-19.

Cordoid Meningioma A Case Report

Introduction: Meningiomas are tumors of the central nervous system derived from the arachnoid layer of cells, represent less than 3% of all primary intracranial tumors in children, are prevalent in adolescents, and are rare in younger ages. Pediatric cases represent approximately 1.5% of all intracranial meningiomas, and very few cases show aggressive histology. The WHO classification meningioma divided into three grades: Grade I benign; II, atypical; and III, anaplastic / malignant. Chordoid meningioma grade II / atypical meningioma is a rare subtype, which represents only 0.5% of all meningiomas, have high growth rates, higher recurrence and greater possibilities to invade the brain parenchyma compared with meningiomas benign. One possible explanation for the high recurrence rate may be related to the quality mucoid stroma, which facilitates extension of tumor and makes it difficult to achieve a complete resection, which leads to subsequent recurrence. Case Report: We report the case of male patient 4 years of age diagnosed with meningioma Grade II, with clinic 2 months of evolution who presented progressive neurological deterioration, tumoral exeresis was performed in 3 opportunities and placement system ventriculo peritoneal in the course of 1 month and radiotherapy. Comments: Accurate diagnosis, therefore, assumes importance because these tumors have an aggressive clinical course and high probability of recurrence so knowing the pathological Clinical Aspects of this rare neoplasm is essential for the Treatment and Comprehensive monitoring.