Lucas Crociati Meguins
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Dionei Freitas De Morais
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Carlos Eduardo Dall’Aglio Rocha
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Ricardo Lourenço Caramanti
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Thayanna Bentes Lemanski Lopes Rodrigues
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Introduction: Choroid plexus tumors (CPTs) are rare papillary neoplasms derived from choroid plexus epithelium. They account for only approximately 0.4%-0.6% of all intracranial tumors, but 10%-20% of brain tumors occurring throughout the first year of life. Objective: The present study describes the case of an adult man presenting a cerebellopontine angle choroid plexus papilloma (CPP) microsurgically treated through suboccipital far-lateral approach. Case report: A 67-years-old-man was admitted presenting progressive headaches and left lower limb weakness. Magnetic resonance images showed a large tumor on the left cerebellopontine angle with heterogeneous contrast enhancement. Total surgical resection was achieved through a right suboccipital far-lateral craniotomy on lateral position with neurophysiological monitoring of lower cranial nerves. No alterations on cranial nerves function was observed during tumor resection. The patient presented an uneventful recovery and was discharged home on the fifth post-operative day. On the six months follow-up, he was asymptomatic. Anatomopathological analysis confirmed the diagnosis of CPP, WHO grade I. Conclusion: Cerebellopontine angle’s cpp is an extremely rare neoplasm that challenges a neurosurgeon ability to deal with tumor in close relation to lower cranial nerves. Appropriate neurosurgical route, surgeons experience and adequate anatomical knowledge of important neural and vascular structures are fundamental to safely remove CPP of the posterior fossa. Suboccipital far-lateral craniotomy gives enough view with minimal retraction to manage the tumor.
Far-lateral Disc Herniation Treated by Lateral Lumbar Interbody Fusion without Complete Fragment Excision: A Case Report and Review of the Literature
