Partial laryngectomy and reconstruction with rotation of the epiglottis in the treatment of a rare laryngeal schwannoma: a case report

Abstract Background Neurogenic tumors of the larynx are rare, with few cases having been reported in the literature. Schwannomas are responsible for 0.1% of all benign tumors of the larynx. They arise in the sheaths of the peripheral, autonomic, and cranial nerves. The objective of this report is to describe a case of a bulky laryngeal schwannoma, the surgical procedure for its removal, and the long-term patient follow-up. Case presentation A 19-year-old Brazilian woman presented to our institution with a complaint of progressive dyspnea over the preceding year, as well as dysphonia, dysphagia for solids, and globus pharyngeus. Direct rigid laryngoscopy showed a supraglottic tumor obstructing approximately 90% of the larynx. With the symptoms progressing to severe dyspnea, an emergency tracheostomy was performed. After infusion of intravenous contrast, magnetic resonance imaging revealed a mass lesion with intense, heterogeneous contrast enhancement along the posterior wall of the hypopharynx, blocking all of the lumen and measuring 2.8 cm and 2.2 cm at its largest diameters. The image suggested a neoplastic lesion. The patient underwent open surgery for tumor resection. Her postsurgical recovery was uncomplicated. Histopathology and immunohistochemistry revealed the tumor to be a laryngeal schwannoma. Conclusion The definitive diagnosis of laryngeal lesions can be difficult, and histopathology plays a pivotal role. Laryngeal schwannomas are rare; however, tumors can become large and may ultimately lead to airway obstruction.

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Extended Middle Fossa Approach for Trigeminal Schwannoma Resection

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0041-1727108 ◽

2021 ◽

Author(s):

Baha'eddin A. Muhsen ◽

Edinson Najera ◽

Hamid Borghei-Razavi ◽

Badih Adada

Keyword(s):

Cavernous Sinus ◽

Brain Mri ◽

Clinical Status ◽

Tumor Resection ◽

Cranial Nerves ◽

Petrous Apex ◽

Benign Tumors ◽

Middle Fossa ◽

Middle Fossa Approach ◽

Trigeminal Schwannoma

AbstractTrigeminal schwannomas are rare benign tumors, it is second most common intracranial schwannomas after vestibular schwannomas. The management includes not limited to observation, stereotactic radiosurgery/radiotherapy, and/or surgical resection. Tumor size and patient clinical status are the most important factors in management.In this video, we describe the technical nuances of an extended middle fossa approach for large trigeminal schwannoma with cavernous sinus extension resection. A 44-year-old right-handed female with several months' history of progressive right facial paresthesia and pain in the distribution of V3 mainly. On physical examination, she had decreased sensation to light touch over the right V1 to V3 distribution with loss of cornel reflex. The brain MRI showed 3.5 cm bilobed mass extends from the pontine root entry zone to the cavernous sinus. Craniotomy was performed and followed by middle fossa dural peeling, peeling of temporal lobe dura away from the wall of the cavernous sinus, extradurally anterior clinoidectomy, drilling of the petrous apex, coagulation of superior petrosal sinus followed incision of the tentorium up to the tentorial notch with preservation the fourth cranial nerve, and tumor dissected away from V1 and then gradually removed from the superior wall of the cavernous sinus.The technique presented here allows for complete tumor resection, safe navigation through the relative cavernous sinus compartments, and minimizes the possibility of inadvertent injury to the cranial nerves.The postoperative course was uneventful except for right eye incomplete ptosis from the swelling. Her facial pain subsided after the surgery without any extra ocular movement impairment.The link to the video can be found at: https://youtu.be/zxi2XK2R9QU.

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Cavernous Sinus Chondromas

JBNC - JORNAL BRASILEIRO DE NEUROCIRURGIA ◽

10.22290/jbnc.v26i3.1339 ◽

2018 ◽

Vol 26 (3) ◽

pp. 211-217

Author(s):

Jonathan Polo Valdez ◽

Ricardo Ramina ◽

Luis Fernando Moura Da Silva Jr ◽

Mauricio Coelho Neto

Keyword(s):

Cavernous Sinus ◽

Clinical Symptoms ◽

Tumor Resection ◽

Cranial Nerves ◽

The Body ◽

Neurological Deficits ◽

Surgical Approaches ◽

Benign Tumors ◽

Surgical Removal ◽

Adequate Knowledge

Background: Chondromas are benign tumors with slow growth pattern that may develop along the body. Intracranial chondromas are rare, 0.1 to 0.3% of all intracranial tumors, usually in parasellar region. Few papers reported cavernous sinus chordomas. Case Description: We reported two cases of cavernous sinus chondromas. Two patients presented diplopia, one facial hypoesthesia and one presented extension to the petroclival region. Surgical approaches were frontotemporal combining presigmoid/middle fossa. Literature was reviewed concerning incidence, clinical symptoms, treatment and outcome. Both cases achieved complete tumor resection without postoperative complication. Preoperative deficits improved. Literature review confirms their rarity, clinical symptoms are related to deficits of cranial nerves passing through the cavernous sinus and cure can be achieved through radical surgical removal. Conclusion: Cavernous sinus chondromas are rare benign lesions with insidious growth. Adequate knowledge of cavernous sinus anatomy, microsurgical experience, intraoperative monitoring of cranial nerves and neuronavigation allows radical tumor removal with no additional neurological deficits.

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A solitary giant neurofibroma of inguinal region: A case report

Science Progress ◽

10.1177/00368504211004269 ◽

2021 ◽

Vol 104 (1) ◽

pp. 003685042110042

Author(s):

Haiying Zhou ◽

Hui Lu

Keyword(s):

Tumor Resection ◽

Clinical Manifestations ◽

Inguinal Region ◽

Nerve Sheath Tumor ◽

Neurogenic Tumors ◽

Long Time ◽

Giant Neurofibroma ◽

History Of ◽

Neuroectodermal Origin ◽

Recurrence Tendency

Neurofibroma is a rare nerve sheath tumor of neuroectodermal origin, especially the huge and isolated neurofibroma located in the inguinal region. To our knowledge, no such case has previously been reported. We report a case of 34-year-old male patient with a 4-year history of progressive enlargement of the medial root mass in his left thigh with sitting and standing disorders along with pain. The tumor was completely removed by operation, and pathological diagnosis showed neurofibroma. There was no obvious neurologic defect after surgery, and no recurrence tendency was found in the follow-up of 2 years. For a large solitary mass with slow growth and no malignant clinical manifestations for a long time, clinicians cannot rule out the hypothetical diagnosis of neurofibroma, even though its growth site is very rare, such as this case of a huge tumor located in the groin. For neurogenic tumors, early operation should be performed, and the prognosis of patients after tumor resection is excellent.

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Calcaneal Reconstruction With Free Deep Circumflex Iliac Artery Osseocutaneous Flap Following Aggressive Benign Bone Tumor Resection

Foot & Ankle International ◽

10.1177/10711007211025280 ◽

2021 ◽

pp. 107110072110252

Author(s):

Mohamad Aizat Rosli ◽

Wan Faisham Wan Ismail ◽

Wan Azman Wan Sulaiman ◽

Nor Azman Mat Zin ◽

Syurahbil Abdul Halim ◽

...

Keyword(s):

Iliac Artery ◽

Donor Site ◽

Tumor Resection ◽

Case Series ◽

Benign Tumors ◽

Reconstruction Method ◽

Short Term ◽

Deep Circumflex Iliac Artery ◽

First Case ◽

Donor Site Pain

Background: Advances in limb-salvage techniques have made total calcanectomy and primary reconstruction possible in managing calcaneal aggressive benign tumors and selected cases of intraosseous malignant tumors. However, there is still no consensus on the operative approach, oncologic margin, and the best reconstruction method to date. These 2 cases describe our experience in calcaneal reconstruction with the free deep circumflex iliac artery (DCIA) osseocutaneous flap in benign aggressive calcaneal tumors. Methods: We reported 2 consecutive male and female patients, with an average age of 25 years (age 19 and 31, respectively), who underwent total calcanectomy and primary calcaneal reconstruction with the free DCIA osseocutaneous flaps for calcaneal chondroblastoma and giant cell tumor. A marginal resection of the entire calcaneus through the subtalar and calcaneocuboid joints (intra-articular approach) was performed in the first case and a wide local resection leaving 1 cm normal calcaneal bone margin anterosuperiorly (intraosseous approach) was performed in the second case. Results: The follow-up period averaged 48 months. Negative oncologic margins were achieved in both cases. The first case was complicated with venous thrombosis; however, the graft remained viable after emergency reexploration. Normal foot function was restored with good solid osseous union and bony hypertrophy observed. Both patients achieved good short-term functional and aesthetic outcomes with no donor site pain or disability. No local recurrence was reported either. Conclusion: Primary calcaneal reconstruction with the free DCIA osseocutaneous flap can lead to good short-term functional and aesthetic outcomes. Level of Evidence: Level IV, case series.

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Giant Cells Tumors of Synovial Sheaths of the Hand are Benign Tumors with a Good Prognosis

Dermatology and Dermatitis ◽

10.31579/2578-8949/013 ◽

2017 ◽

Vol 1 (3) ◽

pp. 01-03

Author(s):

Cesar Edgar ◽

Trey Rafael ◽

Robert Mason ◽

Diego Luis

Keyword(s):

Retrospective Study ◽

Tumor Resection ◽

Tumor Development ◽

Epidemiological Data ◽

Recurrence Risk ◽

Giant Cells ◽

Good Prognosis ◽

Benign Tumors ◽

Macroscopic Appearance ◽

Quick Dash

Introduction: The giant cells tumors (GCT) of the hand are common benign tumors that pose a recurrence problem. The aim of our study is to analyze epidemiological and clinical data, evaluate results and determine the recurrence risk factors. Materials and Methods: This is a retrospective study of 50 patients operated between 2003 and 2015 for a (GCT) of the hand, we observed epidemiological data, clinical outcome (quotation TAM score Kapandji and quick DASH), the appearance of recurrence, the histological appearance, localization, excision margins and invasion of adjacent anatomical structures were analyzed. Results: We report a retrospective study over thirteen years of 50 cases of GCT of the hand, with a mean age of 42 years and a sex ratio of 1/3. The motive for consulting was the presence of a digital mass, followed by discomfort bending in 20%. Palmar localization was found in 54%, especially at the second ray (30%) and facing the distal phalanx (38%). The radiograph showed soft tissue opacity in 60% of cases. All patients underwent surgery, the macroscopic appearance showed an encapsulated, lobed and yellow chamois tumor in 80% of cases. The mean follow up was 30 months with extremes of 2 months to 10 years. We noted 5 recurrences one of which recurred twice; the average time to recurrence was 22 months and ranged from 6 months to 36 years. In each subsequent offense we noted an intra-articular tumor development in 4 cases and tendon erosion in one case. Functional complications type of stiffness in flexion in 2 cases and hypoesthesia of a finger in 2 cases. The quick way DASH was 2.2 on 100. Conclusion: The GCT of synovial sheaths of the hand are a benign tumors with a good prognosis, the main problem is the risk of recurrence that depends on the type of tumor, intra articular tumor development and quality of tumor resection.

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Multiple cystic lesions in the abdominopelvic cavity one and a half years after resection of presacral neurogenic tumor: tumor recurrence or other?

International Surgery Journal ◽

10.18203/2349-2902.isj20205379 ◽

2020 ◽

Vol 7 (12) ◽

pp. 4180

Author(s):

Umar Zeb Khan ◽

Matiullah Masroor ◽

Hai Liu

Keyword(s):

Spontaneous Rupture ◽

Tumor Recurrence ◽

Tumor Resection ◽

Abdominal Distension ◽

Neurogenic Tumor ◽

Ct Scans ◽

Cystic Degeneration ◽

Cystic Lesions ◽

Local Hospital ◽

Neurogenic Tumors

Cystic lesions of abdominopelvic cavity include a variety of pathologies and diagnosis can sometimes be challenging. Urinoma can be caused by iatrogenic injury, spontaneous rupture of ureters or by various causes of ureteral obstruction. It needs to be differentiated from abdominopelvic cystic diseases including tumors that can undergo cystic degeneration. Here we report a case of a 41 years old female underwent a presacral neurogenic tumor resection at a local hospital 5 years ago. The tumor recurred three and a half years after the first surgery and removed at another hospital. She experienced abdominal distension and difficulty in urination from the last 2 months and was diagnosed as having a recurrence of tumor once again at both hospitals on separate CT scans. They believed that the tumor was too large and encroaching on adjacent organs to be surgically resected, she was finally diagnosed as infected urinoma during surgery in our hospital. Even though spontaneous rupture of ureters and urinoma formation is a rare disease but it should be considered as a main differential diagnosis of recurrence of neurogenic tumors especially in post abdominopelvic surgeries patient.

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Giant Lipoma Presents from the Buccal Vestibule

Case Reports in Dentistry ◽

10.1155/2020/8824548 ◽

2020 ◽

Vol 2020 ◽

pp. 1-4

Author(s):

Yuki Sakamoto ◽

Gohei Oyama

Keyword(s):

Benign Tumor ◽

Oral Surgery ◽

Detailed Examination ◽

Benign Tumors ◽

Neoplastic Lesion ◽

Facial Swelling ◽

Giant Lipoma ◽

Pedunculated Tumor ◽

The Right

A lipoma is a benign tumor, where the parenchyma is composed of adipose tissue. Lipomas comprise 0.1%–5% of all benign tumors in the oral cavity. A 43-year-old man, with a known masticatory disorder, visited the Department of Oral Surgery at our hospital because of a facial swelling. The swelling, which had worsened over 15 years, was not painful, but the patient had discomfort while eating and talking. A detailed examination revealed a smooth, elastic, soft, circular, and yellowish pink pedunculated tumor-like lesion, with a diameter of approximately 40 mm, on the right buccal mucosa. An oval-shaped neoplastic lesion with a well-defined border of 40 mm × 20 mm was noted on MRI. Based on these results, the lesion was characterized as being a benign lipoma. The tumor was resected under local anesthesia. The pedunculated tumor was excised with an electric knife, and the wound was sutured. No trismus or paresthesia was noted on the postoperative follow-up.

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Posterior Approach to Meckel's Cave: Retrosigmoid Craniectomy with Endoscopic Assistance

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0039-1677851 ◽

2019 ◽

Vol 80 (S 03) ◽

pp. S331-S332

Author(s):

Paramita Das ◽

Hamid Borghei-Razavi ◽

Nina Z. Moore ◽

Pablo F. Recinos

Keyword(s):

Tumor Resection ◽

Cranial Nerves ◽

Auditory Brainstem ◽

Technical Note ◽

Auditory Brainstem Responses ◽

Case Review ◽

Meckel’S Cave ◽

Meckel's Cave ◽

Endoscopic Assistance ◽

Loss Of Hearing

Background Meckel's cave involvement in tumors pose a challenge due to their surrounding neurovascular structure and deep location. Case Review A 24-year-old male presented with progressive headaches and right sided trigeminal neuralgia with a large epidermoid. The tumor extended from the ambient cistern to the cerebellomedullary cistern and involved Meckel's cave (Fig. 1). Technical Note/Video Description A retrosigmoid craniectomy was performed. Cranial nerves 3, 4, 6, 7, and 10, and auditory brainstem responses were monitored. Once the craniectomy was completed the dura was opened and cerebrospinal fluid (CSF) was released from the cisterna magna to allow for the tumor resection to be done without the use of any retractors (Fig. 2). Care was taken to ensure that cranial nerves in the posterior fossa were detethered to prevent any traction injury. Using ring curettes the pearly white epidermoid tumor was able to be debulked. After all the possible tumor was resected with the microscope, the 30-degree endoscope was used to identify the porus trigeminus. Malleable ring curettes and a malleable suction were used to remove the soft tumor from this location. The patient transiently had loss of hearing but this returned within 2 weeks after surgery. Conclusions The retrosigmoid approach is familiar to all neurosurgeons and with the adjunct of an angled endoscope, the posterior Meckel's cave can be easily reached. This is particularly useful for tumors with soft consistency. The assistance of the endoscope allows Meckel's cave visualization without additional drilling while still allowing safe resection of tumor from around the trigeminal nerve.The link to the video can be found at: https://youtu.be/01aqOyUmSW0.

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Spontaneous Tumors and Non-Neoplastic Proliferative Lesions in Pet Degus (Octodon degus)

Veterinary Sciences ◽

10.3390/vetsci7010032 ◽

2020 ◽

Vol 7 (1) ◽

pp. 32

Author(s):

Tanja Švara ◽

Mitja Gombač ◽

Alessandro Poli ◽

Jožko Račnik ◽

Marko Zadravec

Keyword(s):

Malignant Tumors ◽

Single Case ◽

Case Reports ◽

Hepatocellular Adenoma ◽

Benign Tumors ◽

Malignant Neoplasms ◽

Octodon Degus ◽

Hind Limbs ◽

Neoplastic Lesion ◽

Veterinary Faculty

In recent years, degus (Octodon degus), rodents native to South America, have been becoming increasingly popular as pet animals. Data about neoplastic diseases in this species are still sparse and mainly limited to single-case reports. The aim of this study was to present neoplastic and non-neoplastic proliferative changes in 16/100 pet degus examined at the Veterinary Faculty University of Ljubljana from 2010 to 2015 and to describe the clinic-pathological features of these lesions. Twenty different lesions of the integumentary, musculoskeletal, genitourinary and gastrointestinal systems were diagnosed: amongst these were 13 malignant tumors, six benign tumors, and one non-neoplastic lesion. Cutaneous fibrosarcoma was the most common tumor (7/16 degus). It was detected more often in females (6/7 degus) and lesions were located mainly in hind limbs. The gastrointestinal tract was frequently affected, namely with two malignant neoplasms - an intestinal lymphoma and a mesenteric mesothelioma, four benign tumors – two biliary cystadenomas, an oral squamous papilloma and a hepatocellular adenoma, and a single non-neoplastic proliferative lesion. In one animal, two organic systems were involved in neoplastic lesions.

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Microsurgical Resection of Recurrent Cavernous Sinus Hemangioma by Superior and Lateral Approach: 2-Dimensional Operative Video

Operative Neurosurgery ◽

10.1093/ons/opz313 ◽

2019 ◽

Vol 19 (2) ◽

pp. E165-E166

Author(s):

Qazi Zeeshan ◽

Juan P Carrasco Hernandez ◽

Michael K Moore ◽

Laligam N Sekhar

Keyword(s):

Optic Nerve ◽

Carotid Artery ◽

Cavernous Sinus ◽

Tumor Resection ◽

Cranial Nerves ◽

Brain Magnetic Resonance Imaging ◽

Mass Effect ◽

Lateral Approach ◽

Microsurgical Resection ◽

The Right

Abstract This video shows the technical nuances of microsurgical resection of recurrent cavernous sinus (CS) hemangioma by superior and lateral approach. A 77-yr-old woman presented with headache and difficulty in vision in right eye for 6 mo. She had previously undergone attempted resection of a right CS tumor in another hospital with partial removal, and the tumor had grown significantly. Neurological examination revealed proptosis, cranial nerve 3 palsy, and loss of vision in right eye (20/200). Left side visual acuity was 20/20. Brain magnetic resonance imaging (MRI) demonstrated a large CS mass with homogeneous enhancement, measuring 3.3 × 3.3 × 2.6 cm, extending into the suprasellar cistern with mass effect on the right optic nerve. It extended anteriorly to the region of the right orbital apex and abuted the basilar artery posteriorly. She underwent right frontotemporal craniotomy, posterolateral orbitotomy and anterior clinoidectomy as well as optic nerve decompression, and the CS tumor was removed by superior and lateral approach. An incision was made into the superior wall of the CS medial to the third nerve. On lateral aspect the tumor had extended outside the CS through the Parkinson's triangle. Posteriorly it extended through the clival dura. Anteriorly tumor encased the carotid artery and it was gradually dissected away. At the end of the operation, all of the cranial nerves were intact. Postoperative MRI showed near complete tumor resection with preservation of the internal carotid artery. At 6 mo follow-up her modified Rankin Scale was 1 and vision in left eye was normal. Informed consent was obtained from the patient prior to the surgery that included videotaping of the procedure and its distribution for educational purposes. All relevant patient identifiers have also been removed from the video and accompanying radiology slides.

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