scholarly journals Aggressive primary sinonasal Ewing sarcoma with intraorbital and intracranial extension

2021 ◽  
pp. 201010582110489
Author(s):  
Abdul Azim Al-Abrar Ahmad Kailani ◽  
Baharudin Abdullah ◽  
Dahziela Yunus ◽  
Faezahtul Arbaeyah Hussain ◽  
Sakinah Mohamad
Keyword(s):  
Surgical Resection ◽  
Endoscopic Surgery ◽  
Surgical Approach ◽  
Ewing Sarcoma ◽  
Postoperative Radiotherapy ◽  
Sinonasal Tract ◽  
Intracranial Extension ◽  
Rare Occurrence

Ewing sarcoma (ES) of the extraskeletal form is a rare occurrence and even rarer to manifest in the sinonasal tract. We describe a case of an advanced sinonasal ES with orbital and intracranial extension that was managed with chemotherapy and endoscopic surgery. Despite completing chemotherapy and surgical resection, the tumor progressed rapidly even before postoperative radiotherapy, and subsequently, she succumbed to death due to sepsis. We would like to discuss the management challenges, pitfalls, and surgical approach which may improve the outcome of this complicated disease.

Endoscopic Surgery for Malignant Tumors of the Sinonasal Tract and Adjacent Skull Base: A 10-year Experience

2008 ◽  
Vol 22 (3) ◽  
pp. 308-316 ◽  
Author(s):  
Piero Nicolai ◽  
Paolo Battaglia ◽  
Maurizio Bignami ◽  
Andrea Bolzoni Villaret ◽  
Giovanni Delù ◽  
...  
Keyword(s):  
Skull Base ◽  
Endoscopic Surgery ◽  
Malignant Tumors ◽  
Sinonasal Tract

scholarly journals Safety of Culdotomy as a Surgical Approach: Implications for Natural Orifice Transluminal Endoscopic Surgery

2012 ◽  
Vol 16 (3) ◽  
pp. 413-420 ◽  
Author(s):  
Mary Catherine Tolcher ◽  
Eleftheria Kalogera ◽  
Matthew R. Hopkins ◽  
Amy L. Weaver ◽  
Juliane Bingener ◽  
...  
Keyword(s):  
Endoscopic Surgery ◽  
Surgical Approach ◽  
Natural Orifice

Hemorrhagic and Cystic Brain Metastases Are Associated With an Increased Risk of Leptomeningeal Dissemination After Surgical Resection and Adjuvant Stereotactic Radiosurgery

Neurosurgery ◽  
2018 ◽  
Vol 85 (5) ◽  
pp. 632-641 ◽  
Author(s):  
Robert H Press ◽  
Chao Zhang ◽  
Mudit Chowdhary ◽  
Roshan S Prabhu ◽  
Matthew J Ferris ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Stereotactic Radiosurgery ◽  
Surgical Resection ◽  
Cumulative Incidence ◽  
Postoperative Radiotherapy ◽  
Multivariable Analysis ◽  
Treatment Strategies ◽  
Competing Risk ◽  
Leptomeningeal Dissemination ◽  
Increased Risk

Abstract BACKGROUND Brain metastases (BM) treated with surgical resection and focal postoperative radiotherapy have been associated with an increased risk of subsequent leptomeningeal dissemination (LMD). BMs with hemorrhagic and/or cystic features contain less solid components and may therefore be at higher risk for tumor spillage during resection. OBJECTIVE To investigate the association between hemorrhagic and cystic BMs treated with surgical resection and stereotactic radiosurgery and the risk of LMD. METHODS One hundred thirty-four consecutive patients with a single resected BM treated with adjuvant stereotactic radiosurgery from 2008 to 2016 were identified. Intracranial outcomes including LMD were calculated using the cumulative incidence model with death as a competing risk. Univariable analysis and multivariable analysis were assessed using the Fine & Gray model. Overall survival was analyzed using the Kaplan-Meier method. RESULTS Median imaging follow-up was 14.2 mo (range 2.5-132 mo). Hemorrhagic and cystic features were present in 46 (34%) and 32 (24%) patients, respectively. The overall 12- and 24-mo cumulative incidence of LMD with death as a competing risk was 11.0 and 22.4%, respectively. On multivariable analysis, hemorrhagic features (hazard ratio [HR] 2.34, P = .015), cystic features (HR 2.34, P = .013), breast histology (HR 3.23, P = .016), and number of brain metastases >1 (HR 2.09, P = .032) were independently associated with increased risk of LMD. CONCLUSION Hemorrhagic and cystic features were independently associated with increased risk for postoperative LMD. Patients with BMs containing these intralesion features may benefit from alternative treatment strategies to mitigate this risk.

Trismus and TMJ disorders as first clinical manifestations in an intracranial acquired cholesteatoma

2021 ◽  
Vol 14 (5) ◽  
pp. e242460
Author(s):  
Chiara Copelli ◽  
Domenico Catapano ◽  
Alfonso Manfuso ◽  
Aurelio d’Ecclesia
Keyword(s):  
Hearing Loss ◽  
Temporomandibular Joint ◽  
Otitis Media ◽  
Rare Case ◽  
Clinical Manifestations ◽  
Chronic Otitis Media ◽  
Temporomandibular Joint Disorders ◽  
Intracranial Extension ◽  
Rare Occurrence ◽  
Acquired Cholesteatoma

Intracranial extension of acquired cholesteatoma is a rare occurrence that can develop secondary to trauma, chronic otitis media or acquired aural cholesteatoma. The most commonly observed symptoms are headache and hearing loss. The authors report on a rare case of intracranial cholesteatoma presenting with atypic symptoms: swelling and temporomandibular joint disorders.

Epilepsy Surgery Evaluation

2016 ◽  
pp. 196-208
Author(s):  
Joseph F. Drazkowski
Keyword(s):  
Surgical Resection ◽  
Surgical Approach ◽  
Medical Management ◽  
Gold Standard ◽  
Evaluation Process ◽  
Precise Localization ◽  
Intracranial Eeg ◽  
Seizure Focus ◽  
Surgical Evaluation ◽  
Medically Refractory Epilepsy

Epilepsy can be a devastating illness for those afflicted. Unfortunately, approximately one-third of people diagnosed with epilepsy are not effectively treated with standard medical management. People with medically refractory epilepsy can be treated and possibly cured of their disease utilizing a surgical approach. The electroencephalogram currently remains the “gold standard” for characterizing and localizing the ictal onset zone. Standard surface and sometimes intracranial EEG, when appropriate, are typically utilized in the evaluation process. The epilepsy surgical evaluation is sometimes enhanced with the utilization of SPECT/SISCOM imaging to further help confirm the seizure focus. Data gathered during the evaluation process guide the surgical resection, with improved remission rates correlating with precise localization of the ictal onset zone. This chapter describes the current presurgical epilepsy evaluation using the EEG and SPECT scanning.

scholarly journals Allergic Fungal Sinusitis with Intracranial Extension and Frontal Lobe Symptoms: A Case Report

1994 ◽  
Vol 73 (6) ◽  
pp. 402-404 ◽  
Author(s):  
William M. Lydiatt ◽  
Anne Sobba-Higley ◽  
James V. Huerter ◽  
Lyal G. Leibrock
Keyword(s):  
Case Report ◽  
Brain Injury ◽  
Frontal Lobe ◽  
Surgical Approach ◽  
Cerebral Spinal Fluid ◽  
Intracranial Extension ◽  
Fungal Sinusitis ◽  
Dural Defect ◽  
Allergic Fungal Sinusitis ◽  
Bony Destruction

This is the first report of AFS which caused frontal lobe symptomatology and which resolved with surgical therapy. The surgical approach used provided excellent exposure and the sinuses could be examined and thoroughly cleaned both from above and intranasally. The dural defect, which resulted from the destruction of the cribiform and fovea ethmoidalis, was easily reconstructed with a pericranial flap. This exposure facilitates debridement and reconstruction while minimizing complications such as cerebral spinal fluid leakage or brain injury which may occur with endoscopic manipulations in patients with bony destruction and loss of normal landmarks.

Appraisal and Consideration of Natural Orifice Specimen Extraction Surgery in Colorectal Cancer

Nano LIFE ◽  
2019 ◽  
Vol 09 (04) ◽  
pp. 1930001
Author(s):  
Zheng-Wei Fu ◽  
Li-Xia Wang ◽  
Hai-Yan Ge
Keyword(s):  
Colorectal Cancer ◽  
Laparoscopic Colectomy ◽  
Endoscopic Surgery ◽  
Surgical Approach ◽  
Oncologic Outcomes ◽  
Natural Orifice ◽  
Specimen Extraction ◽  
Short Term ◽  
Natural Orifice Specimen Extraction ◽  
The Times

Although laparoscopic colectomy shows superior short-term outcomes and similar oncologic outcomes in comparison to conventional open colectomy, incision-related complications have weakened its advantages. The natural orifice transluminal endoscopic surgery (NOTES) has been considered as the most perfect surgical approach. However, monumental technical hurdles have precluded widely adoption of this technique. As a transient mode, the natural orifice specimen extraction surgery (NOSES) emerges as the times require. Although it is accepted by surgeons for the treatment of colorectal cancer, there are still many disputes that need to be solved.

scholarly journals Atypical Meningioma: Referral Patterns, Treatment and Adherence to Guidelines

2017 ◽  
Vol 44 (3) ◽  
pp. 283-287 ◽  
Author(s):  
Majed Alghamdi ◽  
Haocheng Li ◽  
Ivo Olivotto ◽  
Jay Easaw ◽  
John Kelly ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Postoperative Radiotherapy ◽  
Progression Free Survival ◽  
Conclusive Evidence ◽  
Referral Rate ◽  
Atypical Meningioma ◽  
Rank Test ◽  
Individualised Care ◽  
New Diagnosis ◽  
The Impact

AbstractObjective:To determine the referral rate to radiation oncologist (RO), use of postoperative radiotherapy (PORT) and the impact of a clinical practice guideline (CPG) on patients with atypical meningioma (AM).Methods:A retrospective review of meningioma patients (n=526) treated between 2003 and 2013 was undertaken. Patients’ characteristics, extent of surgical resection (EOR), RO referral, PORT, date and treatment of first recurrence were collected for all patients >18 years with a new diagnosis of AM after surgical resection (n=83). Progression free survival (PFS) and overall survival (OS) according to EOR were assessed by the Log-Rank test of Kaplan-Meier survival.Results:Median age was 57 years. EOR was gross total (GTR) in 44 patients, subtotal (STR) in 36 patients and 3 patients had unknown EOR. RO referral rate was 26.5% (n=22); 5 patients initially had GTR and 17 had STR. Only 7 patients received PORT. At a median follow up time of 29 months, recurrences occurred in 28 patients, 4 had GTR, 21 had STR and 3 had an unknown EOR. With PORT, 2 patients developed recurrence. 5-year PFS was 62% after GTR and 33% after STR (P=0.002). 5-year OS was 92% after GTR and 83% after STR (P=0.45).Conclusion:In this cohort with AM, RO referral rate was low and was not influenced by the CPG. Use of PORT was also low. Given the lack of conclusive evidence supporting PORT in such patients, a multidisciplinary approach, including RO consultation, is needed to provide patients with optimal and individualised care.

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