Background: Glioma patients with mutant isocitrate dehydrogenase have improved survival; this could be in part due to the suppressive effect of mutant IDH on the level of chronic inflammation. This study aimed to prospectively analyze the association of IDH1 mutation status with preoperative levels of blood inflammatory markers: neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR), C-reactive protein (CRP), and red cell distribution width (RDW) in gliomas. Patients and methods: Receiver operating characteristic curves for cutoff value determination, various bivariate tests, and survival analyses (Kaplan–Meier curves and Cox regression) were performed. Results: Patients with mutant IDH1 had reduced levels of NLR (P<0.032) and CRP (P<0.008). Moreover, these patients showed better median overall survival compared to those without IDH1 mutation (P<0.000). In univariate analysis, IDH1 mutation status (P<0.000), NLR (P<0.000), PLR (P<0.008), and CRP (P<0.001) were among the factors associated with survival. By multivariate analysis, IDH1 mutation (P<0.044) and NLRP<0.022) remained independent factors associated with better survival; other independent variables were tumor grade (P<0.000) and location in noneloquent area (P<0.015). Conclusion: The obtained results show that IDH1 mutation is associated with lower levels of chronic inflammation that could account for an improved prognosis in this group of patients.

Acromegaly is one of the most common syndromes in pituitary adenomas. Naturally, women with this condition have trouble with their reproductive function. The difficulty in diagnosing acromegaly progression in pregnancy is that there is also production of placental growth hormone observed, making it impossible to differentiate from neoplastic growth hormone production using conventional methods of investigation. This article is about a clinical case of acromegaly in a 22 years old woman who was operated on using transnasal transsphenoidal approach and received postoperative treatment with somatostatin analog – lanreotide acetate autogel – for six months. The woman became pregnant in the course of the treatment. During pregnancy, the GH and IGF-I levels in serum remained within normal limits. Lanreotide acetate therapy was discontinued. The woman successfully gave birth to a healthy baby. There was a remission of the disease after pregnancy.

Background: Falcotentorial meningioma is a rare tumor of pineal region, arising from the dural folds where the tentorium and falx meet. Due to the deep location and near closeness to significant neurovascular structures, gross-total tumor resection in this area can be complicated. Pineal meningiomas can be resected using a variety of approaches; however, all these approaches are associated with a significant risk of postoperative complications. Case Description: A 50-year-old female patient who presented with several headaches and visual field defect and diagnosed with pineal region tumor is discussed in the case report. Patient was successfully managed surgically by combined supracerebellar infratentorial and right occipital interhemispheric approach. Cerebrospinal fluid circulation was restored after surgery and neurological defects were regressed. Conclusion: Our case shows that it is possible to completely remove giant falcotentorial meningiomas with minimal brain retraction, preserve the straight sinus and vein of Galen, and prevent neurological impairments by combining two approaches.

Background: Maffucci syndrome is a rare genetic disorder associated with the development of multiple enchondromas and soft tissue cavernous hemangiomas, as well as an increased risk of malignant tumors. Case Description: Here we report a case of Maffucci syndrome in a patient who presented with a giant left frontal lobe tumor. Molecular genetic analysis of the tumor revealed an isocitrate dehydrogenase (IDH) mutation p.R132H (c.395C>A) mutation in the IDH1 gene and a heterozygous duplication of the CDKN2A genes. Conclusions: The presence of an IDH1 mutation is notable because this mutation is frequently seen in glial tumors and other neoplasms, and its co-occurrence with Maffucci syndrome may represent a novel risk factor for the development of gliomas. This case underscores the importance of genetic testing in patients with Maffucci syndrome who present with central nervous system tumors, as well as the need for further research to understand the relationship between IDH1 mutations and the development of gliomas in this population.

Background: Colloid cysts (CCs) are a rare type of benign tumor, and the ones >30 mm in diameter are determined as giant CCs. The giant CCs of the cavum septum pellucidum (CSP) are located in the hard-to-reach areas of the brain, and they can be removed microsurgically and endoscopically. At present, the transition from the microsurgical resection to the endoscopic is observed, and researchers demonstrate several benefits of the endoscopic resection over the microsurgical. We noticed the absence of research illustrating the endoscopic resection of the giant CC of the CSP. Therefore, we decided to demonstrate a rare case performed in our hospital. Case Description: Our patient was a 57-year-old male who had suffered from dizziness, headache, nausea, urinary incontinence, short-term forgetfulness, gait ataxia, cognitive decline, and vision blurring. The eventual diagnosis of the giant CC in the CSP was established, and it was complicated by occlusive hydrocephalus and headache syndrome. The endoscopic resection of the giant CC in the septum pellucidum was performed using the endoscopic transseptal approach. Conclusion: No complications were observed in the postoperative period. The tumor was removed completely, no recurrence was noted, and only a capsule of the tumor was observed in the control magnetic resonance imaging image taken 3 months after the operation. Considering these results, we conclude that endoscopic removal may have positive and safe outcomes as the surgical treatment method for the giant CCs located in the septum pellucidum.

Post-traumatic neuromas are a common complication of peripheral nerve injuries, often resulting in chronic pain, as well as sensory and motor dysfunction. The ulnar and median nerves are most frequently affected. The high incidence of neuroma formation and its significant impact on patients’ quality of life highlight the importance of effective surgical management. Intraoperative ultrasound is increasingly being utilized in neuroma surgery, offering real-time visualization of nerve pathology, although its routine use remains limited. This paper presents a clinical case of a 27-year-old patient with a recurrent post-traumatic neuroma of the left median nerve. The patient had undergone multiple previous surgeries, including primary neurorrhaphy and revision neurolysis. Due to persistent neuropathic symptoms, a revision surgery was performed with the use of intraoperative ultrasound, which enabled accurate identification of the neuroma, evaluation of lesion extent, and precise delineation of resection margins. Early postoperative outcomes demonstrated reduced pain, decreased swelling, stabilization of neurological function, and no recurrence on follow-up ultrasound. This case illustrates the potential of intraoperative ultrasound as a safe and effective tool that can improve surgical precision and reduce the risk of neuroma recurrence.