Rare Tumors of the Cerebellopontine Angle

1980 ◽  
Vol 88 (5) ◽  
pp. 555-559 ◽  
Author(s):  
Derald E. Brackmann ◽  
Loren J. Bartels
Keyword(s):  
Posterior Fossa ◽  
Cerebellopontine Angle ◽  
Malignant Tumors ◽  
Rapid Development ◽  
Cranial Nerves ◽  
Benign Tumors ◽  
Rare Tumors ◽  
Cerebellopontine Angle Tumors ◽  
Acoustic Neurinomas ◽  
The Subject

In a series of 1,354 cerebellopontine angle tumors treated at the Otologic Medical Croup, approximately 10% were lesions other than acoustic neurinomas. Of the non-acoustic tumors, the majority were meningiomas, primary cholesteatomas, and neurinomas of other cranial nerves in the posterior fossa. Twenty-five other lesions were encountered; these rare tumors are the subject of this study. The benign tumors resemble acoustic neurinomas in appearance and in the method of treatment. Malignant tumors are characterized by rapid development of symptoms and are difficult to treat because of invasion of vital structures in the area.

Surgical Treatment of Intracavernous Neoplasms: A Four-Year Experience

Neurosurgery ◽  
1989 ◽  
Vol 24 (1) ◽  
pp. 18-30 ◽  
Author(s):  
Laligam N. Sekhar ◽  
Chandra N. Sen ◽  
Hae Dong Jho ◽  
Ivo P. Janecka
Keyword(s):  
Cavernous Sinus ◽  
Malignant Tumors ◽  
Cranial Nerves ◽  
Balloon Occlusion ◽  
Benign Tumors ◽  
Adjuvant Radiation ◽  
Margins Of Excision ◽  
Balloon Occlusion Test ◽  
Preoperative Status

Abstract Forty-two patients with neoplasms involving the cavernous sinus had operations between 1983 and 1987. The lesions included 25 benign tumors (e.g., meningioma, neurilemoma) and 17 malignant tumors (e.g., chondrosarcoma, adenoid cystic carcinoma). The cavernous sinus was entered by inferior, anterolateral, or medial extradural approaches or by superior or lateral intradural approaches. The intracavernous internal carotid artery was managed by dissecting tumor away from it or by occlusion and excision with or without direct vein graft reconstruction, based on the results of a preoperative balloon occlusion test. Cranial nerves III, IV, V, and VI usually were dissected from tumor, but in 3 cases of tumor invasion, the excised nerve segment was reconstructed by direct suture or with a sural nerve interposition graft. Twenty-one of the benign tumors and 8 of the malignant tumors were excised totally and the remainder subtotally. On follow-up ranging from 3 to 48 months, one subtotally excised meningioma recurred and was treated with reexcision and adjuvant radiation therapy. Two “totally” excised malignant tumors recurred outside the cavernous sinus at the margins of excision. There was no operative mortality or permanent cerebral morbidity. Postoperatively, the ocular and neurological function of most patients was similar to the preoperative status; in some, it was significantly improved. Thirteen additional patients with intracavernous neoplasms also were evaluated during the same period and followed without operation. The early follow-up information regarding these patients is provided.

scholarly journals Classification of Breast Ultrasound Tomography by Using Textural Analysis

2020 ◽  
Vol 17 (2) ◽  
Author(s):  
Chih-Yu Liang ◽  
Tai-Been Chen ◽  
Nan-Han Lu ◽  
Yi-Chen Shen ◽  
Kuo-Ying Liu ◽  
...  
Keyword(s):  
Roc Analysis ◽  
Malignant Tumors ◽  
Rapid Development ◽  
Ultrasound Image ◽  
Breast Ultrasound ◽  
Image Features ◽  
Benign Tumors ◽  
Ultrasound Images ◽  
The Mean

Background: Ultrasound imaging has become one of the most widely utilized adjunct tools in breast cancer screening due to its advantages. The computer-aided detection of breast ultrasound is rapid development via significant features extracted from images. Objectives: The main aim was to identify features of breast ultrasound image that can facilitate reasonable classification of ultrasound images between malignant and benign lesions. Patients and Methods: This research was a retrospective study in which 85 cases (35 malignant [positive group] and 50 benign [negative group] with diagnostic reports) with ultrasound images were collected. The B-mode ultrasound images have manually selected regions of interest (ROI) for estimated features of an image. Then, a fractal dimensional (FD) image was generated from the original ROI by using the box-counting method. Both FD and ROI images were extracted features, including mean, standard deviation, skewness, and kurtosis. These extracted features were tested as significant by t-test, receiver operating characteristic (ROC) analysis and Kappa coefficient. Results: The statistical analysis revealed that the mean texture of images performed the best in differentiating benign versus malignant tumors. As determined by the ROC analysis, the appropriate qualitative values for the mean and the LR model were 0.85 and 0.5, respectively. The sensitivity, specificity, accuracy, positive predicted value (PPV), negative predicted value (NPV), and Kappa for the mean was 0.77, 0.84, 0.81, 0.77, 0.84, and 0.61, respectively. Conclusion: The presented method was efficient in classifying malignant and benign tumors using image textures. Future studies on breast ultrasound texture analysis could focus on investigations of edge detection, texture estimation, classification models, and image features.

scholarly journals Retrosigmoid Craniotomy for Resection of an Epidermoid Cyst of the Posterior Fossa

2018 ◽  
Vol 79 (S 05) ◽  
pp. S411-S412
Author(s):  
M. Kalani ◽  
William Couldwell
Keyword(s):  
Posterior Fossa ◽  
Epidermoid Cyst ◽  
Cranial Nerve ◽  
Cranial Nerves ◽  
Disease Process ◽  
Mass Effect ◽  
Sudden Onset ◽  
Benign Tumors ◽  
Cranial Nerve Function ◽  
Grade Ii

This video illustrates the case of a 51-year-old woman who presented with sudden-onset headache, vertigo, and nausea. Imaging revealed an epidermoid cyst of the posterior fossa with mass effect upon the brainstem and displacement of the basilar artery. This lesion was approached using a left-sided keyhole retrosigmoid craniotomy with monitoring of the cranial nerves. This video illustrates the technique of internal debulking of the cyst contents with minimal manipulation of the cyst capsule, which is often densely adherent to the brainstem, cranial nerves, and vessels in the posterior fossa. Resection of the capsule is often associated with a higher rate of cranial nerve deficits. The tumor was removed completely, but the cyst capsule was left in place. The patient had House–Brackmann grade II facial paralysis postoperatively and complained of some diminished hearing in the left ear. Epidermoid cysts are benign tumors, but the patient may experience much morbidity from their overly aggressive resection, especially when the capsule is densely adhering to critical structures. An alternate strategy is to decompress the contents of the epidermoid cyst, thereby decompressing the brainstem and converting this disease process into a chronic disease that may require reoperation in the long term. Given the tight confines of the posterior fossa, aggressive internal decompression of tumors and mobilization from the brainstem and adjacent nerves are key to avoiding injury to the brainstem and cranial neuropathies. In patients with benign tumors, the goal of the operation should be decompression of the brainstem and preservation of cranial nerve function.The link to the video can be found at: https://youtu.be/nk8-VztB0OI.

Restoration of Hearing after Removal of Cerebellopontine Angle Meningioma: Diagnostic and Therapeutic Implications

Neurosurgery ◽  
1988 ◽  
Vol 22 (3) ◽  
pp. 573-575 ◽  
Author(s):  
Paul Kurt Maurer ◽  
Shige H. Okawara
Keyword(s):  
Posterior Fossa ◽  
Cerebellopontine Angle ◽  
Hearing Impaired ◽  
Acoustic Neurinoma ◽  
Therapeutic Implications ◽  
Translabyrinthine Approach ◽  
Impaired Patient ◽  
Acoustic Neurinomas

Abstract A case of cerebellopontine angle meningioma with restoration of hearing from a profoundly deaf state is presented. Meningiomas of the posterior fossa commonly present with decreased or absent hearing and can appear deceptively similar to acoustic neurinomas on radiographic and audiometric testing. Because total restoration of hearing can occur with meningioma, even with significant preoperative deficit, utilization of the translabyrinthine approach is less desirable if any preoperative question as to the diagnosis exists. Any hearing-impaired patient with a cerebellopontine angle mass that is not conclusively thought to represent acoustic neurinoma should be approached by the suboccipital technique to maximize the opportunity for restoration of hearing. (Neurosurgery 22:573-575, 1988)

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