A rare association of ganglioglioma and cavernous malformation: Report of two cases and literature review

Background: Some glial tumors have been observed in association with different types of vascular malformations of the brain (angiogliomas). However, the association of ganglioglioma with other vascular malformations is extremely rare, with only few cases reported in the literature, one of which is referred to as “angioganglioglioma.” Case Description: Two patients presented with acute onset of neurological symptoms, with magnetic resonance imaging (MRI) nding of cavernoma of the left middle cerebellar penduncle, and small mass of the chiasmatic region, respectively. After microsurgical excision, histopathological examination revealed mixed ganglioglioma and cavernous malformation in both cases. Postoperative course was uneventful, and follow‐up MRI showed complete removal of the tumor with no recurrence after 4 years. Conclusions: Angiogliomas are very uncommon tumors. In literature, we found different interpretations of such lesions, although they should most probably be considered as distinct pathological entities. Although the association of ganglioglioma with cavernoma is extremely rare, it could be considered as a most peculiar form of angioglioma, and supports the existence of angioganglioglioma

Intraoperative Ultrasound applications in Brachial Plexus Tumoral Lesions

Ultrsonography is useful for exploring peripheral nerves and it is an established modality for the pre-operative evaluation of peripheral nerve tumoral pathology, surgical planning and approach. Brachial plexus is one area where US is difficult because of complex anatomy and bony relations hindering exploration. Anesthesiological US techniques for brachial plexus block are consolidated because of high spatial and contrast resolution of the method. The same technical tricks can be used during the intra- and perioperative planning. Neurofibromas are hyperechoic, with well defined homogeneous margins. Doppler shows intratumoral blood vessels. The roots are usually clearly hypoechoic and the tumor relatively hyperechoic. The lesion is centrally positioned relative to the nerve fibers and intraoperative techniques give a very useful indication for the better pathway to be followed for the tumor removal reducing nerve damage. Schwannomas are eccentric relative to the nerve fibers, well encapsulated, hypoechoic at US and with regular margins. Sometime an echogenic capsule can be distinguished, but it is difficult to recognize in the fat which is hyperechoic. Doppler may show an internal vascular circulation. When the peripheral fat is removed, the capsula and tumor borders can be very well defined, allowing complete and safe removal

Schwannoma of median nerve at the elbow. Case report and short review of the literature

Gli Autori presentano un caso di neurinoma del nervo mediano, a rara localizzazione nel gomito, associato ad anomala divisione dello nervo in una donna di 42 anni. Sono descritti il trattamento chirurgico e il follow-up