Spinal cord ependymoma: Retrospective analysis of treatment outcomes of 14 patients

2004 ◽  
Vol 4 (4) ◽  
pp. 155-160 ◽  
Author(s):  
R. Zaucha ◽  
K. Sosińska-Mielcarek ◽  
I. Zander ◽  
P. Szewczyk ◽  
J. Jassem
Keyword(s):  
Spinal Cord ◽  
Retrospective Analysis ◽  
Postoperative Radiotherapy ◽  
Primary Tumour ◽  
Surgical Excision ◽  
Subtotal Resection ◽  
Term Survival ◽  
Primary Surgery ◽  
Rare Tumours

Spinal cord ependymomas are relatively rare tumours and their management is not well established. This retrospective analysis was performed to examine the outcome of patients treated for this malignancy at our institution between 1982 and 2004.Hospital charts of 14 consecutive patients (10 men and four women) aged 8 to 58 years (median 32 years) were retrospectively analysed. This series included nine extramedullary and five intramedullary well differentiated (eight – G1, six – G2) ependymomas. All patients were treated with primary surgery. Postoperative radiotherapy was administered in 12 patients after subtotal excision. Total dose ranged from 35Gy in 17 fractions to 50.4Gy in 28 fractions. One patient experienced spinal axis failure despite complete resection of the primary tumour and was managed with salvage radiotherapy and chemotherapy following surgical excision of the relapse. There have been no radiotherapy-related serious side effects.One patient was lost to follow-up. Of the remaining 13 patients, at a median follow-up of 5.5 years (3 months to 20 years), 12 were alive including 11 without progression.Conclusion: In our group of patients radiotherapy following subtotal resection or used as a single modality was well tolerated and resulted in 92% long-term survival.

Ganglioglioma: A Correlative Clinicopathological and Radiological Study of Ten Surgically Treated Cases with Follow-Up

Neurosurgery ◽  
1987 ◽  
Vol 20 (3) ◽  
pp. 428-433 ◽  
Author(s):  
Uma P. Kalyan-Raman ◽  
William C. Olivero
Keyword(s):  
Postoperative Radiotherapy ◽  
Benign Tumors ◽  
Subtotal Resection ◽  
Low Grade ◽  
Term Survival ◽  
Computed Tomographic ◽  
Histological Criteria ◽  
The Central Nervous System

Abstract Gangliogliomas are rare benign tumors of the central nervous system containing neoplastic ganglion and low grade glial cells. In studying 10 surgically treated cases, we evaluated the clinical, pathological, radiological, and immunocytochemical features, with follow-up. Ranging from 18 to 58 years in age, 7 patients were women, and 3 were men. The most common presenting symptom was seizure. Computed tomographic scan showed a low density enhancing mass in 8 and calcification in 5. Six had minimally abnormal vascularity on angiography. Seven patients had total and 3 had subtotal resections of the tumor. The temporal lobe was the location of the tumor in 6 cases. All of the cases met the histological criteria of Russell and Rubinstein for ganglioglioma. Four patients received postoperative radiotherapy because of subtotal resection or aggressive histological makeup. On follow-up, from 2.5 to 7 years, 8 patients are alive and tumorfree, and 7 are also seizure-free. Two died after operation: one immediately and the other of a glioblastoma that developed 5 years later. Our study confirms that ganglioglioma is a distinct histological entity, anatomically localized, with characteristic clinical and radiological findings and long term survival. Aggressive histological makeup is not a definite indication of malignant potential. The definitive role of follow-up radiotherapy for this tumor needs further study. Malignant evolution is rare, but warrants follow-up.

scholarly journals Cardiac Metastasis from Medullary Thyroid Cancers with Long-Term Survival under Vandetanib

2021 ◽  
pp. 1-6
Author(s):  
Camille Buffet ◽  
Sophie Leboulleux ◽  
Françoise Kraeber-Bodéré ◽  
Caroline Bodet-Milin ◽  
Laure Cabanes ◽  
...  
Keyword(s):  
Kinase Inhibitor ◽  
Surgical Excision ◽  
Cardiac Metastasis ◽  
Term Survival ◽  
Long Term Survival ◽  
Thyroid Cancers ◽  
Medullary Thyroid ◽  
Cardiac Metastases

<b><i>Background:</i></b> Cardiac metastases from thyroid cancers are uncommon with a poor prognosis. There is a lack of long-term follow-up studies. <b><i>Cases:</i></b> We report 2 cases of cardiac metastasis from medullary thyroid cancer (MTC). Both patients presented limited metastatic disease apart from a cardiac metastasis. The initial diagnosis was challenging and was facilitated by functional imaging with an immuno-PET-CT using an anti-CEA bispecific antibody and a <sup>68</sup>Ga-labeled peptide. Both patients were treated with the multitarget kinase inhibitor vandetanib with prolonged stability. The first patient was alive at the last follow-up, 14 years after the diagnosis of cardiac metastasis. The second patient required surgical excision of the cardiac mass because of disease progression under vandetanib. <b><i>Conclusion:</i></b> These cases illustrate long-term survival and effectiveness of clinical management of 2 patients who developed cardiac metastases from MTC, in the current era of personalized medicine with targeted therapy.

Surgical excision of extensive sacrococcygeal chordomas assisted by occlusion of the abdominal aorta

2010 ◽  
Vol 12 (5) ◽  
pp. 490-496 ◽  
Author(s):  
Liu Xue-Song ◽  
You Chao ◽  
Yang Kai-Yong ◽  
Huang Si-Qing ◽  
Zhang Heng
Keyword(s):  
Abdominal Aorta ◽  
Postoperative Radiotherapy ◽  
Balloon Dilation ◽  
Surgical Excision ◽  
Neurological Dysfunction ◽  
Pelvic Cavity ◽  
Large Tumor ◽  
Electrophysiological Monitoring ◽  
Complex Anatomy

Object An extensive sacrococcygeal chordoma is considered a challenge for neurosurgeons. Because of the complex anatomy of the sacral region, the risk of uncontrollable intraoperative hemorrhage, and the typically large tumor size at presentation, complete resections are technically difficult and the tumor recurrence rate is high. The aim of this study was to assess the value of using occlusion of the abdominal aorta by means of a balloon dilation catheter and electrophysiological monitoring when an extensive sacrococcygeal chordoma is removed. Methods Between 2004 and 2008, 9 patients underwent resection of extensive sacrococcygeal chordomas in the authors' department with the aid of occlusion of the abdominal aorta and electrophysiological monitoring. All of these operations were performed via the posterior approach. The records of the 9 patients were reviewed retrospectively. Results Wide resections were performed in 6 cases and marginal excisions in the other 3. Five patients underwent postoperative radiotherapy. Intraoperative hemorrhage was controlled at 100–400 ml. Postoperatively, none of the patients had any new neurological dysfunction, and 2 patients regained normal urinary and bowel function. The mean follow-up period was 31.4 months (range 10–57 months). No patient developed local recurrence or had metastatic spread of tumor during follow-up. Conclusions Occlusion of the abdominal aorta and electrophysiological monitoring are useful methods for assisting in resection of sacrococcygeal chordoma. They can reduce intraoperative hemorrhage and entail little chance of tumor cell contamination. They can also help surgeons to protect the organs in the pelvic cavity and neurological function. Use of these methods could give patients better quality of life.

scholarly journals O10 Effect of hemodialysis dose (spKt/V) on survival in patients on maintenance hemodialysis since childhood – a retrospective analysis

2019 ◽  
Vol 104 (6) ◽  
pp. e4.3-e5
Author(s):  
V Gotta ◽  
A Atkinson ◽  
O Marsenic ◽  
M Pfister
Keyword(s):  
Retrospective Analysis ◽  
Rank Test ◽  
Maintenance Hemodialysis ◽  
Nephrol Dial Transplant ◽  
List Type ◽  
Dialysis Dose ◽  
Term Survival ◽  
Kaplan Meier ◽  
Urea Distribution Volume

BackgroundHemodialysis (HD) prescription significantly differs between pediatric and adult patients on maintenance HD, resulting in greater difference between prescribed and delivered HD dose.1,2 HD dose targets have formally not been evaluated for children, hence targets are mainly derived from adults (spKt/V >1.4; sp: single-pool model of urea distribution, K: urea clearance, t: duration of HD session, V: urea distribution volume). This analysis aimed to evaluate the relationship between delivered dialysis dose and survival in a large cohort of patients having started HD therapy in childhood.MethodsThis retrospective analysis included a cohort of patients < 30 years (y) on chronic HD treatment since childhood, having received thrice-weekly HD between 2004 and 2016 in outpatient DaVita dialysis centers. Survival while on HD (death from any cause) was investigated using Kaplan-Meier analysis stratified by age at start of HD (0–2, >2–6, >6–12, and >12–18 y), and three mean delivered dialysis dose levels (spKt/V < 1.4, 1.4–1.6, >1.6). Survival curves between subgroups were compared using the Log-rank test.Results1773 patients were included in the analysis, among n=34 having started HD at age of 0–2y, n=57 at >2–6y, n=244 at >6–12y, and n=1438 at >12–18y. Median follow-up on HD ranged between 1.5 (>2–6y) to 4.7 years (>6–12y) with maximal follow-up of 23 years. Death while on HD occurred in 1/34, 6/57, 26/244, and 101/1438 patients during recorded follow-up (p=0.075, n.s.). Patients with mean spKt/V < 1.4 had lower survival on HD than those with spKt/V >1.4–1.6 (p=0.019) and those with spKt/V >1.6 (p=0.035), with 10-year survival estimated to 75% (65.2–86.2%) versus 84.5% (78.5–90.9%) and 85.0% (80.8–89.5%), respectively.ConclusionsThis is the first study to report long term survival and its relationship with delivered HD dose in patients starting HD in childhood. Our results support targeting spKt/V(urea)>1.4 in children on chronic HD treatment.ReferencesGotta V, Marsenic O, Pfister M. Age- and weight-based differences in haemodialysis prescription and delivery in children, adolescents and young adults. Nephrol Dial Transplant 2018 Apr 18.Gotta V, Marsenic O, Pfister M. Understanding urea kinetic factors that enhance personalized hemodialysis prescription in children. ASAIO J 2019 Jan 14.Disclosure(s)M Pfister is a consultant at Quantitative Solutions a Certara Company. V Gotta has been supported for this project by the Research Fund for Junior Researchers, University of Basel, Switzerland. O Marsenic and A Atkinson declare no financial conflict of interest.

scholarly journals A Rare Malignant Disease, Dermatofibrosarcoma Protuberans of the Breast: A Retrospective Analysis and Review of Literature

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Yihua Wang ◽  
Yu Wang ◽  
Rui Chen ◽  
Zhenrong Tang ◽  
Shengchun Liu
Keyword(s):  
Retrospective Analysis ◽  
Smooth Muscle Actin ◽  
Clinical Information ◽  
Dermatofibrosarcoma Protuberans ◽  
Surgical Excision ◽  
Low Grade ◽  
Pubmed Database ◽  
Storiform Pattern ◽  
Rare Malignancy

Dermatofibrosarcoma protuberans (DFSP) is a rare low-grade fibroblastic mesenchymal tumor derived from the dermis. The aim of this retrospective analysis was to summarize the clinicopathological data from our cases and published cases to offer more evidence for the recognition of dermatofibrosarcoma protuberans (DFSP). A total of 6 breast DFSP patients who had received treatment in our hospital were retrospectively enrolled, and detailed clinicopathological data were gathered for analysis. The median age was 29.5 years (ranging from 17 to 42 years). Most cases presented a red or brown-red, mobile, well-circumscribed, protruding, breast mass (ranging from 1 to 3 cm). For histopathology, all cases (6/6) showed a storiform pattern of spindle cells that were positive for CD34 (6/6) and Vimentin (5/6) and negative for smooth muscle actin (0/6) and S-100 protein (0/6). The majority of patients (5/6) underwent wide local excision, with 2 cases treated with radiotherapy. With a median follow-up of 36 months, all 6 patients survived without recurrence or metastasis. The PubMed database was used to search for similar cases. Eventually, 36 cases were included in this review, while cases without detailed clinical information or not reported in English were excluded from the analysis. To summarize, DFSP of the breast is an extremely rare malignancy characterized by spindle tumor cells arranged in a storiform pattern and positivity for CD34. The core needle biopsy is one of the crucial methods for its preoperative diagnosis. Management of DFSP is mainly based on surgical excision. It is prone to local recurrence, so long-term follow-up is required.

A Novel Surgical Stapling Technique for Rectal Mass Removal: A Retrospective Analysis

2009 ◽  
Vol 45 (2) ◽  
pp. 67-71 ◽  
Author(s):  
Jen Swiderski ◽  
Stephen Withrow
Keyword(s):  
Adjuvant Therapy ◽  
Retrospective Analysis ◽  
Surgical Excision ◽  
Histopathological Diagnosis ◽  
Surgical Stapling ◽  
Stapling Device ◽  
Novel Technique ◽  
Rectal Mass ◽  
Mean Time

Both benign and malignant rectal masses occur in dogs. The mainstay of treatment is surgical excision with adjuvant therapy based on histopathological diagnosis and completeness of removal. Location of the mass within the rectum helps dictate the approach used. This paper describes the use of a novel technique for removal of rectal masses involving the distal third of the rectum in seven dogs. To perform this technique, the rectum is prolapsed and stay sutures are placed to maintain prolapse. A thoracoabdominal stapling device is placed at the base of the mass with a minimum of 0.5- to 1-cm margins, and the mass is amputated. Mean time to veterinarian follow-up was 564 days, and no dog had recurrence of disease during this time.

scholarly journals Thirteen-year follow-up of parasellar intravascular papillary endothelial hyperplasia successfully treated by surgical excision: case report

2015 ◽  
Vol 15 (4) ◽  
pp. 384-391 ◽  
Author(s):  
Sook Young Sim ◽  
Yong Cheol Lim ◽  
Keun Soo Won ◽  
Kyung Gi Cho
Keyword(s):  
Surgical Excision ◽  
Subtotal Resection ◽  
Intravascular Papillary Endothelial Hyperplasia ◽  
Long Term Follow Up ◽  
History Of ◽  
Papillary Endothelial Hyperplasia ◽  
The Right ◽  
Frontal Skull Base

Intracranial intravascular papillary endothelial hyperplasia (IPEH) is very rare, and to our knowledge long-term follow-up results have not been previously published. An 11-year-old boy presented with a 6-month history of progressive visual impairment in the right eye. Magnetic resonance imaging revealed a well-enhanced, large parasellar mass involving the cavernous sinus, right frontal skull base, and ethmoid and sphenoid sinuses. Frontotemporal craniotomy and subtotal resection were performed, and the diagnosis of IPEH was confirmed. The mass increased in size during the following 3 months. A second operation was performed via frontotemporal craniotomy combined with a transsphenoidal approach, and gross-total resection of the tumor was achieved. Adjuvant radiotherapy (5040 cGy) and chemotherapy with interferon were administered. The patient's visual symptoms improved, and there was no recurrence during a 13-year follow-up period. The results of this case indicate that intracranial IPEH can recur with subtotal resection; however, optimal resection with multimodal adjuvant treatment can control the disease for many years, if not permanently.

scholarly journals Post-traumatic cutaneous meningioma

2004 ◽  
Vol 118 (3) ◽  
pp. 228-230 ◽  
Author(s):  
Pepijn A. Borggreven ◽  
Floris H. de Graaf ◽  
Paul van der Valk ◽  
C. René Leemans
Keyword(s):  
Head Trauma ◽  
Histopathological Examination ◽  
Surgical Excision ◽  
Surgical Removal ◽  
Incisional Biopsy ◽  
Rare Tumours ◽  
Progressive Growth ◽  
Post Traumatic

Cutaneous meningiomas are extremely rare tumours and their diagnosis is difficult. We describe the case of a patient who developed a paranasal swelling after head trauma and associated fractures in the same region years before. Histopathological examination of an incisional biopsy revealed the diagnosis of cutaneous meningioma. After one and a half years’ follow up, surgical excision was performed because of progressive growth of the tumour and associated aesthetic problems. Extracranial meningiomas can develop probably secondary to trapping of meningeal tissue after trauma. If there is no intracranial connection surgical removal can be considered.

scholarly journals A Rare Presentation of Schwannoma as a Purely-Cystic Superficial-Intermuscular Extra-Spinal Swelling over Upper Back.

2020 ◽  
Author(s):  
Srinjoy Saha
Keyword(s):  
Surgical Excision ◽  
Thoracic Vertebrae ◽  
Rare Presentation ◽  
Complete Surgical Excision ◽  
Rare Tumours ◽  
S 100 ◽  
One Year ◽  
Atypical Presentations ◽  
Upper Thoracic

Abstract Schwannomas are rare tumours arising from peripheral nerve sheath. Here, a 44-year-old lady came to our clinic with an asymptomatic progressively-enlarging swelling over her upper back. It was fluctuant, with an absence of pain and tenderness. MRI showed a benign, purely-cystic, superficial-intermuscular, extra-spinal swelling nearby upper thoracic vertebrae. Complete surgical excision proceeded smoothly through a well-defined plane between the swelling and the muscles. It was not attached to any identifiable nerve. A 6.5x5.0x2.5 cm ovoid lesion with a glistening whitish-grey capsule was excised and wound reconstructed in layers. Histopathology showed hypercellular areas with nuclear palisading or oval-shaped Verocay bodies. Only S-100 tested positive amongst the five-antigen immunohistochemistry, thus establishing the diagnosis of a schwannoma. Postoperatively, a one-year follow-up period was uneventful. Schwannomas can surprise clinicians by arising anywhere and with atypical presentations. It needs to be in the differential diagnoses of any asymptomatic slowly-growing lesion.

Surgical Technique and Outcomes in the Treatment of Spinal Cord Ependymomas: Part II: Myxopapillary Ependymoma

2011 ◽  
Vol 68 (suppl_1) ◽  
pp. ons90-ons94 ◽  
Author(s):  
Elisa J Kucia ◽  
Peter H Maughan ◽  
Udaya K Kakarla ◽  
Nicholas C Bambakidis ◽  
Robert F Spetzler
Keyword(s):  
Spinal Cord ◽  
Radiation Therapy ◽  
Gross Total Resection ◽  
Subtotal Resection ◽  
Myxopapillary Ependymoma ◽  
Postoperative Radiation ◽  
Total Resection ◽  
Postoperative Radiation Therapy ◽  
Duration Of Symptoms

Abstract BACKGROUND: Myxopapillary ependymomas usually occur in the filum terminale of the spinal cord. OBJECTIVE: This report summarizes our experience treating myxopapillary ependymomas. METHODS: The records of 34 patients (14 men, 20 women; mean age 45.5 years; age range, 14-88 years) who underwent resection of a myxopapillary ependymoma between 1983 and 2006 were reviewed for age, sex, tumor location, symptoms at diagnosis, duration of symptoms, treatment before presentation, extent of surgical resection, adjuvant therapy, length of follow-up, evidence of recurrence, and complications. Neurological examinations performed at presentation, immediately after surgery, and last follow-up were graded according to the McCormick grading scale. RESULTS: The average duration of symptoms before diagnosis was 22.2 months. The most common symptom was pain followed by weakness, bowel/bladder symptoms, and numbness. The rate of gross total resection was 80%. All patients with a subtotal resection (20%) underwent postoperative radiation therapy. Presentation and outcomes of patients who underwent subtotal resection followed by radiation therapy were compared with those who underwent gross total resection. There was no significant difference in neurological grade between the groups at presentation or final follow-up. The overall recurrence rate was 10% (3/34 patients). CONCLUSION: The goal of surgical treatment of myxopapillary ependymomas is resection to the greatest extent possible with preservation of function. In cases of subtotal resection, postoperative radiation therapy may improve outcome. If neurological function is maintained at treatment, these indolent lesions allow years of good function.

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