Patient 70 year old male initially presented with a low grade astrocytoma in 2011 underwent Craniotomy followed by RT. Patient was doing well following the same. After 10 years Patient presented with headache and dizziness along with behavioral changes. On evaluation patient was noted to have grade 2 Anaplastic astrocytoma. Patient underwent recurrent Craniotomy followed by Radiotherapy 50Gy for 6 weeks . Patient underwent chemotherapy prior to the surgery. Patient was better following the same.

WHo has almost nullified the terms like Anaplastic and Glioblastoma multiforme and has almost completely replaced with Grades of Tumours . Histological evidences have gained more importance and treatments cam be based on the same. PCV regimen is composed of Procarbazine , Lomustine and Vincristine and has gained momentum as a wonderful treatment regimen for sensitive astrocytomas and are usually given for 6weeks.

A patient with recent Adenocarcinoma of Lungs underwent lobectomy presented with 3 episode of seizures and was seizing on the way to the hospital . Patient was noted in the post ictal period . Patient has gaze preference towards the left. Patient was started on Lorazepam and Levetricetam. Patient underwent contrast CT which showed multiple metastasis in the left side of the brain . Patient was started on dexamethasone 4mg and treated with IV fluids and antiepileptics. Patient was then referred to the neurosurgery team.

Adenocarcinoma of Lungs are usually seen among smokers and mostly seen among young females. It is one among the many non small cell carcinoma and they commonly metastasis to bones. Very few spread to the brain as well . Around 10 % of patients with adenocarcinoma present with distant metastasis.

A Young girl of 20 years presented with anaphylaxis to blue berries. Patient had two similar episodes which resolved with adrenaline. But patient developed progressive cough and dyspnoea over the next few weeks. Chest Xray was suggestive of anterior mediastinal mass. CECT of thorax revealed a malignancy . The Histopathology was suggestive of a round cell tumour (sheets of small round cells with scanty cytoplasm ) . Desmoplastic tumour was diagnosed on immunohistochemistry. Patient was referred for radiotherapy and chemotherapy as CT scan showed involvement of SVC and esophageal encashment.

Patient denied further treatment as she wanted to get a second opinion.

Desmoplastic tumours are usually found in abdomen and is usually seen among the males . Other differential diagnoses for anterior mediastinal tumours are

Lymphoma , Thymoma

Story of a rare bilateral cerebellar tumour

A polish lady aged 68 yearswith no comorbidities presented with history of multiple falls over a period of 3 months . She also had on and off episodes of headache as well . On evaluation patient was noted to have bilateral cerebellar signs . Urgent CT scan was done which was suggestive of Bilateral Large cerebellar tumours. Patient showed symptomatic improvement with steroids and Urgent Neurosurgery referral was made . Patient underwent surgery after which patient improved .

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A 70 year old lady was noticed to have increased tending for gaming all of a sudden noticed by her husband. Husband also noticed that she was having on and off headaches with progressive frequency. After 1 week of symptoms husband brought her to hospital and a CT scan done was suggestive frontal lobe tumour which was suggestive of a Glioblastoma Mutiforme. Patient underwent surgery for the same (ALA) . Her symptoms resolved following the same. Patient was previously diagnosed to have Breast Canrcinoma 4 years back and Basal Cell Carcinoma 10 years back . Glioblastoma multiforme usually arises from P53 mutations and patients are usually prone for multiple malignancies with strong family history tendencies.

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