Intracranial hemangiopericytomas are a rare type of primary brain tumor, representing only about 0.5% of all primary brain tumors. Even more rare is the coexistence of two juxtaposed primary brain tumors, termed a "collision" tumor. This report provides the first documentation in the literature of a hemangiopericytoma colliding with a meningioma, and recurring after treatment with gross total resection. Surgical samples were fully evaluated with hematoxylin and eosin and reticulin staining, as well as immunohistochemical analysis. Results were classically representative of a hemangiopericytoma (World Health Organization grade II) and of a meningioma (World Health Organization grade I). This report of a unique collision tumor not only augments the repertoire of collision tumor combinations described in literature but also provides follow-up on the clinical outcome of the patient, thereby raising clinically relevant issues ranging from presentation to treatment paradigms.

Presentation of CaseA 32-year-old right-handed man was admitted to the hospital because of an ataxic gait and right-sided weakness.He was well until 15 months earlier, when he became aware of intermittent diplopia during vigorous exercise. Eleven months before entry the diplopia became more persistent, especially at night. Eight months before admission he began to have difficulty in keeping his balance, followed shortly by dysphagia. Four months later he noticed numbness of the left side of the thorax. Two months before entry a physician observed nystagmus on lateral gaze, for which prisms were prescribed. The patient continued to drive . . .

Villonodular synovitis is believed to be an inflammatory, proliferative reaction of synovial tissues. The case of a 65-year-old woman with a cervical epidural mass is presented in which histological examination showed that the lesion was villonodular synovitis, an extremely rare occurrence. Because of its cellularity and occasional multinucleated giant cells, villonodular synovitis may be confused with metastatic malignancies or giant-cell tumor of bone.

Presentation of Case First admission. A 60-year-old man was admitted to the hospital because of anorexia. He was well until two months previously, when anorexia, fatigue, and dyspnea developed, and he entered another hospital because of a question of pneumonia. Laboratory studies revealed that the thyroxine was reduced; the triiodothyronine resin uptake was normal. Thyroid hormone, 60 mg daily, was prescribed, and erythromycin was given. After discharge anorexia persisted, with occasional vomiting and a loss of 4 kg in weight. He was referred to this hospital.The temperature was 36.8°C, the pulse 92, and the respirations 18. The blood . . .

Presentation of CaseA 70-year-old woman was admitted to the hospital because of ataxia.She was well until nine years earlier, when she began to have an unsteady gait. Six years before admission a neurologist found a bland affect and a depressed appearance; her mental status was intact. No nystagmus, facial weakness, or dysarthria was evident. The finger-to-nose test elicited slight unsteadiness, and heel-to-shin movements were not normally smooth or rapid. She wavered when standing with her feet less than 8 cm apart; when performing tandem gait she veered to the left or right after three to five steps. Sensory . . .

Presentation of Case First admission. A 43-year-old man was admitted to the hospital because of ataxia.He was well until one year earlier, when herpes zoster appeared in the right eighth thoracic distribution and cleared within two weeks. Seven months before admission he began to experience mild vertigo, which persisted. One month later a physician found that the cerebrospinal fluid and a computed tomographic (CT) scan of the brain were normal. Four months before entry injections of bacillus Calmette–Guérin (BCG) vaccine and transfer factor were administered, without improvement. The patient began to have episodes of horizontal diplopia, a change . . .

Presentation of CaseA 79-year-old woman was admitted to the hospital because of weakness and falling.She was well until six years earlier, when a diagnosis of chronic lymphocytic leukemia was made. Lymphadenopathy was well controlled with prednisone and chlorambucil; chlorothiazide was prescribed because of slight peripheral edema. The white-cell count remained in the vicinity of 24,000, with 96 per cent lymphocytes; the hematocrit was 35 per cent, and the platelet count 120,000. Several months before admission she fell because of "weakness in the legs," without loss of balance. Two days before entry she complained to her physician of generalized . . .

Presentation of Case First admission. A 43-year-old man was admitted to the hospital because of ataxia. He was well until one year earlier, when herpes zoster appeared in the right eighth thoracic ...

Degeneration of the white matter is uncommon in Creutzfeldt-Jakob disease (CJD), and when it occurs is usually mild, and limited in distribution. In the case of a 77-year-old woman with CJD lasting 1 year, there was extensive degeneration of cerebral white matter in addition to severe loss of neurons and hypertrophic astrogliosis in cortex and striatum. The extent and severity of white matter lesions makes the case unusual.

Presentation of CaseA 59-year-old woman was admitted to the hospital because of fever and confusion.She was well until one month earlier, when an ear infection was treated with an antibiotic. One week before admission she had an upper-respiratory-tract infection with a "cold sore." Five days before entry a bitemporal headache and back pain developed. Two days later she became febrile. On the following day her daughter observed that she was confused and disoriented, speaking to persons who were not in the room and commenting on an odor of fish on her hands. One day before admission she was . . .

Presentation of CaseA 51-year-old right-handed man was admitted to the hospital because of neck pain.Three years earlier he experienced aching pain in the left nuchal region. Evaluation, including x-ray films of the neck, led to a diagnosis of cervical arthritis with osteophytes at multiple levels. The administration of anti-inflammatory agents and cervical traction gave little relief. Sixteen months before admission the pain intensified. A cervical myelographic examination was reported to show a ventral extradural abnormality at the C3–C4 level and possibly at the C6–C7 level. Eleven months before entry anterior-disk removal and decompression were performed at the C6–C7 . . .