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+--- Thread: robins q - sandoc77 (/showthread.php?tid=77135)
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robins q - sandoc77 - ArchivalUser - 03-08-2006
an 18 yr old university student has had decreased vision on the left for 6 mths.on physical ex-papilledema on right.she has 14 scattered ,2-5-cm flat hyperpigmented skin lesions with irregular borders on the extrmities and torso.ct head shows only the mass in the region of optic nerve.optin nerve glioma excised--8mths later follow up exam--mass palpated on the right wrist. histologically it will show--
1.shwannoma
2.lipoma
3.fibrosarcoma
4.meningioma
5hemangioma
0 - ArchivalUser - 03-08-2006
ct mass in the region of right optic nerve.
0 - ArchivalUser - 03-08-2006
1) Schwannoma (neurofibromatosis type-1)
0 - ArchivalUser - 03-08-2006
I agree,its scwannoma
0 - ArchivalUser - 03-08-2006
its schwannoma
0 - ArchivalUser - 03-08-2006
thanks for replies.
my problem here is not the answer..it is that rt /left side ?
left side symptom and lesion on the right..which is not expained in the answer..so anybody knows why?thanks!
0 - ArchivalUser - 03-09-2006
no one?
0 - ArchivalUser - 03-09-2006
okay..
I think i figured this out.nf type 1 is diagnosed if there r 6 or more cafe u lait spots.
but the nf type2 which is more predisposed to gliomas...etc.so 'may be' the q is wrong?
and that expains the vision in left side.ie there is characteristic juvenile[in this case whether to consider 18yrs age as juvenile]posterior subcapsular opacity.which I dont know if has to be bilateral.if not this is it?
0 - ArchivalUser - 03-10-2006
The question as well as the answer is correct.
Big Robbins page# 1411-1413
Summary:
In neurofibromatosis type-1 : Multiple nerve sheath tumors i.e. Schwannomas that are MALIGNANT. Can occur ANYWHERE.
In neurofibromatosis type-2 : Bilateral ACOUSTIC neuromas i.e. VIII nerve Schwannomas ( BENIGN)are more common.
Kaplan fails to mention this point i.e. Malignant schwannomas in NF-1 ( Occur anywhere)
Rest is written i.e. NF-2 has bilateral acoustic neuromas ( Add benign )
0 - ArchivalUser - 03-10-2006
thank you henna,
but can u explain why there is left sided decreased vision?