Resection of a Thoracic Hemangioblastoma in a Patient With Von Hippel-Lindau: 3-Dimensional Operative Video

2018 ◽  
Vol 16 (3) ◽  
pp. 395-395 ◽  
Author(s):  
Simone E Dekker ◽  
Thomas A Ostergard ◽  
Chad A Glenn ◽  
Berje Shammassian ◽  
Efrem Cox ◽  
...  
Keyword(s):  
Treatment Options ◽  
Spinal Cord Tumor ◽  
Tumor Resection ◽  
En Bloc ◽  
Intramedullary Spinal Cord ◽  
Von Hippel Lindau ◽  
3 Dimensional ◽  
Intramedullary Lesion ◽  
Postoperative Mri ◽  
History Of

Abstract This 3-dimensional operative video illustrates resection of a thoracic hemangioblastoma in a 30-year-old female with a history of Von Hippel-Lindau disease. The patient presented with right lower extremity numbness and flank pain. Magnetic resonance imaging (MRI) demonstrated an enhancing intradural intramedullary lesion at T 7 consistent with a hemangioblastoma. The patient underwent a thoracic laminectomy with a midline dural opening for tumor resection. This case demonstrates the principles of intradural intramedullary spinal cord tumor resection. In this particular case, internal debulking was untenable owing to the vascular nature of hemangioblastomas. The operative video demonstrates en bloc tumor removal. Postoperative MRI demonstrated gross total resection. The postoperative course was uneventful. The natural history of this disease, treatment options, and potential complications are discussed.

Resection of a Lumbar Intradural Extramedullary Schwannoma: 3-Dimensional Operative Video

2018 ◽  
Vol 16 (5) ◽  
pp. 640-640 ◽  
Author(s):  
Simone E Dekker ◽  
Chad A Glenn ◽  
Thomas A Ostergard ◽  
Mickey L Smith ◽  
Brian D Rothstein ◽  
...  
Keyword(s):  
Back Pain ◽  
Treatment Options ◽  
Tumor Resection ◽  
Sensory Nerve ◽  
En Bloc ◽  
3 Dimensional ◽  
Postoperative Mri ◽  
Intradural Extramedullary ◽  
Magnetic Resonance Imaging Mri ◽  
Dural Opening

Abstract This 3-dimensional operative video illustrates resection of a lumbar schwannoma in a 57-yr-old female who presented with right lower extremity numbness, paresthesias, as well as a long history of lower back pain with rest. On magnetic resonance imaging (MRI), there was evidence of an intradural extramedullary enhancing lesion at L5, nearly completely encompassing the spinal canal. This video demonstrates the natural history, treatment options, surgical procedure, risks, and complications of treatment of these types of tumors. The patient underwent a posterior lumbar laminectomy with a midline dural opening for tumor resection. The tumor was encountered intradurally and electromyography recording confirmed that the tumor arose from a lumbar sensory nerve root. The sensory root was then divided and the tumor was then removed. The mass was removed en bloc and histopathologic analysis was consistent with a schwannoma. Postoperative MRI demonstrated gross total resection of the patient's neoplasm with excellent decompression of the spinal cord. The patient had an uneventful postoperative course with full recovery and complete resolution of her back pain and leg paresthesias.

scholarly journals Intramedullary spinal cord tumor resection

2012 ◽  
Vol 33 (Suppl1) ◽  
pp. 1
Author(s):  
Mari L. Groves ◽  
Patricia L. Zadnik ◽  
Pablo F. Recinos ◽  
Violette Renard ◽  
George I. Jallo
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Tumor ◽  
Tumor Resection ◽  
Progression Free Survival ◽  
Low Grade ◽  
High Definition ◽  
En Bloc ◽  
Intramedullary Spinal Cord ◽  
Free Survival ◽  
Intramedullary Spinal Cord Tumor

The authors present a case of a 27-year-old patient who presented with spastic gait and worsening difficulty walking over a 6 month period. Spinal MR imaging revealed a heterogeneously enhancing intramedullary spinal cord tumor (IMSCT) with associated syrinx in the cervical spine. The lesion was resected through posterior en bloc laminotomy, durotomy, and microscopic resection of the intramedullary component followed by laminoplasty reconstruction. Surgical resections with a goal of gross total resection can significantly improve overall survival and progression free survival in patients with low-grade IMSCT. The procedure is presented in an edited, high-definition format with accompanying narrative. The video can be found here: http://youtu.be/Ui9bn82PtP8.

Posterior Cervical Laminoplasty for Resection Intradural Extramedullary Spinal Meningioma: 2-Dimensional Operative Video

2018 ◽  
Vol 16 (3) ◽  
pp. 392-392 ◽  
Author(s):  
Simone E Dekker ◽  
Thomas A Ostergard ◽  
Chad A Glenn ◽  
Efrem Cox ◽  
Nicholas C Bambakidis
Keyword(s):  
High Speed ◽  
Treatment Options ◽  
Tumor Resection ◽  
Cervical Laminoplasty ◽  
En Bloc ◽  
Who Grade ◽  
Left Hand ◽  
Postoperative Mri ◽  
Intradural Extramedullary ◽  
Magnetic Resonance Imaging Mri

Abstract This operative video demonstrates a posterior cervical laminoplasty for the resection of a cervical intradural extramedullary meningioma. In addition, the natural history, treatment options, and potential complications are discussed. The patient is a 68-yr-old male who presented with left-hand grip weakness and paresthesias. Magnetic resonance imaging (MRI) demonstrated an enhancing mass that displacing the spinal cord anteriorly and causing severe flattening of the cord at C4 and C5. The patient underwent a posterior cervical laminoplasty for tumor resection. Removal of the dorsal elements with a high-speed drill was performed at C3, C4, and C5. A midline durotomy was performed and a large extra-axial intradural tumor was encountered. The tumor was resected en bloc and specimens were sent for permanent pathological analysis. The dura was closed in a watertight fashion using 6-0 Prolene sutures. The laminoplasty was performed by using titanium miniplates and screws to reconstruct the dorsal bony elements, and the wound was closed in layers using sutures. There were no complications. Final pathology was consistent with a WHO grade I meningioma. Postoperative MRI demonstrated gross total resection. The patient's perioperative course was uncomplicated and his preoperative weakness completely resolved by time of discharge.

Resection of 2 Intradural Extramedullary Cervical Spine Tumors in a Patient With Neurofibromatosis Type 2: 3-Dimensional Operative Video

2018 ◽  
Vol 16 (2) ◽  
pp. 274-274
Author(s):  
Simone E Dekker ◽  
Chad A Glenn ◽  
Thomas A Ostergard ◽  
Osmond C Wu ◽  
Fernando Alonso ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Treatment Options ◽  
Tumor Resection ◽  
Neurofibromatosis Type ◽  
Cord Compression ◽  
Neurofibromatosis Type 2 ◽  
3 Dimensional ◽  
Intradural Extramedullary

Abstract This 3-dimensional operative video illustrates resection of 2 cervical spine schwannomas in a 19-yr-old female with neurofibromatosis type 2. The patient presented with lower extremity hyperreflexity and hypertonicity. Magnetic resonance imaging (MRI) demonstrated 2 contrast-enhancing intradural extramedullary cervical spine lesions causing spinal cord compression at C4 and C5. The patient underwent a posterior cervical laminoplasty with a midline dural opening for tumor resection. Curvilinear spine cord compression is demonstrated in the operative video. After meticulous dissection, the tumors were resected without complication. The dural closure was performed in watertight fashion followed by laminoplasty using osteoplastic titanium miniplates and screws. Postoperative MRI demonstrated gross total resection with excellent decompression of the spinal cord. The postoperative course was uneventful. The natural history of this disease, treatment options, and potential complications are discussed.

scholarly journals Frontal sinus adenocarcinoma

2000 ◽  
Vol 118 (4) ◽  
pp. 118-120 ◽  
Author(s):  
Márcio Abrahão ◽  
Ana Paula Vieira Gonçalves ◽  
Roberto Yamashita ◽  
Rogério Aparecido Dedivitis ◽  
Rodrigo Oliveira Santos ◽  
...  
Keyword(s):  
Case Report ◽  
Frontal Sinus ◽  
Tumor Resection ◽  
Posterior Wall ◽  
Wood Dust ◽  
Medial Aspect ◽  
En Bloc ◽  
Tissue Mass ◽  
History Of ◽  
The Right

CONTEXT: Paranasal sinus cancer is considered rare, with an incidence of less than 1 per 100,000 per year, with the frontal sinus being the primary site in only 0.3%. We report a case of adenocarcinoma arising in the frontal sinus. DESIGN: Case report. CASE REPORT: A 59-year-old woman, secretary, came in February 1998 with a 4-month history of low intensity frontal headache. She denied contact with wood dust. On examination a non-tender swelling was noted over her right forehead next to the medial aspect of the right orbit. CT scan showed a soft-tissue mass involving frontal sinus with intracranial invasion through the posterior wall. The anterior ethmoid sinus and the medial aspect of the right orbit were also involved. MRI demonstrated dural thickening in communication with the frontal mass. She underwent an en-bloc tumor resection by craniotomy including orbital clearance. Histology revealed an adenocarcinoma. After surgery she had tumor recurrence, and chemotherapy and radiotherapy were started resulting in partial improvement.

Spinal Cord Diffuse Leptomeningeal Glioneuronal Tumor Presenting without Leptomeningeal Dissemination

2021 ◽  
pp. 1-6
Author(s):  
Carlos Perez-Vega ◽  
Oluwaseun O. Akinduro ◽  
Bradley J. Cheek ◽  
Alexandra D. Beier
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Tumor ◽  
Tumor Resection ◽  
World Health ◽  
Glioneuronal Tumor ◽  
Pathology Report ◽  
Leptomeningeal Dissemination ◽  
Unique Type ◽  
Intramedullary Spinal Cord ◽  
Diffuse Leptomeningeal Glioneuronal Tumor

<b><i>Background and Importance:</i></b> Diffuse leptomeningeal glioneuronal tumor (DLGNT) represents a provisional entity in the 2016 World Health Organization classification of tumors; it is characterized by a widespread leptomeningeal growth and oligodendroglial-like cytology. To this day, 4 pediatric patients have been reported to present with an isolated spinal cord tumor in the absence of leptomeningeal dissemination. Gross total resection (GTR) was achieved in only 1 patient. We present the clinical and technical nuances of this unique type of tumor, as well as the second reported case of GTR in a patient with DLGNT. <b><i>Clinical Presentation:</i></b> A 4-year-old boy presented to the emergency department after an episode of flaccid paralysis of bilateral lower extremities. MRI showed an intramedullary spinal cord tumor centered at T8. The patient was taken to the operative room, where a laminectomy and tumor resection were performed; cystic and solid tumor components were identified. Pathology report was consistent with DLGNT. After achieving GTR, patient is free of recurrence after a 15-month follow-up. <b><i>Conclusion:</i></b> No standard treatment for DLGNT has been identified. Current literature report surgery and chemotherapy with variable success rates. DLGNT presenting as an isolated intramedullary tumor is an uncommon condition which progression appears to be halted when treated promptly. Identifying solid and cystic components of this tumor is crucial for achieving GTR.

Dorsal Column Mapping for Intramedullary Spinal Cord Tumor Resection Decreases Dorsal Column Dysfunction

2012 ◽  
Vol 25 (4) ◽  
pp. 205-209 ◽  
Author(s):  
Ankit Indravadan Mehta ◽  
Cindy A. Mohrhaus ◽  
Aatif M. Husain ◽  
Isaac O. Karikari ◽  
Betsy Hughes ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Tumor ◽  
Tumor Resection ◽  
Dorsal Column ◽  
Intramedullary Spinal Cord ◽  
Intramedullary Spinal Cord Tumor

Dorsal Column Mapping via Phase Reversal Method

Neurosurgery ◽  
2014 ◽  
Vol 74 (4) ◽  
pp. 437-446 ◽  
Author(s):  
Dinesh Nair ◽  
Vishakhadatta M. Kumaraswamy ◽  
Diana Braver ◽  
Ronan D. Kilbride ◽  
Lawrence F. Borges ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Evoked Potentials ◽  
Somatosensory Evoked Potentials ◽  
Spinal Cord Tumor ◽  
Tumor Resection ◽  
Dorsal Column ◽  
Neurological Deficits ◽  
Reliable Technique ◽  
Intramedullary Spinal Cord ◽  
Phase Reversal

ABSTRACT BACKGROUND: Safe resection of intramedullary spinal cord tumors can be challenging, because they often alter the cord anatomy. Identification of neurophysiologically viable dorsal columns (DCs) and of neurophysiologically inert tissue, eg, median raphe (MR), as a safe incision site is crucial for avoiding postoperative neurological deficits. We present our experience with and improvements made to our previously described technique of DC mapping, successfully applied in a series of 12 cases. OBJECTIVE: To describe a new, safe, and reliable technique for intraoperative DC mapping. METHODS: The right and left DCs were stimulated by using a bipolar electric stimulator and the triggered somatosensory evoked potentials recorded from the scalp. Phase reversal and amplitude changes of somatosensory evoked potentials were used to neurophysiologically identify the laterality of DCs, the inert MR, as well as other safe incision sites. RESULTS: The MR location was neurophysiologically confirmed in all patients in whom this structure was first visually identified as well as in those in whom it was not, with 1 exception. DCs were identified in all patients, regardless of whether they could be visually identified. In 3 cases, negative mapping with the use of this method enabled the surgeon to reliably identify additional inert tissue for incision. None of the patients had postoperative worsening of the DC function. CONCLUSION: Our revised technique is safe and reliable, and it can be easily incorporated into routine intramedullary spinal cord tumor resection. It provides crucial information to the neurosurgeon to prevent postoperative neurological deficits.

scholarly journals Hemangioblastoma of the lateral ventricle

2018 ◽  
Vol 22 (1) ◽  
pp. 94-96
Author(s):  
Carlos Augusto Ferreira Lobão ◽  
Albedy Moreira Bastos ◽  
Leonidas Braga Dias Junior
Keyword(s):  
Lateral Ventricle ◽  
English Literature ◽  
Tumor Resection ◽  
Uneventful Recovery ◽  
Von Hippel Lindau ◽  
Left Lateral Ventricle ◽  
Pubmed Search ◽  
History Of ◽  
Brain Ct Scan

Introduction: Hemangioblastomas are capillary-rich benigntumors mainly found in the infratentorial compartment. When at the supratentorial space, they are rarely located at the lateral ventricle. We report on a case of a 25 years-old female patient treated at our institution. Case report: The patient came to our service with a three months history of progressive headache, bilateral visual loss, and right hemiparesis. Brain CT-scan and MRI showed a heterogeneous intraventricular contrast-enhancing lesion at the left lateral ventricle. Von Hippel-Lindau was investigated but she had neither family history of the disease nor any signs of it. She was submitted to microsurgical tumor resection with a parieto-occipital craniotomy via the intraparietal sulcus, with an uneventful recovery. Hystological examination confirmed the diagnosis of hemangioblastoma. The patient is in outpatient clinic follow-up completely integrated to her familiar and professional life. Discussion: According to a PubMed search, this is the seventh case of lateral ventricle hemangioblastoma reported on English literature. It has a cystic characteristic that differs from other cases, and a bigger volume compared to the previous ones. 

Interhemispheric Contralateral Transfalcine Approach for Subparacentral Arteriovenous Malformation: 3-Dimensional Operative Video

2021 ◽  
Author(s):  
Matías Baldoncini ◽  
Alvaro Campero ◽  
Sabino Luzzi ◽  
Juan F Villalonga
Keyword(s):  
Right Hemisphere ◽  
Vascular Lesion ◽  
Neurological Deficits ◽  
3 Dimensional ◽  
Postoperative Mri ◽  
Drainage Vein ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
Superior Longitudinal Sinus ◽  
The Right

Abstract Neurovascular procedures along the interhemispheric fissure harbor unique features differentiating them from those arteriovenous malformations (AVMs) located at the lateral surface of the brain.1-4  The aim of this 3-dimensional operative video is to present a microsurgical resection of an AVM in a subparacentral location, operated through an interhemispheric contralateral transfalcine approach.1,3,5  This is a case of a 29-yr-old female, with headaches and history of seizures. The patient presented an interhemispheric bleeding 6 mo before the surgery. The magnetic resonance imaging (MRI) showed a vascular lesion located on the medial surface of the right hemisphere at the confluence between the cingulate sulcus and its ascending sulcus. In the cerebral angiography, a right medial AVM was observed, receiving afference from the right anterior cerebral artery and draining to the superior longitudinal sinus. The patient signed an informed consent for the procedure and agreed with the use of her images and surgical video for research and academic purposes.  The patient was in a supine position, and a left interhemispheric contralateral transfalcine approach was performed,1-3 a circumferential dissection of the nidus, and, finally, the AVM was resected in one piece.  The patient evolved without neurological deficits after the surgery. The postoperative MRI and angiography showed a complete resection of the AVM.  In the case presented, to avoid exposing the drainage vein first and to use the gravity of the exposure, the contralateral transfalcine interhemispheric approach was used,1,2 which finally accomplished the proposed objectives.

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