Publications by authors named "Santhosh Nagaraju"

Background: Collision tumors involving the co-occurrence of two morphologically and genomically distinct neoplasms in the same anatomical site are exceptionally rare in the central nervous system (CNS).

Case Description: We report a unique case of a CNS collision tumor comprising chronic lymphocytic leukemia and myxopapillary ependymoma in a 77-year-old male with acute neurological decline. Presumed to represent leukemic infiltration, urgent laminectomy was pursued for tissue diagnosis and spinal cord decompression, revealing the unexpected ependymal component.

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  • The study focuses on the T2-FLAIR mismatch sign, which indicates a specific type of astrocytoma with IDH mutations, and how this sign changes as the tumor progresses.
  • A total of 128 IDH-mutant gliomas were analyzed using advanced MRI techniques to observe the evolution of the T2-FLAIR mismatch and the tumors' internal variations over time.
  • The research shows that smaller tumors start as uniform T2 lesions but develop a T2-FLAIR mismatch as they grow, while larger tumors demonstrate increased heterogeneity, suggesting a progression to higher grade tumors.
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  • - Managing chemotherapy-induced nausea and vomiting (CINV) in children is complicated due to variations in chemotherapy types, their emetic potential, and differences in how children process medications compared to adults.
  • - Common anti-emetics for CINV in kids include dexamethasone, neurokinin-1 receptor antagonists, 5HT3 receptor antagonists, and olanzapine, with discrepancies in dosing and formulations leading to challenges, especially for younger children.
  • - Newer agents like olanzapine show promise but come with potential side effects, while careful consideration of drug interactions—especially concerning safety risks like QTc prolongation—is essential in treatment planning.
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  • A diagnostic delay in identifying primary central nervous system lymphoma (PCNSL) often arises from recognizing lesions incorrectly and premature steroid treatment, complicating biopsy results.
  • Multiparametric MRI, which includes advanced imaging techniques, is emphasized as crucial for reducing diagnostic uncertainties in PCNSL cases.
  • In a study of 10 patients, most exhibited consistent MRI parameters indicative of PCNSL, suggesting this imaging approach could streamline diagnosis and hasten treatment initiation.
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Infected Rathke's cleft cysts (RCC) are extremely rare with only a few published cases. We report the case of a 31-year-old man who presented with headaches, visual disturbance, and hypopituitarism secondary to an infected RCC with extension of abscesses along the optic tract. Magnetic resonance imaging showed ring enhancing cystic lesions within an expanded sella with suprasellar and intraparenchymal extension.

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Background: Glioblastoma (GB) is the most common intrinsic brain cancer and is notorious for its aggressive nature. Despite widespread research and optimization of clinical management, the improvement in overall survival has been limited. The aim of this study was to characterize the impact of service reconfiguration on GB outcomes in a single centre.

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Intracranial abscess coexistent with a high grade glioma, without prior surgical intervention, is an unusual occurrence. This paper presents two such cases with abscess surrounding the glioblastoma in an immunocompromised individual and abscess within the glioblastoma in an immunocompetent patient. Adjuvant therapy was tapered as per each patient's clinical response.

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Intracranial myxoid mesenchymal tumors (IMMTs) are a relatively new group of tumors, first described in 2017. We report this rare variant in a 27-year-old female which was initially suspected to be a high-grade glial neoplasm. Next-generation sequencing confirmed the presence of fusion between the FET and cAMP response element-binding (CREB) family of genes.

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Objectives: Diagnosing the idiopathic inflammatory myopathies (IIMs) can be challenging as several conditions, including genetic myopathies such as limb girdle muscular dystrophy type R12 (LGMD 2 l, anoctaminopathy) mimic the presentation. Here we describe learning points identified from review of four patients with LGMD 2 l who were initially incorrectly diagnosed with IIM. Our aim is to provide clinicians working in adult rheumatology services with a toolkit to help identify non-inflammatory presentations of myopathy.

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  • MRI is crucial for evaluating brain lesions, but conventional MRI lacks specificity.
  • Multiparametric MRI, which includes advanced techniques like diffusion and perfusion-weighted imaging, offers better insights into tissue conditions.
  • This review aims to illustrate the effectiveness of multiparametric MRI in diagnosing and planning treatment, showcasing cases that highlight its superior ability to distinguish between cancerous and non-cancerous lesions compared to standard MRI.
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Background Context: Intradural extramedullary (IDEM) cavernomas are rare vascular malformations. They are well-circumscribed dark berry-like lesions with a histologic appearance of sinusoidal vascular channels. Neurofibromas are the most common IDEM tumors, originating from all nerve elements and leading to firm enlargement of the affected nerve root.

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