Tumor Workup Research Articles

Neuroendoscopic Management of a Solitary Pineal Region Tumor. Case Report of an Adenocarcinoma Metastasis

The present case describes a two-step endoscopic management of hydrocephalus and diagnosis of a single pineal region metastasis arising from a gastric adenocarcinoma. A 62-year-old man presenting with signs of subacute obstructive hydrocephalus from a pineal region mass had at first been treated with an endoscopic third ventriculostomy. As cerebrospinal fluid tumor markers (alpha-fetoprotein, beta-human chorionic gonadotropin) were negative, an endoscopic biopsy of the pineal region tumor was performed through a more anterior frontal burr hole. Pathology showed an adenocarcinoma and primary tumor work-up revealed an unsuspected gastric tumor, the pathology of which matched with the intracranial metastasis. The present report emphasizes the role of neuroendoscopy in pineal region tumors and reports a rare case of a solitary gastric adenocarcinoma metastasis in this location.

MDP Bone Scan: A Key Step in Assessment and Staging of a Rare Presentation of Ewing Sarcoma in a Young Adult Man

A Spanish speaking young man who presented with a painful supra-orbital head mass causing progressive diplopia and epistaxis. Initial clinical and radiological work-up suggested an esthesioneuroblastoma (i.e., olifactory neuroblastoma) with its associated good prognosis. However, further history (obtained through an interpreter) caused the primary physician to order a nuclear bone scan. The results from this scan dramatically changed the clinical approach, tumor work-up, diagnosis and treatment of this patient who was found to have an atypical metastatic Ewing sarcoma.

Central adenocarcinoma of the mandible

A seemingly straightforward clinical diagnosis of ameloblastoma was made of a large radiolucent, multicystic lesion in the mandible. Biopsy and metastatic tumor work-up revealed the tumor to be primary in the mandible. A histopathologic diagnosis of papillary adenocarcinoma of salivary gland origin was made. This article reports a well-documented primary mandibular salivary gland tumor. A review of the literature and light and electron microscopic interpretation of this tumor are presented.