First case : Rawan ali hasan 6 yr female c/o of left eye proptosis Examination: lt maxillary sw & mild lt eye projection. No organomegaly. No LN no intra- buccal extension C.T orbit: S.T fill lt maxillary sinus with destruction of wall C.T chest: free Surgical biopsy:PNET with neoplastic diff Received outside 3 cycles (A B A) chemo every 3 weeks A (oncovin-adria-endoxan) for 1 day B(Ifosfamide--vp16) for 5 days C.T paranasal sinuses: increase mass size with lt eye compression Refered to N.C.I BMA:free BMB:pending Slides are broken so block is revised Bone scan: increase tracer uptake at maxillary sinus & lt ethmoid MRI local: pending C.T chest&Abd: pending MOHAMED AH ABD-ELFATAH 13 YR MALE C/O: recurrent fever&chest wheezes C.T Chest: lt posterior hemithorax mass Biopsy &pathological ex:N.B NSE:324 Ferritin:76 BMA:free VMA:pending Slide revision in N.C.I N.B fibrillary stroma with +ve reaction to NSE Examination :diminished air entry on lt side of chest. Otherwise free AHMAD ABD-ELNASER 3 yr male C/O: lt ocular swelling U.S orbit: distorted ocular contour,high amplitude calcification of intra-vitreal mass? R.B with extension& infilteration of optic nerve head with the mass infilterating post. BMA, CSF, Bone scan: free C.T Brain&orbit: S.T mass in post lt globe, breeching with extension along optic nerve. NO C.T evidence of intracranial extension Fundus examination of RT eye: free , preserved visual acuity Examination: lt ocular fungating mass, no L.N PROF. DR: EMAD EBEED advised for enucleation. Faten mohamed 5 monthes female • C/O: Abd distension • ABD U/S :multiple hepatic focal lesion with lt supra-renal mass • C.T Abd: lt supra-renal mass 6*4*3 with multiple hepatic focal lesion • BMA, BMB, Bone scan :free NSE:135 Ferritin:73 • C.T chest &Abd in N.C.I: well defind mass at lt adrenal 3*4 inseperable from lt renal upper pole, small retro-caval< para-aortic L.N, enlarged liver with multiple hypodense focal lesion of both lobes, likely metastatic. • Biopsy is not taken yet • Examination: hepatomegaly, no L.N, no other masses felt MOHAMED FATHY • 10 yr male • C/O: fever &sever vomiting, followed by squint • C.T Brain: large RT parietal subcortical SOL • Surgical excision &path ex: Astrocytoma grade 3 (in 57357) • Received 60 CGY/ 30 sessesion ,end 14/11/07 (in NCI) • MRI: regression of the mass • Later: sever proj vomiting , C.T BRAIN : dilated ventricles • Shunt operation is done in 57357 • New MRI : RT parietal SOL MRI spectero: tumour necrosis(in 57357) • CSF: -ve for malignancy • New MRI: intracranial &intraspinal nodules • No improv of vomiting despite shunt functioning • Slide revision in NCI: anaplastic astrocytoma , • MRI spectero in NCI: active les • PROF. DR : EMAN SEDHOM advised for VCR(1,5mg/msq d1,d8), • CCNU(100mg/msq d1 on empty stomach, Pred 40mg/msq d1-d14 • The shunt is opened &he is sent for neurological consultation. Nader tarek • 13 yr male • C/O: vomiting& blurred vision • C.T Brain: brain tumour ? No available report • Surgical excision & path ex: ependymoma low grade • CSF: free • Received 5580 CGY ended 10/99 • C.T Brain: post fossa lesion. Put under follow up • 2 monthes ago , he developed sever vomiting, blurred vision, bulbar palsy. • MRI(3/08): Ependymoma, local recurrence ,with extension • EXAMINATION: lat divergent squint ,intact motor&sensory power • CSF: suspecious cells ,for cytological ex. • Patient is on dehydrating measures.
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