scholarly journals Cavernoma in septum pellucidum: descriptive analysis and review of existing literature

2021 ◽  
Author(s):  
Samiul Haque ◽  
Asraful Islam ◽  
Tyfur Rahman ◽  
Mohammad D. Hossain ◽  
Abu Bakar Siddik ◽  
...  
Keyword(s):  
Descriptive Analysis ◽  
Distinct Type ◽  
Cavernous Angioma ◽  
Brain Parenchyma ◽  
Septum Pellucidum ◽  
Gross Total Resection ◽  
Qualitative Synthesis ◽  
Total Resection ◽  
System A ◽  
Clinical Presentations

AbstractBackgroundCavernomas are rare central nervous system (CNS) lesions that constitute a distinct type of vascular malformation encountered in the brain parenchyma or ventricular system. A cavernoma can be familial or sporadic forms and exhibit a range of presentation from incidental findings to seizures, headaches, hemorrhage. Septum pellucidum cavernoma is exceedingly rare and should be studied for its unique topographical location and clinical course.MethodWe performed a comprehensive literature search and review using multiple databases. the title/abstract and MeSH keywords used included “cavernoma,” “cavernous hemangioma,” “cavernous malformation,” “cavernous angioma,” “CM,” “septum pellucidum” “SP” and “intraventricular,” along with “AND” and “OR” operators. Demographic and clinical data of each patient were collected for qualitative synthesis.ResultReported cases were diagnosed at a median age of 42 years; the most frequent symptom was headaches. The incidence of hemorrhage and hydrocephalus was 30%. Gross total resection was performed in 100% of patients and exhibit clinical improvement.ConclusionThe unique location of the cavernoma exhibits clinical presentations seen and the surgical approach used. Gross total resection conveys the impression of optimum management strategy and leads to a magnificent outcome in most cases.

Intracranial and Spinal Metastases From Eccrine Mucinous Carcinoma

Neurosurgery ◽  
2010 ◽  
Vol 67 (3) ◽  
pp. E861-E862 ◽  
Author(s):  
Rishi N. Sheth ◽  
Dimitris G. Placantonakis ◽  
Philip H. Gutin
Keyword(s):  
Radiation Therapy ◽  
Lymph Node ◽  
Spinal Metastases ◽  
Distinct Type ◽  
Gross Total Resection ◽  
Leptomeningeal Disease ◽  
Total Resection ◽  
Neck Lymph Node ◽  
First Case ◽  
The Brain

Abstract BACKGROUND AND IMPORTANCE Mucinous eccrine carcinoma (MEC) is a rare but distinct type of sweat gland tumor. MECs tend to recur locally, and their spread to distant organs is very uncommon. This article describes the first case of MEC metastasizing to the brain and the spine. CLINICAL PRESENTATION A 45-year-old female presented with a 2-year history of a scalp mass in the occipital area with lymph node spread. She underwent excision of the mass and neck lymph node dissection. Pathology confirmed the diagnosis of MEC. Postoperatively, she received radiation to the involved areas. Four years later the patient presented with left hemiparesis and underwent craniotomy for gross total resection of the metastasis. This recurred after 2.5 years and she underwent another craniotomy for gross total resection followed by whole brain radiation. In addition, the patient had metastases to T11 vertebral body and the left C6 to 7 neural foramen. Moreover, the patient developed leptomeningeal disease in the spine. The metastases to the spine were treated with radiation therapy. The patient died 1.5 years later. CONCLUSION Even though it is rare for MEC to spread to distant organs, physicians should be aware of the risk of metastatic invasion of the brain and spine and be vigilant about surveillance of these sites. MEC metastases to the brain should be treated aggressively with surgical resection followed by stereotactic radiosurgery to the tumor bed. Spine metastases should be treated with a combination of surgery and image-guided radiation therapy, depending on the degree of cord compression from epidural metastatic disease.

scholarly journals the Irradiation of Two Cases of Gliosarcoma: Place and Modalities of Radiotherapy

2020 ◽  
Vol 8 (6) ◽  
pp. 469-473
Author(s):  
Dr. Rajae En Nouichi ◽  
Dr. Ghita Chbihi Hassani ◽  
Dr. F. Allouche ◽  
Dr. Mohamed Ait Erraisse ◽  
Dr. Z. Alami ◽  
...  
Keyword(s):  
Overall Survival ◽  
Brain Tumor ◽  
Brain Parenchyma ◽  
Optimal Treatment ◽  
Malignant Brain Tumor ◽  
Gross Total Resection ◽  
Total Resection ◽  
The Brain ◽  
Primary Malignant Brain Tumor

Introduction: Gliosarcoma is a rare histopathologic variant of glioblastoma traditionally associated with a poor prognosis.We present two cases of Gliosarcoma treated in our department. Discussion: Gliosarcoma (GSM) is a variant of glioblastoma (GBM), the most common primary malignant brain tumor that occurs in adults. GSM is characterized by its biphasic components: the gliomatous and sarcomatous components and categorized into primary and secondary GSM. Intrinsic to the brain parenchyma, GSM is usually managed by gross total resection, and radiotherapy with/without chemotherapy. Conclusion: Despite the notable advances and improvement in overall survival (OS), a consensus on the optimal treatment for GSM patients is unclear.

scholarly journals RARE-08. ROSAI-DORFMAN-DESTOMBES DISEASE OF THE NERVOUS SYSTEM; A SYSTEMATIC LITERATURE REVIEW

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi222-vi223
Author(s):  
Ruham Alshiekh Nasany ◽  
Anne Reiner ◽  
Katherine Panageas ◽  
Eli Diamond
Keyword(s):  
Progressive Disease ◽  
Brain Parenchyma ◽  
Neurological Deficits ◽  
First Line ◽  
Presenting Symptoms ◽  
Treatment Information ◽  
System A ◽  
Neurologic Involvement ◽  
Clinical Literature ◽  
Clinical Presentations

Abstract INTRODUCTION Rosai-Dorfman-Destombes disease (RDD) is a rare non–Langerhans cell histiocytosis with neurologic involvement in fewer than 5% of cases. Data about neurologic RDD is limited. Our objective was to synthesize the clinical literature about presentation, treatments, and outcomes of neurologic RDD. METHODS A multi-database English systematic review search using keywords related to (1) histiocytosis and (2) neurologic involvement. Candidate articles were screened for clinical content. Secondary literature and cases without treatment information were excluded. Sites of involvement, presenting symptoms, treatments, and therapeutic responses were reviewed. RESULTS Of 4768 screened, 153 articles presenting 223 patients were included. Mean age was 37.7 years (range 2–79; IQR 23.5–52.5). 149 patients (66.8%) were male and 74 (33.2%) were female. RDD lesions were located in the dura in 111 (49.8%) of cases, spine in 16.6%, brain parenchyma in 9.0%, orbit in 7.2%, calvarium in 2.7%, and in multiple sites in 13.5%. The most frequent presenting symptoms were headache in 101 (45.3%.), focal neurological deficits (32.7%), visual symptoms (31.8%), seizures (24.7%), cranial (11.7%), and cerebellar dysfunction (11.2%). Cognitive decline, masses were less common presentations. First-line treatments included resection, radiation, corticosteroids, chemotherapy, and combinations of these. First-line treatment led to complete (CR) or partial response (PR) in 153 (68.6%) of cases, stable disease in 30 (13.5%), and progressive disease in 40 (17.9%). CR or PR was observed in the calvarium in 5/6 (83.3%), dura in 82/111 (73.9%), spine in 29/37 (78.4%), orbit 8/16 (50.0%), parenchyma in 15/20 (75.0%), and multiple sites in 14/30 (46.7%). 47 (21.1%) of patients required second-line therapy. DISCUSSION Neurologic RDD is a rare form of histiocytosis with varying sites of involvement, clinical presentations, and responses to treatment. Further investigation of effective therapies for neurologic RDD may improve outcomes for this disease.

Recurrence of Rathke’s Cleft Cysts Based on Gross Total Resection of Cyst Wall: A Meta-analysis

2020 ◽  
Author(s):  
Victor Lu ◽  
Avital Perry ◽  
Christopher Graffeo ◽  
Krishnan Ravindran ◽  
Jamie Van Gompel
Keyword(s):  
Cyst Wall ◽  
Meta Analysis ◽  
Gross Total Resection ◽  
Total Resection ◽  
Rathke's Cleft Cysts ◽  
Rathke's Cleft

Letter to the Editor Regarding “Association Between Facility Volume and Overall Survival for Patients with Grade II Meningioma after Gross Total Resection”

2020 ◽  
Vol 142 ◽  
pp. 537
Author(s):  
Gustavo Correa Lordelo ◽  
Victor Salviato Nespoli ◽  
Iuri Santana Neville ◽  
Wellingson Silva Paiva
Keyword(s):  
Overall Survival ◽  
Gross Total Resection ◽  
Total Resection ◽  
Letter To The Editor ◽  
Grade Ii

scholarly journals Resection of a Lumbar Intradural Extramedullary Schwannoma: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Michael J Strong ◽  
Timothy J Yee ◽  
Siri Sahib S Khalsa ◽  
Yamaan S Saadeh ◽  
Whitney E Muhlestein ◽  
...  
Keyword(s):  
Spinal Nerve ◽  
Gross Total Resection ◽  
Preoperative Imaging ◽  
Benign Tumors ◽  
Total Resection ◽  
Intradural Tumor ◽  
Key Points ◽  
Intraoperative Fluoroscopy ◽  
Patient Consent ◽  
Intradural Extramedullary

Abstract Schwannomas are typically benign tumors that arise from the sheaths of nerves in the peripheral nervous system. In the spine, schwannomas usually arise from spinal nerve roots and are therefore extramedullary in nature. Surgical resection-achieving a gross total resection, is the main treatment modality and is typically curative for patients with sporadic tumors. In this video, we present the case of a 38-yr-old male with worsening left leg radiculopathy, found to have a lumbar schwannoma. Preoperative imaging demonstrated that the tumor was at the level of L4-L5. A laminectomy at this level was performed with gross total resection of the tumor. The key points of the video include use of intraoperative fluoroscopy to confirm surgical level and help plan surgical exposure, use of ultrasound for intradural tumor localization, and advocating for maximum safe resection using neurostimulation. The patient tolerated the surgery well without any complications. He was discharged home with no additional therapy needed. Appropriate patient consent was obtained.

scholarly journals Transcavernous Resection of a Giant Extensive Chondrosarcoma with Endoscopic Assistance

2021 ◽  
Author(s):  
Walid Elshamy ◽  
Burcak Soylemez ◽  
Sima Sayyahmelli ◽  
Nese Keser ◽  
Mustafa K. Baskaya
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Skull Base ◽  
Internal Carotid ◽  
Gross Total Resection ◽  
Petrous Apex ◽  
Left Internal Carotid Artery ◽  
Total Resection ◽  
Complete Occlusion ◽  
Grade Ii

AbstractChondrosarcomas are one of the major malignant neoplasms which occur at the skull base. These tumors are locally invasive. Gross total resection of chondrosarcomas is associated with longer progression-free survival rates. The patient is a 55-year-old man with a history of dysphagia, left eye dryness, hearing loss, and left-sided facial pain. Magnetic resonance imaging (MRI) showed a giant heterogeneously enhancing left-sided skull base mass within the cavernous sinus and the petrous apex with extension into the sphenoid bone, clivus, and the cerebellopontine angle, with associated displacement of the brainstem (Fig. 1). An endoscopic endonasal biopsy revealed a grade-II chondrosarcoma. The patient was then referred for surgical resection. Computed tomography (CT) scan and CT angiogram of the head and neck showed a left-sided skull base mass, partial destruction of the petrous apex, and complete or near-complete occlusion of the left internal carotid artery. Digital subtraction angiography confirmed complete occlusion of the left internal carotid artery with cortical, vertebrobasilar, and leptomeningeal collateral development. The decision was made to proceed with a left-sided transcavernous approach with possible petrous apex drilling. During surgery, minimal petrous apex drilling was necessary due to autopetrosectomy by the tumor. Endoscopy was used to assist achieving gross total resection (Fig. 2). Surgery and postoperative course were uneventful. MRI confirmed gross total resection of the tumor. The histopathology was a grade-II chondrosarcoma. The patient received proton therapy and continues to do well without recurrence at 4-year follow-up. This video demonstrates steps of the combined microsurgical skull base approaches for resection of these challenging tumors.The link to the video can be found at: https://youtu.be/WlmCP_-i57s.

scholarly journals Transcavernous Approach for Gross Total Resection of a Dumbbell-Shaped Giant Trigeminal Schwannoma

2021 ◽  
Author(s):  
Sima Sayyahmelli ◽  
Emel Avci ◽  
Burak Ozaydin ◽  
Mustafa K. Başkaya
Keyword(s):  
Skull Base ◽  
Cavernous Sinus ◽  
Tumor Resection ◽  
Mass Effect ◽  
World Health ◽  
Gross Total Resection ◽  
Petrous Apex ◽  
Total Resection ◽  
Who Grade ◽  
Trigeminal Schwannoma

AbstractTrigeminal schwannomas are rare nerve sheet tumors that represent the second most common intracranial site of occurrence after vestibular nerve origins. Microsurgical resection of giant dumbbell-shaped trigeminal schwannomas often requires complex skull base approaches. The extradural transcavernous approach is effective for the resection of these giant tumors involving the cavernous sinus.The patient is a 72-year-old man with headache, dizziness, imbalance, and cognitive decline. Neurological examination revealed left-sided sixth nerve palsy, a diminished corneal reflex, and wasting of temporalis muscle. Magnetic resonance imaging (MRI) showed a giant homogeneously enhancing dumbbell-shaped extra-axial mass centered within the left cavernous sinus, Meckel's cave, and the petrous apex, with extension to the cerebellopontine angle. There was a significant mass effect on the brain stem causing hydrocephalus. Computed tomography (CT) scan showed erosion of the petrous apex resulting in partial anterior autopetrosectomy (Figs. 1 and 2).The decision was made to proceed with tumor resection using a transcavernous approach. Gross total resection was achieved. The surgery and postoperative course were uneventful, and the patient woke up the same as in the preoperative period. MRI confirmed gross total resection of the tumor. The histopathology was a trigeminal schwannoma, World Health Organization (WHO) grade I. The patient continues to do well without any recurrence at 15-month follow-up.This video demonstrates important steps of the microsurgical skull base techniques for resection of these challenging tumors.The link to the video can be found at https://youtu.be/TMK5363836M

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