Magnetic Resonance Imaging For The Diagnosis Of Chordoma

Tumors can be classified into three types: 1) benign 2) pre malignant 3) malignant tumor. Benign tumors are those which are incapable of abrupt expanding and affecting the other healthy brain tissues. Premalignant tumor is a pre cancerous stage, if not treated properly it may lead to cancers. It is often considered as a disease. Malignant tumor grows rapidly with time an ultimately leads to death of patient. Malignant is a medical term describing a sever growth of a disease. The most common primary brain Tumors are gliomas, wherein 70% are in the group of malignant gliomas, glioblastoma multiform (GBM).The GBM is one of the highest malignant human

Fig. 47: An 18 year old male having a myxoliposarcoma of the left thigh. The mass has hyperintense streaks in T1WI denoting its fatty component and has a bright T2 signal denoting its myxoid content. It has a bright signal in DWI which turns dark in EADC denoting its facilitated diffusion. ADC measures 2.5.quoted from( S. Osman et al ;2014)

Apparent diffusion coefficient is the most widely used diffusion MRI parameter which can be easily and rapidly obtained and could be used to grade cerebral gliomas. ADC assesses water diffusivity and inversely correlated with tumor grade.

CNS tumors represent the second most frequent tumor of childhood and the most common pediatric solid tumor; approximately 2,200 patients under the age of 20 are diagnosed each year with invasive CNS tumors, and CNS tumors are the number one cause of death from childhood cancer. [1] Therapeutic strategies generally involve surgery as a primary intervention, but complete resection is often not possible due to tumor location. In such cases, adjunct therapies, including chemotherapy and radiation therapy, may be required based on the tumor histology and presence of residual tumor. [2]

the American Cancer Society there are benign tumors, which are rare and often develop in

Cancer affects individuals from all backgrounds, regardless of class, age, gender or ethnicity. It is known to be the leading cause of death in many countries (World Health Organization, 2013). According to the Canadian Cancer Society (2013) approximately half of all Canadians will develop cancer at some point during their lifetime. There are many different types of cancers affecting various regions of the body. A sarcoma is one classification of cancer that arises from connective tissues present in the body including bone, fat, muscles, blood vessels or the linings of joints (American Cancer Society, 2014). Rhabdomyosarcoma is defined as a cancerous tumor of undifferentiated skeletal muscle, and generally involves regions of the head and neck (Ojo, Si, Pelaez, & Younis, 2014). Rhabdomyosarcoma can be classified into three main types: embryonal, alveolar and anaplastic (Kikuchi et al., 2013). The purpose of this paper is to explore the disease process of rhabdomyosarcoma and analyze the findings relative to nursing practice.

Gliomas are the most common type of primary brain tumor, accounting for 10-20% of its total. (5,19–21). Histopathology pattern is the most important feature in glioma classification. (22) The 2007 WHO classification of tumors of the central nervous system divides gliomas into four main types, with increasing degree of malignancy (from I-IV). Low-grade gliomas are defined a grade I and grade II, in opposition to the “high-grade gliomas”, WHO grade III and IV. The so-called “diffuse low-grade gliomas” integrate 2007 WHO II class, and include diffuse astrocytomas, oligodendroglioma and oligoastrocytoma (mixed glioma) (19). There are some pertinent critics to this grading system, such as the great inter-variability among neuropathologist experts. More importantly, 2007 WHO grading doesn’t contemplate the continuum between grade II and III. In fact, many DLGG has an “intermediate” behavior, with some more aggressive microfoci lodged in the core of the neoplasm (19,23,24). Hence, the term diffuse low-grade glioma is preferred in this article.

Although conventional MRI has been used widely now to diagnose and follow up the brain tumor patients, it provides narrow information on tumor physiology, as well as the degree of contrast enhancement of glioblastoma has a relatively poor correlation with tumor grade, also its difficult to distinguish between glioma and radiation necrosis.

Facial never tumours are exceedingly rare (Marzo, Zender & Leonetti, 2009). These tumours present with facial twitching, hearing loss, dizziness, loss of balance, and unilateral facial weakness (Marzo, Zender & Leonetti, 2009). These are strikingly similar symptoms that Ingrid presented with. Major differences include a slow onset of symptoms and the facial weakness is intermittent and recurring (Marzo, Zender & Leonetti, 2009). It would need to be taken into consideration that depending on the specific location of the tumour the symptoms would vary.

A noncalcifying lesion that is isodense with brain, round with a smooth outline, and located in the superiolateral bony orbit is typically seen on CT (5). Postcontrast CT scans show no enhancement of cholesterol granulomas (6). On MRI, a cholesterol granuloma show bright signal intensity on both T1- and T2-weighted images without significant enhancement with gadolinium contrast.(7). Signal of high intensity on both T1- and T2- weighted images is seen because of the presence of hemoglobin breakdown product around the cholesterol crystals

Larger examples may necessitate resection and reconstruction with a bone graft (Mintz & Velez, 2007). Because of the presence of a fibrous capsule, the tumour typically easily comes out in one piece from its bony crypt during curettage (Slootweg, 1996, Waldron, 1993). This tendency to shell out in one or a few pieces clinically differentiates OF from FocOD. Microscopically, the presence of a fibrous capsule separating the tumour from adjacent bone can be a useful distinguishing feature (Waldron, 1993). Recurrence rate is highly variable according to different studies. Some authors claim it is very low or inexistent (Brannon & Fowler, 2001, Waldron, 1985), while others have reported a 12-28% recurrence rate (Eversole et al., 1985a, MacDonald-Jankowski, 2009b). Until now, no microscopic feature distinguishes the tumours that have a higher risk of recurrence (Eversole et al., 1985a). Long-term radiographic follow-up is therefore recommended for patients with OF. For cases with rapid growth, a tendency to recur, especially affecting children, a diagnosis of juvenile ossifying fibroma (JOF) should be considered. Hyperparathyroidism-jaw tumour syndrome, a rare autosomal dominant syndrome caused by mutations in the tumour suppressor gene HRPT2, should be suspected in patients presenting OF of the jaws, familial hyperparathyroidism, renal cysts and Wilms tumours (Chen et al.,

The asymptomatic nature of the lesion means that the presentation is late in most patients. Local recurrence is a problem with this tumor,

Diffusion weighted imaging (DWI) is a form of MR imaging based upon measuring the random Brownian motion of water molecules within a voxel of tissue. The relationship between histology and diffusion is complex, however generally densely cellular tissues or those with cellular swelling exhibit lower diffusion coefficients, and thus diffusion is particularly useful in tumour characterisation and cerebral ischaemia.(11)

The articles utilized in this review were found via the search engine Pubmed. The first search term used was: ((diffusion weighted imaging ("Fluorodeoxyglucose F18"[Mesh]) AND "Diffusion Magnetic Resonance Imaging"[Mesh] ) AND neoplasm) NOT brain. This gave a total of 66 possible articles. After filtration of only clinical trials in the past 10 years 5 articles lasted. Only one of these articles was included into this review (1). The others were excluded due to: the absence of statistical numbers (sensitivity, specificity, accuracy), and the participation of less than 25 patients.

Tumors are one of the most feared diseases of our time. Many people upon hearing the word “tumor” immediately resonate to the conclusion of it being cancer, which is not necessarily true. Tumors fall into to two main types, benign and malignant. Although they are considerably different in tissue invasion, their nature that makes them distinct and symptoms, they are also quite similar in the way they recur in the same location, growth size and their health risks.