Showing posts with label Ependymoma. Show all posts
Showing posts with label Ependymoma. Show all posts

Friday, December 2, 2011

Ependymoma, Two years follow up.

17 yrs, Female.
with persistent headache.
Known case of ITP.
MRI showed
 non enhancing mass 
periventricular area 
more on Lt. side.
Burhole biopsy 
showed
Ependymoma Gr.II.

Complete resolution after one year of Gamma knife Treatment.

                       At GKRS                             After one year                              After Two years



Saturday, July 23, 2011

Ependymoma,complete resolution.


Case summary:
This, 26 years nice man from Karachi had undergone insertion of VP shunt on right side on November 22, 2010 on radio diagnosis of heterogeneous enhancing solid cum cystic mass in posterior fossa in fourth ventricle causing hydrocephalus. This was diagnosed when patient had presented with severe headache on and off associated with vomiting worst since last month and blurred vision since one month.

On referral, he had presented some improvement in headache and vomiting and significant improvement in blurring of vision. Clinical examination had revealed no obvious neurologic deficit. MRI brain spectroscopy had revealed markedly elevated Choline levels up to 399. Patient has referred us for the management with GKSRS.  Risk of GKSRS explained all in Urdu along with requirement of strict follow up. These agreed upon wished to proceed. He had treatment with following prescription,

Target
                             Location
                   Prescription
       Volume
A
Ependymoma.
     12Gy @ 50%
   18.6 cm³

Multiple isocenters with 18, 14 & 8 mm collimator used in APS mode. He had discharged on tapering doses of Dexamethasone and advised follow up after 3 months


Follow up at 3 months showed almost complete resolution of the tumor.


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Saturday, July 16, 2011

Ependymoma, Complete Resolution at 8 month follow up.

This 17 years old lady presented with with headache& vomiting since 6 months, ataxia,diplopia,diminished vision since 2 months.On MRI there was large
Post. fossa mass and hydrocephalus. She was operated for Rt.V.P.Shunt and tumor
was debulked. Histopathology was consistent with Ependymoma.

Gamma knife Radiosurgery done for residual tumor. 31 cc volume treated with 12 Gy at 50% isodose line.


Follow up MRI at 8 months showed complete disappearance
of the residual tumor as can be seen in following images.