Fatal cyst formation after fetal mesencephalic allograft transplant for XXXX .

@entity1 @entity3976 @entity5219 @entity772 @entity2850 @entity191
OBJECT: In recent years, fetal mesencephalic tissue transplant for the treatment of @entity191 ( @entity191 ) has been demonstrated to hold promise, but potential complications related to growth of allograft tissue have not been well described. This report explores the development and possible causation of a fatal cyst arising from a fetal transplant in the brain. METHODS: The authors report the case of a 52-year-old @entity1 who underwent bilateral putamenal fetal mesencephalic allograft transplant for @entity191 at another hospital. Twenty-three months later she presented to the authors' institution in a @entity772 . Admission computerized tomography and magnetic resonance (MR) studies revealed a contrast-enhancing mural nodule and associated large cyst arising from the left putamen and causing @entity2850 . Despite surgical decompression of the cyst, the @entity1 did not regain consciousness. Biopsy and autopsy specimens were obtained, along with an analysis of the cyst fluid. Genotyping of the nodule and the @entity1 's peripheral lymphocytes by using polymerase chain reaction-based microsatellite analysis was also performed. Biopsy samples and autopsy histopathological studies showed inflammatory cells, hemosiderin-laden macrophages, and @entity5219 . Scattered neurons and multiple rests of choroid plexus were also noted. The cyst had a thin wall and contained liquid that was identical in composition to cerebrospinal fluid (CSF). Genotyping demonstrated the presence of alleles in the nodule DNA that were not present in lymphocytic DNA, indicating that the nodule contained allograft tissue. CONCLUSIONS: The authors hypothesize that the choroid plexus tissue contained in the allograft resulted in CSF production and cyst formation at the transplant site, ultimately leading to the @entity1 's @entity3976 . The clinical history and large size of the mural nodule indicate slow growth of this allograft site and cyst over time. This case demonstrates that unusual patterns of tissue growth can occur in the brain after fetal tissue transplant and emphasizes the need for long-term monitoring of posttransplant @entity1 by means of MR imaging. Cell sorting should be considered to ensure transplant of pure neuronal and astroglial populations.
