INTRADURAL CLIVAL CHORDOMA AND ECCHORDOSIS PHYSALIPHORA

Neurosurgery ◽  
2009 ◽  
Vol 64 (2) ◽  
pp. E387-E388 ◽  
Author(s):  
Riccardo Ciarpaglini ◽  
Ernesto Pasquini ◽  
Diego Mazzatenta ◽  
Andrea Ambrosini-Spaltro ◽  
Vittorio Sciarretta ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Memory Loss ◽  
Histological Findings ◽  
Postoperative Radiation ◽  
Resonance Imaging ◽  
Postoperative Radiation Therapy ◽  
Ecchordosis Physaliphora ◽  
Subtotal Removal ◽  
With Memory

Abstract OBJECTIVE Purely intradural clival chordomas are rare neoplasms, and only a few cases have been reported. The reported cases present features similar to ecchordosis physaliphora, which is a notochordal remnant. We describe these 2 entities and their differential diagnoses, clinical courses, and management. This is the first reported case to be treated using a neuroendoscopic technique. CLINICAL PRESENTATION A 60-year-old man presenting with memory loss underwent magnetic resonance imaging, which revealed an intradural retroclival mass without bone involvement. INTERVENTION The patient underwent an endoscopic transsphenoidal-transclival procedure with subtotal removal of the tumor. Histological findings confirmed the diagnosis of a chordoma. CONCLUSION Even if some parameters exist for a differential diagnosis, ecchordosis physaliphora and intradural chordoma may represent different aspects of the spectrum of the same pathology. Intradural clival chordomas have a better prognosis with respect to classic chordomas. Therefore, in subtotal removal such as that performed in our case, postoperative radiation therapy should be performed only if a regrowth of the remnant is seen during neuroradiological follow-up.

Aggressive Intramedullary Melanotic Schwannoma: Case Report

Neurosurgery ◽  
2004 ◽  
Vol 55 (6) ◽  
pp. E1430-E1434 ◽  
Author(s):  
Carlo Santaguida ◽  
Abdulrahman J. Sabbagh ◽  
Marie-Christine Guiot ◽  
Rolando F. Del Maestro
Keyword(s):  
Clinical Presentation ◽  
Magnetic Resonance Imaging Scan ◽  
Resonance Imaging ◽  
Total Resection ◽  
Neck Stiffness ◽  
Neck Extension ◽  
Melanotic Schwannoma ◽  
Pathological Characteristics ◽  
Intramedullary Lesion

Abstract OBJECTIVE AND IMPORTANCE: Intramedullary melanotic schwannomas are very rare lesions; only four cases have been reported previously. We describe a patient with an intramedullary melanotic schwannoma that had a more aggressive course than those reported in the literature, and we review the theories regarding the cause of these lesions. CLINICAL PRESENTATION: A 35-year-old man presented with neck stiffness and paraesthesia extending down his right arm upon neck extension. A magnetic resonance imaging scan revealed an intramedullary lesion extending from C4 to C5. INTERVENTION: Gross total resection of the mass was performed, and pathological characteristics were consistent with a melanotic schwannoma. Two years after resection the tumor recurred, and the patient was treated with radiation therapy. The tumor progressed 2 years after radiotherapy, and at repeat resection, multiple pigmented foci were present on the surface of the spinal cord and dura consistent with metastatic seeding. CONCLUSION: In a patient with intramedullary melanotic schwannoma with an unusually aggressive course, careful follow-up may be essential.

A STUDY OF CLINICAL PRESENTATION AND MANAGEMENT OF PITUITARY TUMORS

2021 ◽  
pp. 58-60
Author(s):  
Manthan Patel ◽  
Naimish Patel
Keyword(s):  
Clinical Presentation ◽  
Clinical Symptoms ◽  
Pituitary Tumors ◽  
Csf Leak ◽  
Total Removal ◽  
Diagnostic Investigation ◽  
Subtotal Removal ◽  
Visual Disturbances ◽  
Bitemporal Hemianopia

The study includes 25 cases of pituitary adenomas. Most common age group by pituitary tumors falls between 41-50 years of age. Male: Female incidence of these tumors is 1: 2.12. Most common clinical symptoms in our series are visual disturbances followed by headache. Optic nerve involvement is other common clinical nding presenting in form of decreased vision or loss of vision, eld defect or fundus changes. Commonest eld defect is bitemporal hemianopia. MRI is the diagnostic investigation of choice in pituitary tumors to dene extent, invasion and relationship to major vessels and nerves. Approximately half (44%) of the patients exhibited normal preoperative pituitary function in form of baseline hormone prole. Increased GH level (32%) followed by hyperprolactinemia (20%) are the most common endocrinologic abnormalities. Total/near total removal was done in 21 patients (84%) and subtotal removal done in 4 patients (16%). Adjuvant therapies were given in 5 patients. Two patients were given radiotherapy and 3 were given pharmacotherapy. Post operative complications were CSF leak, diabetes insipidus and meningitis. 20 patients (80%) had improvement in their symptoms including relief from headache, improvement in vision and endocrinal dysfunction. Post operatively visual functions improved in 13 patients (52%) and it remained stationary in 11 (44%) patients. Only one patient (4%) complained of worsening of his visual function and it was improved in follow up period

JUVENILE INTRADURAL CHORDOMA

Neurosurgery ◽  
2008 ◽  
Vol 62 (2) ◽  
pp. E525-E527 ◽  
Author(s):  
Steven W. Chang ◽  
Pankaj A. Gore ◽  
Peter Nakaji ◽  
Harold L. Rekate
Keyword(s):  
Clinical Presentation ◽  
Radiation Treatment ◽  
Complete Resection ◽  
Magnetic Resonance Imaging Scan ◽  
Resonance Imaging ◽  
Total Resection ◽  
Surgical Cure ◽  
Neurologically Intact ◽  
Resonance Imaging Scan

Abstract OBJECTIVE We report the youngest known case of a prepontine intradural chordoma. These tumors are exceedingly rare. Unlike their more common extradural counterparts, no recurrence of an intradural chordoma has been reported. CLINICAL PRESENTATION A 9-year-old boy underwent diagnostic imaging for evaluation of headaches. Although neurologically intact, a magnetic resonance imaging scan revealed a large prepontine mass with focal enhancement. INTERVENTION Endoscopic-assisted gross total resection was attained with staged bilateral retrosigmoid approaches. There were no additional adjuvant therapies. At the time of the 1-year follow-up evaluation, the patient had no recurrence. CONCLUSION By using an endoscopic-assisted procedure, we achieved complete resection of an intradural chordoma offering a potential for surgical cure. Resection is particularly advantageous because it spares the young child the need for radiation treatment. Close follow-up is warranted because we postulate that this tumor exists in a biological continuum between benign notochordal hamartomatous remnants and typical invasive chordomas.

scholarly journals Spinal angiolipoma: a report of two cases and review of the literature

2020 ◽  
Vol 48 (9) ◽  
pp. 030006052095469
Author(s):  
RuiDeng Wang ◽  
Hai Tang
Keyword(s):  
Standard Treatment ◽  
Clinical Presentation ◽  
Cord Compression ◽  
Benign Tumors ◽  
Fatty Tissue ◽  
Resonance Imaging ◽  
Total Resection ◽  
Vascular Channels ◽  
Spinal Angiolipomas

Spinal angiolipomas (SALs) are extremely rare benign tumors composed of both mature fatty tissue and anomalous vascular channels. We present two cases of SALs and review the clinical presentation, radiological appearance, pathological aspects, and treatment of this distinct clinicopathological mass. The patients’ neurologic symptoms improved postoperatively and follow-up revealed no signs of tumor recurrence or neurological deficit. SAL should be considered as a differential diagnosis in patients with spinal cord compression. Magnetic resonance imaging is important for detecting and characterizing SALs. The gold standard treatment modality should be total resection.

Intraparenchymal Myxopapillary Ependymoma: Case Report

Neurosurgery ◽  
2004 ◽  
Vol 55 (4) ◽  
pp. E996-E1000 ◽  
Author(s):  
Nikolaos Tzerakis ◽  
Nikolaos Georgakoulias ◽  
George Kontogeorgos ◽  
Aristotelis Mitsos ◽  
Alistair Jenkins ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Cauda Equina ◽  
Uneventful Recovery ◽  
Myxopapillary Ependymoma ◽  
Histological Feature ◽  
Histological Findings ◽  
Resonance Imaging ◽  
Intracranial Ependymoma ◽  
Histological Variant ◽  
Neurologically Intact

Abstract OBJECTIVE AND IMPORTANCE: Myxopapillary ependymoma is a histological variant of ependymoma found in the cauda equina region. The most characteristic histological feature of myxopapillary tumors is the abundance of intercellular and perivascular mucin and the arborizing vasculature, which tends to form papillae. Primary intracerebral myxopapillary ependymomas are extremely rare; only three cases have been reported in the previous literature. CLINICAL PRESENTATION: A 68-year-old man presented with disorientation and dizziness caused by a cystic left frontal intraparenchymal lesion. This proved to be a myxopapillary ependymoma. Similarities to previously reported cases are discussed, as are the findings on magnetic resonance imaging. There is also a literature review of the histological findings, natural history, and outcome of surgically treated myxopapillary ependymoma. INTERVENTION: The lesion was totally removed. After surgery, the patient was neurologically intact and had an uneventful recovery. CONCLUSION: This is the fourth reported case of histologically proven primary myxopapillary intracranial ependymoma.

Surgical Technique and Outcomes in the Treatment of Spinal Cord Ependymomas: Part II: Myxopapillary Ependymoma

2011 ◽  
Vol 68 (suppl_1) ◽  
pp. ons90-ons94 ◽  
Author(s):  
Elisa J Kucia ◽  
Peter H Maughan ◽  
Udaya K Kakarla ◽  
Nicholas C Bambakidis ◽  
Robert F Spetzler
Keyword(s):  
Spinal Cord ◽  
Radiation Therapy ◽  
Gross Total Resection ◽  
Subtotal Resection ◽  
Myxopapillary Ependymoma ◽  
Postoperative Radiation ◽  
Total Resection ◽  
Postoperative Radiation Therapy ◽  
Duration Of Symptoms

Abstract BACKGROUND: Myxopapillary ependymomas usually occur in the filum terminale of the spinal cord. OBJECTIVE: This report summarizes our experience treating myxopapillary ependymomas. METHODS: The records of 34 patients (14 men, 20 women; mean age 45.5 years; age range, 14-88 years) who underwent resection of a myxopapillary ependymoma between 1983 and 2006 were reviewed for age, sex, tumor location, symptoms at diagnosis, duration of symptoms, treatment before presentation, extent of surgical resection, adjuvant therapy, length of follow-up, evidence of recurrence, and complications. Neurological examinations performed at presentation, immediately after surgery, and last follow-up were graded according to the McCormick grading scale. RESULTS: The average duration of symptoms before diagnosis was 22.2 months. The most common symptom was pain followed by weakness, bowel/bladder symptoms, and numbness. The rate of gross total resection was 80%. All patients with a subtotal resection (20%) underwent postoperative radiation therapy. Presentation and outcomes of patients who underwent subtotal resection followed by radiation therapy were compared with those who underwent gross total resection. There was no significant difference in neurological grade between the groups at presentation or final follow-up. The overall recurrence rate was 10% (3/34 patients). CONCLUSION: The goal of surgical treatment of myxopapillary ependymomas is resection to the greatest extent possible with preservation of function. In cases of subtotal resection, postoperative radiation therapy may improve outcome. If neurological function is maintained at treatment, these indolent lesions allow years of good function.

USE OF TEMOZOLOMIDE IN AGGRESSIVE PITUITARY TUMORS

Neurosurgery ◽  
2009 ◽  
Vol 64 (4) ◽  
pp. E773-E774 ◽  
Author(s):  
Safraz Mohammed ◽  
Kalman Kovacs ◽  
Warren Mason ◽  
Harley Smyth ◽  
Michael D. Cusimano
Keyword(s):  
Pituitary Adenomas ◽  
Clinical Presentation ◽  
Pituitary Tumors ◽  
Clinical State ◽  
Resonance Imaging ◽  
First Line ◽  
Cell Variant ◽  
Potential Use ◽  
Pituitary Macroadenomas

Abstract OBJECTIVE The management of aggressive pituitary macroadenomas represents a challenge to neurosurgeons. These tumors are very difficult to treat, owing mainly to their invasive nature, thus resulting in incomplete resections and propensity for recurrence. Multiple surgical procedures (transsphenoidal, transcranial, or a combination of both) are the first line management, followed by radiotherapy and chemotherapy. CLINICAL PRESENTATION Three cases of patients with pituitary adenomas who underwent temozolomide treatment are presented. The first 2 patients had corticotroph macroadenoma of the Crooke's cell variant. Deterioration occurred in both cases despite multiple surgeries and adjuvant therapy. The third patient had a glioblastoma multiforme with an incidental pituitary tumor. INTERVENTION All 3 patients had temozolomide administered orally on the first 5 days of a 28-day cycle for 12 cycles. Magnetic resonance imaging, endocrinological, and clinical follow-up were performed at monthly intervals. CONCLUSION The marked improvement in clinical state of the first 2 patients accompanied by radiological evidence of tumor shrinkage in all patients demonstrates the potential use of temozolomide in treating aggressive pituitary macroadenomas. The usefulness of temozolomide in aggressive pituitary adenomas should be studied in larger trials.

scholarly journals The Rare Lateral Cuneocuboid Coalition: A Case Report

2019 ◽  
Vol 109 (3) ◽  
pp. 231-234
Author(s):  
Eric So ◽  
Kevin Renner ◽  
Amanda Quisno ◽  
Daniel Logan
Keyword(s):  
Case Report ◽  
Clinical Presentation ◽  
Limited Range ◽  
Activity Level ◽  
Resonance Imaging ◽  
Pes Planus ◽  
The Third ◽  
Limited Range Of Motion ◽  
The Common

Tarsal coalitions typically occur at the talocalcaneal or calcaneonavicular joints. Common findings are pain, limited range of motion, and a pes planus deformity. The focus of this case report includes the presentation, imaging, treatment, and outcomes for a 21-year-old woman diagnosed with a rare lateral cuneocuboid coalition with chronic pain. Clinical and radiographic examinations, typically used to diagnose the common coalition, were unremarkable. Magnetic resonance imaging was diagnostic of the lateral cuneocuboid coalition, which was successfully treated with surgical resection. At 6-year follow-up, she reports resolution of symptoms and has returned to her normal presurgical activity level pain-free. This case is only the third lateral cuneocuboid coalition reported in the literature. The rarity of this coalition and its nonsuspicious clinical presentation make it worthy of acknowledgment.

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