scholarly journals Fluorescein Sodium Use during Spinal Ependymoma Resection

2017 ◽  
Vol 3 (3) ◽  
pp. 123-134
Author(s):  
Zhenxing Sun ◽  
Dan Yuan ◽  
Yaxing Sun ◽  
Zhanquan Zhang ◽  
James Wang ◽  
...  
Keyword(s):  
Removal Rate ◽  
Sensory Function ◽  
Fluorescent Light ◽  
Surgical Removal ◽  
Fluorescein Sodium ◽  
Tumor Removal ◽  
Intramedullary Tumors ◽  
Complete Tumor Removal ◽  
Complete Tumor

Spinal ependymomas (SEs) are common adult intramedullary tumors; however, determining the absolute boundary between the tumor and the tumor residual may be difficult. We assessed outcomes following the use of fluorescein sodium (FS) during surgical removal of SEs. We performed a retrospective analysis of 112 patients with SEs who were treated at Beijing Tsinghua Changgung Hospital between December 2014 and December 2016. Each patient received intravenous FS (3–4 mg/kg) to determine the SE boundaries during surgery. Tumor removal efficiencies and tumor residuals were assessed using magnetic resonance imaging (MRI) at 10 days and 3 months after surgical recovery; McCormick's spinal function classification was also performed at the 3-month follow-up. The complete tumor removal rate was 92% (103/112). Ninety-four patients underwent tumor removal under fluorescent light, which provided distinctive tumor fluorescence. Tumor removal under white light was performed in 18 patients; fluorescent images were invisible or indistinctive in these 18 patients. At the 3-month follow-up, sensory function (85.8% (91/106)) and movement (84.3% (86/102)) were improved in patients with pre-surgical dysfunction; urination and defecation functions were improved in 66.7% (16/24). The McCormick spinal cord functional classifications, at the 3-month follow-up, showed significant differences in the percentages of patients with disease classified to each grade (I–IV), compared with preoperative classifications (each, P < 0.05). There was no MRI evidence of tumor relapse or residuals at the 3-month follow-up. FS use during the surgical treatment of SE enables complete tumor removal and detection of tumor residuals.

Spinal Meningiomas: Review of 174 Operated Cases

Neurosurgery ◽  
1989 ◽  
Vol 25 (2) ◽  
pp. 153-160 ◽  
Author(s):  
Carlo L. Solero ◽  
Maurizio Fornari ◽  
Sergio Giombini ◽  
Giovanni Lasio ◽  
Giuseppe Oliveri ◽  
...  
Keyword(s):  
Neurological Impairment ◽  
Neurological Deficits ◽  
Long Term Results ◽  
Tumor Removal ◽  
Microsurgical Technique ◽  
Complete Tumor Removal ◽  
Spinal Meningiomas ◽  
Subtotal Removal ◽  
Complete Tumor

Abstract The long-term results obtained in a series of 174 patients operated on for spinal meningiomas are critically analyzed. This series was similar to those of other authors with regard to age, sex, location of the tumors, and clinical presentation. Before surgery, about 70% of the patients were included in Groups I and II (mild neurological impairment), and about 30% of the patients were classified in Groups III and IV (significant to severe neurological impairment, up to paraplegia). Complete tumor removal was achieved in 96.5% of the patients, and surgical mortality was about 1%. Microsurgical technique, which was adopted in the last 29 cases, proved to be very effective in reducing undue damage to the spinal cord and in minimizing the postoperative neurological deficits. Of the 174 patients who underwent surgery, 156 underwent late follow-up study for an average of 15 years (2 patients died in the immediate postoperative period, and 16 patients were lost to follow-up). Twenty-nine patients died of causes unrelated to the spinal meningioma; of the remaining 126 patients, 92% were categorized in Groups I and II, and only 8% in Groups III and IV. The rate of recurrence was 6% (9 patients) among the 150 patients who had complete tumor removal, and the rate of regrowth was 17% (1 patient with anaplastic meningioma) among the 6 patients treated by subtotal removal. The early diagnosis of the disease and the use of microsurgical technique appeared as the most relevant factors for further improvement of the surgical results.

Spinal en Plaque Meningiomas: A Contemporary Experience

Neurosurgery ◽  
2004 ◽  
Vol 55 (6) ◽  
pp. 1275-1279 ◽  
Author(s):  
Emanuela Caroli ◽  
Michele Acqui ◽  
Raffaelino Roperto ◽  
Luigi Ferrante ◽  
Giancarlo D'Andrea
Keyword(s):  
Surgical Treatment ◽  
Surgical Removal ◽  
Tumor Removal ◽  
Medline Search ◽  
Complete Tumor Removal ◽  
Spinal Arachnoiditis ◽  
Surgical Cure ◽  
Spinal Meningiomas ◽  
Subtotal Removal ◽  
Complete Tumor

Abstract OBJECTIVE: Spinal en plaque meningiomas are rare and challenging lesions because of their tendency to induce spinal arachnoiditis. The surgical treatment of this type of meningioma is more complex than that of classic meningioma. METHODS: We report seven cases of spinal en plaque meningiomas and review all the cases reported in the literature accessible to us by a MEDLINE search. RESULTS: All patients underwent microsurgery. Complete tumor removal was achieved in three patients. Subtotal removal was performed in four patients. A permanent neurological worsening was observed in one patient. CONCLUSION: Spinal meningiomas en plaque bear a prognosis poorer than that of classic meningiomas with regard to the possibility of a definitive surgical cure because recurrence or postoperative arachnoiditis occurs frequently. Total surgical removal should be attempted only when a clear plane of cleavage between tumor and arachnoid exists.

Intracanalicular Acoustic Neurinomas

Neurosurgery ◽  
1991 ◽  
Vol 29 (2) ◽  
pp. 189-199 ◽  
Author(s):  
Madjid Samii ◽  
Cordula Matthies ◽  
Marcos Tatagiba
Keyword(s):  
Resonance Imaging ◽  
Tumor Removal ◽  
Diagnostic Reliability ◽  
Computed Tomographic ◽  
Acoustic Neurinomas ◽  
Vestibular Symptoms ◽  
Symptoms And Signs ◽  
Facial Function ◽  
Complete Tumor

Abstract The cases of 16 patients with acoustic neurinomas confined to the intracanalicular area are presented. These represent 2.7% of the 600 patients with acoustic neurinomas consecutively operated upon at the Neurosurgical Clinic at Nordstadt Hospital during the last 8 years. The comparatively earlier onset of vestibular symptoms and signs was characteristic of this group and precipitated diagnosis. The diagnostic reliability of magnetic resonance imaging was at least equivalent to that of air computed tomographic cisternography. Complete tumor removal was accomplished via the suboccipital approach in all patients, with 100% preservation of facial nerve and facial function; the cochlear nerve was preserved anatomically in 100% of the patients and functionally in 57%. No recurrence has occurred during follow-up periods of up to 8 years in all 16 patients. A broad spectrum of the current literature is considered, and purely intracanalicular acoustic neurinomas are discussed with regard to clinical characteristics, diagnostic steps—including neuroradiological and neurophysiological approaches—and surgical treatment and results.

Early results of surgery in patients with nonfunctioning pituitary adenoma and analysis of the risk of tumor recurrence

2008 ◽  
Vol 108 (3) ◽  
pp. 525-532 ◽  
Author(s):  
Marco Losa ◽  
Pietro Mortini ◽  
Raffaella Barzaghi ◽  
Paolo Ribotto ◽  
Maria Rosa Terreni ◽  
...  
Keyword(s):  
Tumor Recurrence ◽  
Postoperative Radiotherapy ◽  
Residual Tumor ◽  
Benign Tumors ◽  
Surgical Removal ◽  
Tumor Diameter ◽  
Tumor Removal ◽  
Early Results ◽  
Results Of Surgery

Object Nonfunctioning pituitary adenomas (NFPAs) are benign tumors of the pituitary gland that typically cause visual and/or hormonal dysfunction. Surgery is the treatment of choice, but patients remain at risk for tumor recurrence for several years afterwards. The authors evaluate the early results of surgery and the long-term risk of tumor recurrence in patients with NFPAs. Methods Between 1990 and 2005, 491 previously untreated patients with NFPA underwent surgery at the Università Vita-Salute. Determinations of recurrence or growth of the residual tumor tissue during the follow-up period were based on neuroradiological criteria. Results Residual tumor after surgery was detected in 173 patients (36.4%). Multivariate analysis showed that invasion of the cavernous sinus, maximum tumor diameter, and absence of tumor apoplexy were associated with an unfavorable surgical outcome. At least 2 sets of follow-up neuroimaging studies were obtained in 436 patients (median follow-up 53 months). Tumors recurred in 83 patients (19.0%). When tumor removal appeared complete, younger age at surgery was associated with a risk of tumor recurrence. In patients with incomplete tumor removal, adjunctive postoperative radiotherapy had a marked protective effect against growth of residual tumor. Conclusions Complete surgical removal of NFPAs can be safely achieved in > 50% of cases. Visual symptoms and, less frequently, pituitary function may improve after surgery. However, tumor can recur in patients after apparently complete surgical removal. In patients with incomplete tumor removal, radiation therapy is the most effective adjuvant therapy for preventing residual tumor growth.

Extraspinal ependymomas

1979 ◽  
Vol 51 (3) ◽  
pp. 383-391 ◽  
Author(s):  
Robert A. Morantz ◽  
John J. Kepes ◽  
Solomon Batnitzky ◽  
Byron J. Masterson
Keyword(s):  
Anterior Approach ◽  
Ependymal Cell ◽  
Review Of The Literature ◽  
Tumor Removal ◽  
Nerve Roots ◽  
Content Type ◽  
The Third ◽  
Complete Tumor Removal ◽  
Pilonidal Cyst ◽  
Complete Tumor

✓ Spinal ependymomas may rarely arise from heterotopic ependymal cell clusters and thus occur in an extraspinal location. Presentation of three cases and a review of the literature reveal that these tumors have characteristic radiographic and clinical features. They occur mainly in patients in the third decade of life, and present either in the soft tissue posterior to the sacrum or in the pelvis. In the case of posterior tumors, the patient exhibits a mass which is usually mistaken for a pilonidal cyst. Patients whose tumor is pelvic in location present with sphincter disturbances or dysfunction of the sacral nerve roots. Conventional and computerized tomographic studies will reveal erosion of the sacrum. Myelography will demonstrate an extradural mass indenting the thecal sac from below. The protein in the cerebrospinal fluid will be normal. A combined posterior and anterior approach with the goal of complete tumor removal is the procedure of choice. If this is not feasible, then radiation therapy should be employed. Because of the increased incidence of systemic metastases, the average postoperative survival is approximately 10 years.

Meningioma Involving Meckel's Cave: Transpetrosal Surgical Anatomy and Clinical Considerations

2002 ◽  
Vol 111 (9) ◽  
pp. 850-854 ◽  
Author(s):  
Daniel I. Choo ◽  
David L. Steward ◽  
Myles L. Pensak
Keyword(s):  
Facial Pain ◽  
Skull Base Surgery ◽  
Surgical Anatomy ◽  
Tumor Removal ◽  
Meckel’S Cave ◽  
Complete Tumor Removal ◽  
Meckel's Cave ◽  
Intimate Knowledge ◽  
Clinical Considerations ◽  
Complete Tumor

Meningiomas originating in Meckel's cave (MC) are uncommon lesions that represent 1% of all intracranial meningiomas. Innovations in skull base surgery have enabled resection of these lesions with less morbidity, but require an intimate knowledge of both lesional pathology and regional microneuroanatomy. To review the surgical and clinical considerations involved in the management of MC meningiomas, we retrospectively reviewed data from patients who underwent transpetrosal resection of primary MC meningiomas between 1984 and 1998. Of 146 patients who underwent transpetrosal removal of meningiomas, 7 were believed to have tumors originating in MC. All 7 patients presented with trigeminal dysfunction, facial pain, and/or headache. Complete tumor removal was achieved in 5 of the 7 patients. Facial hypoesthesia or anesthesia, paralysis of cranial nerve VI, and ophthalmoplegia were among the postoperative complications encountered. Meningiomas of MC represent treatable lesions whose diagnosis requires prompt imaging of patients with trigeminal dysfunction and symptoms of facial pain and headache.

Primary polymorphous low-grade adenocarcinoma of the bronchus: Complete tumor removal with bronchoscopic resection

Lung Cancer ◽  
2009 ◽  
Vol 63 (2) ◽  
pp. 301-304 ◽  
Author(s):  
Viboon Boonsarngsuk ◽  
Thitiporn Suwatanapongched ◽  
Mana Rochanawutanon ◽  
Montian Ngodngamthaweesuk ◽  
Piemsak Prakardvudhisarn
Keyword(s):  
Low Grade ◽  
Tumor Removal ◽  
Complete Tumor Removal ◽  
Complete Tumor

Olfactory Groove Meningiomas: Clinical Outcome and Recurrence Rates after Tumor Removal Through the Frontolateral and Bifrontal Approach

Neurosurgery ◽  
2007 ◽  
Vol 60 (5) ◽  
pp. 844-852 ◽  
Author(s):  
Makoto Nakamura ◽  
Melena Struck ◽  
Florian Roser ◽  
Peter Vorkapic ◽  
Madjid Samii
Keyword(s):  
Clinical Outcome ◽  
Recurrence Rate ◽  
Tumor Resection ◽  
Surgical Removal ◽  
Tumor Removal ◽  
Recurrence Rates ◽  
Olfactory Groove ◽  
Total Tumor Removal ◽  
Frontolateral Approach

Abstract OBJECTIVE Olfactory groove meningiomas account for 8 to 13% of all intracranial meningiomas. Surgical removal is often performed through the bifrontal, unilateral subfrontal (frontolateral), or pterional approach. We report on the clinical outcome and recurrence rate after surgical treatment of olfactory groove meningiomas in our neurosurgical department. METHODS A retrospective study was conducted by analyzing the charts of the patients, including surgical records, discharge letters, histological records, follow-up records, and imaging studies. RESULTS A total of 1800 meningiomas were operated on between 1978 and 2002 in our department. There were 82 patients with olfactory groove meningiomas, including 63 women and 19 men with a mean age of 57.8 years (age range, 33–91 yr). Most patients presented with mental disturbance. Tumors were operated through the bifrontal (n = 46), frontolateral (n = 34), and pterional (n = 2) approaches. Total tumor removal (Simpson Grade 1 or 2) was achieved in most cases (91.2% frontolateral, 93.5% bifrontal). Perioperative mortality was 4.9% (four out of 82 patients, all operated through the bifrontal approach). The overall recurrence rate was 4.9%, with four patients requiring surgery. The mean follow-up period was 63.4 months (range, 4–270 mo). CONCLUSION Olfactory groove meningiomas were removed mainly through two different surgical approaches. Even in large tumors, high rates of total tumor resection could also be achieved with low recurrence rates using the simple and minimally invasive frontolateral approach. In recent years, we have preferred to use the frontolateral approach, which provides quick access to the tumor with less brain exposure while still enabling total tumor removal with a low morbidity rate and no mortality.

Sign in / Sign up

Export Citation Format

Share Document