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Giant cell tumors (GCTs) are rare neoplasms, primarily found in long bones, typically affecting the epiphysis of the distal femur, proximal tibia, and distal radius. However, their occurrence in the cervical spine is exceedingly rare. Here, we present a case report of a 21-year-old female patient who presented with progressive neck pain, radiating numbness, and right hemiparesis. Radiographic imaging revealed a lytic lesion in the C3 vertebral body, further characterized by magnetic resonance imaging (MRI) and computed tomography (CT) scans. The patient underwent surgery for stabilization of the cervico-occipital hinge, decompression, and biopsy. Histopathological examination confirmed the diagnosis of a giant cell tumor. Postoperatively, the patient showed improvement in motor impairment, cervical pain, and numbness. She was proposed for adjuvant treatment based on Denosumab. However, she returned 1 month after surgery with worsened motor deficit, developing tetraparesis. Control MRI revealed a tumor flare-up. The decision was made not to reoperate on the patient and to accelerate the administration of Denosumab. Meanwhile, she experienced a pulmonary embolism leading to her demise. This case underscores the importance of considering giant cell tumors in the differential diagnosis of cervical spine lesions and emphasizes the successful and prompt management through a multidisciplinary approach involving surgical intervention and adjuvant therapy.

Hydatidosis, caused by the larval stage of Echinococcus granulosus, is a zoonotic disease typically affecting the liver and lungs. Cerebral localizations are rare, especially in the brainstem. We present a case of a 9-year-old boy with a brainstem hydatid cyst. The patient exhibited progressive walking difficulties and limb impairment. MRI revealed a brainstem mass consistent with a hydatid cyst. Due to the lesion's size and location, surgical intervention was necessary. The cyst was decompressed and removed without complications, followed by albendazole treatment. Postoperative recovery was uneventful, and the patient showed no signs of recurrence after 2 years. This case highlights the importance of early diagnosis, precise surgical techniques, and thorough postoperative care in managing rare cerebral hydatid cysts.

Thymomas are benign epithelial neoplasms originating from the thymus gland and are among the most common primary mediastinal tumors. Malignancy is typically determined by evidence of pathological invasion beyond the capsule, with local invasion being the primary mode of spread to adjacent organs. Distant metastases are exceedingly rare. We present the case of a 63-year-old man who exhibited symptoms suggestive of increased intracranial pressure and motor deficit. Brain imaging revealed multiple intracranial lesions. Surgical intervention was performed to excise the largest lesion. Subsequent body CT scan and pathological examination confirmed that the brain metastases originated from a primary thymoma, classified as B3. The patient was recommended for adjuvant chemotherapy and radiotherapy, but unfortunately passed away at the initiation of therapy. The prognosis for patients with brain metastases from thymomas remains poor. Optimal management strategies typically involve prompt surgical intervention whenever feasible, followed by adjuvant therapy aimed at improving mean survival rates.

Background: Intracranial inflammatory pseudotumours (IPT) are rare entities that frequently lead to misdiagnosis with malignant lesions. The identification of these lesions is difficult, but important to avoid inadvertent iatrogenicity and to adjust therapeutic protocols. Case Presentation: We report the case of a 30-year-old man who presented a single tonic-clonic seizure. Brain imaging showed a right frontal lesion with intra and extra axial components. Facing the radiologic presentation, a brain tumor was suspected, thus the patient underwent surgery. Pathological exam concluded to a plasma cell granuloma. A whole-body CT-scan showed only a thoracic aortitis. Complete blood work studies came back negative. The patient was also tested for an array of antibodies among which antinuclear antibodies were positive (blood level superior to 1/100). CSF evaluation revealed clear fluid with normal glucose concentration, normal protein levels and lymphocytic pleocytosis. Finally, IgG-4 plasma levels were elevated which led to the diagnosis of an IgG4-RD. The patient was put under prednisolone with a favorable outcome. Conclusion: IPT have several etiologies, among which IgG4 related disease may be one of the less known as only 2 cases have previously been reported. Herein, we report a new case of a young man who presented for seizures related to an intracranial lesion of an IgG4 related disease. The challenge is to suspect such conditions to avoid unnecessary surgeries.

Background: Intracranial inflammatory pseudotumors (IIPT) are one of the differential diagnosis for the central nervous system (CNS) tumors. They represent a rare condition that may mimic clinically and radiologically intracranial tumors and induce their complications. Among their etiologies, neurosarcoidosis is one of the less known and less frequent. To the best of our knowledge, only two cases of posterior fossa IIPT have been reported in the literature. We present here the 3rd case related to a neurosarcoidosis. Case presentation: We report the case of a 55-year-old female patient who presented with an altered state of consciousness associated to severe intracranial hypertension syndrome for four months. Glasgow coma scale on admission was 14/15. Brain imaging revealed bilateral cerebellar micronodular meningeal enhancement regarding the mesencephalon and the pons, as well as a nodular lesion of the 4th ventricle causing a triventricular acute hydrocephalus. The patient had a ventriculo-peritoneal shunt with a favorable outcome. Afterwards, she underwent a salivary gland biopsy which confirmed the diagnosis of neurosarcoidosis. Conclusion: Posterior fossa IIPT are very rare, mainly when located in the posterior fossa, leading to confusion with other pathologies. MRI has an important role in the diagnosis of these lesions, and the determination of their etiology. It shows other than the IIPT itself, many other signs such as leptomeningeal enhancement, nodular lesions or pituitary stalk thickening. These signs can orientate towards the diagnosis. Treatment may associate to symptomatic approach, corticosteroids. Surgical resection may be proposed when the diagnosis remains doubtful.

Abstract We report the case of a 4‐year‐old boy who had a ventriculoperitoneal shunt due to hydrocephalus related to a cystic craniopharyngioma. Postoperative, he presented abdominal distension and meningismus. Imaging showed regression of the tumor. The cyst was drained by the shunt. No similar situations were reported in the literature.

Gadolinium diethylenetriamine penta-acetic acid (Gd-DTPA) is the main contrast agent used in MRI, known for its good tolerance and rare toxicity. Even intrathecal injection of limited doses of Gadolinium can be performed in some indications. To our knowledge, only 3cases of accidental intraventricular injection of Gadolinium have been yet reported in the literature. We report the case of a 40-year-old male patient, who presented with headaches and vomiting. Brain MRI showed a right parietal abscess. The patient underwent emergent surgery for drainage of the septic collection. Postoperative MRI showed the development of a hydrocephalus related to a ventriculitis. Another surgery was performed to set up an external ventricular shunt, which lead to an improvement of the neurological status. A control brain MRI was scheduled for the patient, which revealed extensive abnormal enhancement inside the right lateral ventricle, on the basal cisterns as well as a leptomeningeal enhancement. Shortly after Gadolinium injection, the patient presented a tonic-clonic seizure. This clinico-radiological context leads to discover of the inadvertent intraventricular administration. Afterward, the patient's condition quickly deteriorated. Two days after the MRI he presented a cardiorespiratory arrest followed by death. Direct administration of Gadolinium into a ventriculostomy mistaken for intravenous catheter is a rare but harmful situation. Despite their rarity, such cases prove the importance of tracing all lines to their insertion sites to be confident of their appropriateness for injection.

Abstract Sellar region is a rare localization for intracranial metastases. The diagnosis is frequently delayed as symptoms are generally non specific. Radiologic diagnosis may be difficult as these tumours present similiraities to other more frequent sellar tumours. There is still no consensus regarding therapeutic approach. Prognosis is related to several features.

Abstract Lumbar pigmented villonodular synovitis is rarely localized on the lumbar spine. Awareness of pigmented villonodular synovitis is important despite its rarity because it may mimic several other lesions of this location.

Chronic subdural hematoma (CSDH), which commonly affects the elderly, is one of the most frequent, but also benign neurosurgical pathologies. Burr hole drainage is the standard surgical modality for evacuation of a CSDH. This technique is known to be safe, with low morbidity and mortality rates. However, postoperative complications have occasionally been reported. We report the case of a 70-year-old man who presented a fatal brain stem hemorrhage after burr-hole drainage for unilateral chronic subdural hematoma. Asymmetrical and rapid decompression were thought to be leading to vascular disruption or sudden increase in cerebral blood flow, was probably responsible for the secondary brain stem bleeding. Therefore, a slow rate of evacuation of chronic subdural hematomas, as well as rigorous postoperative reanimation, are recommended in order to prevent serious complications.