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Summary Most cases of periaqueductal tumours were found in children and adolescents, so treatment modalities in adults are not evaluated yet. A case of 40 years old woman with tectal and periaqueductal protoplasmatic astrocytoma grade II with history of headache and episodes of syncope is described. MRI showed triventricular hydrocephalus. After a shunt procedure she was doing well for about 15 months. Then she became somnolent, disoriented, and Parinaud syndrome appeared. The solid tumour was resected microsurgically in one stage. A part of it was removed via the supracerebellar infratentorial approach and tectal plate incision. The remainder of the tumour was removed through the fourth ventricle and the aqueduct which was filled by tumour mass. Postoperatively bilateral ptosis, vertical gaze palsy, slight horizontal gaze limitation and pupilloplegia were the main neurological sequelae. They all almost completely resolved within a year. The patient is doing well two and half years after the surgery. MRI showed patency of the aqueduct and no residual tumour. The authors suggest, that direct surgical attempt at total tumour removal should be considered in cases of periaqueductal and tectal gliomas. They also believe it is the first described case, in whom this type of tumour was totally removed by a combined transtectal and transaqueductal route. [ABSTRACT FROM AUTHOR]

Isolated sarcoidosis of the hypothalamic-pituitary system is a very rare form of neurosarcoidosis. A high index of suspicion is required for diagnosis and the choice of therapy embodies another challenge due to lack of standardized protocols. Glucocorticoids are the mainstay of initial treatment, whereas the second and third-line therapy include immunomodulators and cytotoxic drugs, in addition to monoclonal antibodies. This report presents an unusual case of panhypopituitarism in a 32-year-old previously healthy male patient due to isolated hypothalamo-pituitary sarcoidosis confirmed histologically, refractory to pulsedose glucocorticoids and then successfully treated by methotrexate. Based on our report, in patients requiring additional therapy usage of the methotrexate as the second line agent should be considered, however the time frame and the dosing schedule of methotrexate are still unknown and deserve further investigation. [ABSTRACT FROM AUTHOR]

Aim: Foramen magnum tumours represent about 1.1–3.8% of all CNS tumours. The aim of this study was to evaluate the results of the microsurgical treatment of foramen magnum tumours with a retrospective analysis of 20 cases operated upon between 2007 and 2020. Material and Methods: Age at diagnosis, sex, location and size of the tumour in the sagittal plane, surgical approach, extent of resection, symptoms upon admission and after surgery, the duration of the symptoms and length of hospitalization time from surgery until discharge were analyzed. Results: 15 patients were women and 5 were men. The average age at diagnosis was 55 years. There were mostly extraspinal and intradural tumours between 1030 mm in size in the sagittal dimension in the MRI examination. The most common procedure performed was hemilaminectomy with a posterolateral approach. Total resection rate was about 85%. The most common symptoms were headache and weakness with duration of more than a year. 90% of patients reported improvement of their clinical status. The hospitalization length from surgery until discharge was about 12 days. Conclusion: Despite the anatomically difficult area, microsurgical operations can be performed in a safe manner in patients suffering from a foramen magnum tumour. [ABSTRACT FROM AUTHOR]

Cadmium is a toxic element, generally highly mobile and easily transferred from Cd-bearing ore minerals to the environment as shown by numerous leaching experiments and studies of biota. However, the behaviour of Cd is less understood during smelting activities, when it is transferred from Cd-bearing ore to the metal as well as to the smelting by-product: slag. Slag material, with Cd concentrations over 500 mg/kg, occurs at an abandoned slag pile after Pb-Zn metal smelting in Swiętochłowice (Upper Silesia). Such material, extremely enriched in Cd (15 mg/kg is a legislative guideline for industrial soils), offers a possibility to study the distribution of Cd within slag fragments composed of silicates and oxides, gaining insight into Cd mobility. Electron microprobe analyses of primary slag show that Cd partitioning between different phases is not controlled by site preference and Cd does not substitute for elements with similar radius, such as Zn in Zn-spinel or Ca in Pb-hardystonite. Cadmium is strongly incompatible and enriched in late melts that, in the case of the studied slag, crystallize Pb-hardystonite rims, late Pb-silicates (probably alamosite) and rare phosphates. These phases contain most of the Cd budget, but in a small volume (5–10 μm phases). As such, Cd behaviour and distribution in silicate slags may contrast to that of other potentially toxic elements, which are generally selectively partitioned into one or more major phases. The study of another slag fragment, composed of secondary Fe-(hydro)oxides, formed after sulphide weathering, shows low Cd contents suggesting that either Cd was mobilized from the sulphide during weathering or lost in the smelting process. The concentration of Cd within slag in parts easily accessible to fluids and weathering (enrichment at rims and in late phases occurring at grain boundaries) and not in secondary phases, suggests that Cd has a high potential mobility from the slag to the environment. [ABSTRACT FROM AUTHOR]