Iodine-125 interstitial brachytherapy after tumor excision: an alternative eye-sparing surgery for lacrimal gland carcinoma

2021 ◽  
Author(s):  
Yang-jun Li ◽  
Ping Wang ◽  
Shao-bo Zhang ◽  
Xiao-na Ning ◽  
Chen-jun Guo ◽  
...  
Keyword(s):  
Lacrimal Gland ◽  
Tumor Recurrence ◽  
Tumor Resection ◽  
Interstitial Brachytherapy ◽  
Tumor Excision ◽  
Control Tumor ◽  
Gland Carcinoma ◽  
Iodine 125 ◽  
Good Cosmesis

Abstract Background:To describe the preliminary suppressive effects of iodine 125 brachytherapy for malignant lacrimal gland tumors after excisionMethods:The study recruit 9 patients with lacrimal gland carcinoma from May 2017 to December 2020. All patients underwent eye sparing surgical tumor resection first and then received iodine 125 interstitial brachytherapy to prevent tumor recurrence. We look over whether tumor recurred or metastasized by detecting the visual function and CT/MRI/PET MRI of every patient.Results1 patient was lost visit. The median follow up period was 29 months of other 8 patients (range, 7 43 months). One patient experienced recurrence two years later but was free from local disease after iodine 125 seeds were implanted one more time. The vision of one female patient was lost due to the seeds moving to the optic nerve. In the remaining 6 patients the vision was no changed, and CT/MRI showed no tumor was recurrencedConclusions:Permanent iodine 125 strip implantation in the orbit can be used as an alternative eye sparing surgery for malignant lacrimal gland tumors after tumor excision. It can control tumor recurrence and maintenance of vision and good cosmesis.

scholarly journals C.02 Delayed new-onset hormone dysfunction following complete and incomplete resection of nonfunctioning pituitary adenomas

2017 ◽  
Vol 44 (S2) ◽  
pp. S12-S12
Author(s):  
J Han ◽  
AL Hebb ◽  
SA Imran ◽  
DB Clarke
Keyword(s):  
Pituitary Adenomas ◽  
Tumor Recurrence ◽  
Tumor Resection ◽  
Residual Tumor ◽  
Incomplete Resection ◽  
Inclusion Criteria ◽  
Nonfunctioning Pituitary Adenomas ◽  
One Year ◽  
Complete Tumor

Background: Post-operative delayed hormone dysfunction (DHD) in patients with nonfunctioning pituitary adenomas (NFPA) is highly variable and is predicted based on limited evidence. This study was undertaken to assess the likelihood of developing new DHD and its relation to the extent of tumor resection and recurrence. Methods: Four hundred fifty-five prospectively collected patient files were reviewed from our Program’s database. Inclusion criteria: NFPA; underwent surgery; and minimum follow-up of two years. Tumor recurrence was correlated with DHD (starting one year post-operatively) based on standardized annual imaging and hormone testing. Results: Eighty-nine patients met our inclusion criteria: 39 males and 50 females; mean follow-up was 4.3yrs (ranging from 2 to 11yrs). With no post-op residual tumor, the probability of developing DHD was only 7% by six years; no patient in this group developed DHD after three years of follow-up. In contrast, by six years, the probability of DHD was 33% in patients with residual stable tumor, and 54% in those with tumor recurrence/growth. Conclusions: By six years, approximately one third of patients with incomplete resection, and over half with tumor regrowth, will likely develop DHD. In contrast, the risk of DHD with complete tumor resection is <10% and, when seen, occurs within three years of surgery.

Myxopapillary Ependymoma of the Filum Terminale and Cauda Equina in Childhood: Report of Seven Cases and Review of the Literature

Neurosurgery ◽  
1984 ◽  
Vol 14 (2) ◽  
pp. 204-210 ◽  
Author(s):  
Helen S. L. Chan ◽  
Laurence E. Becker ◽  
Harold J. Hoffman ◽  
Robin P. Humphreys ◽  
Bruce E. Hendrick ◽  
...  
Keyword(s):  
Tumor Recurrence ◽  
Tumor Resection ◽  
Cauda Equina ◽  
Good Prognosis ◽  
Myxopapillary Ependymoma ◽  
Filum Terminale ◽  
Spinal Ependymoma ◽  
Neuroectodermal Tumors ◽  
Lost To Follow Up

Abstract Seven of fourteen children with spinal cord ependymoma had myxopapillary tumors of the filum terminale. These tumors made up 15.9% of all primary spinal neuroectodermal tumors in children (44 cases) seen during a 62-year period (1919 to 1981). Their clinical presentation, radiological features, pathological findings, treatment, and outcome are reported. Six of the seven patients were known to be alive at the time of writing. The seventh patient was lost to follow-up after 3 years without tumor recurrence. Of 5 patients whose primary mode of treatment was operation alone, 3 had intraspinal or intracranial recurrences. Despite tumor recurrences, 2 patients were long term survivors after further operation and irradiation, whereas the third patient recently received craniospinal irradiation for intracranial tumor recurrence. The 2 patients who did not have tumor recurrence after operation alone had been followed for 3 and 7 years, respectively. Two children with subtotal tumor resection and spinal irradiation had no recurrences at 1 and 17 years, respectively. Our data suggest that this unusual subtype of spinal ependymoma is not uncommon during childhood and has a good prognosis. All patients with this tumor require prolonged follow-up for tumor recurrence after operation and irradiation.

Late course of preserved hearing and tinnitus after acoustic neurilemoma surgery

1992 ◽  
Vol 77 (5) ◽  
pp. 685-689 ◽  
Author(s):  
Atul Goel ◽  
Laligam N. Sekhar ◽  
Walter Langheinrich ◽  
Donald Kamerer ◽  
Barry Hirsch
Keyword(s):  
Tumor Recurrence ◽  
Tumor Resection ◽  
Internal Auditory Canal ◽  
Cochlear Nerve ◽  
Nerve Section ◽  
Preoperative Level ◽  
Content Type ◽  
Fine Print ◽  
Better Than

✓ The late course of preserved hearing and tinnitus following retrosigmoid transmeatal surgery for acoustic neurilemoma is reported. Over a period of 5 years, useful hearing was preserved in 15 patients after preservation was attempted in 42 patients. In five patients the hearing was better than the preoperative level; in three it was worse. Three patients developed delayed worsening and fluctuations of hearing in the surgically treated ear during a median follow-up period of 2½ years. While the exact reason for such worsening was not clear in two patients, in one patient it appeared that the muscle graft placed in the internal auditory canal after tumor resection resulted in fibrosis and compromise of the cochlear nerve. The causes of delayed worsening of hearing in the absence of tumor recurrence are analyzed, and possible treatment and methods of prevention of worsening are suggested. In six patients, tinnitus persisted after surgery in the ear with successful preservation of hearing, but hearing was not worsened and the tinnitus was not bothersome to the patient. In one patient with preoperative tinnitus, hearing was not preserved and tinnitus persisted sufficiently to necessitate re-exploration and cochlear nerve section.

The long-term outcome after surgical treatment of dorsally exophytic brain-stem gliomas

1993 ◽  
Vol 78 (6) ◽  
pp. 859-863 ◽  
Author(s):  
Ian F. Pollack ◽  
Harold J. Hoffman ◽  
Robin P. Humphreys ◽  
Larry Becker
Keyword(s):  
Radiation Therapy ◽  
Brain Stem ◽  
Fourth Ventricle ◽  
Tumor Resection ◽  
Postoperative Radiation Therapy ◽  
Tumor Excision ◽  
Tumor Enlargement ◽  
Brain Stem Gliomas

✓ Dorsally exophytic brain-stem gliomas represent a distinctive subgroup of pediatric brain-stem neoplasms that are amenable to radical excision because of their benign histology and growth characteristics. However, their attachment to the floor of the fourth ventricle invariably precludes complete tumor excision. The long-term behavior of the residual tumor remains a subject of concern. To address this issue, the authors reviewed their experience with 18 dorsally exophytic brain-stem gliomas treated between 1974 and 1990. At operation, the tumors filled the fourth ventricle, fungating out of a broad-based area of the dorsal brain stem. The exophytic tumor was resected, but no attempt was made to remove tumor from the brain stem. Histological examination showed that 16 of the tumors were grade I or II astrocytomas, one was a ganglioglioma, and one was an otherwise benign-appearing glioma with several foci of anaplasia that was classified as a grade III astrocytoma. The latter patient was one of only two in the series to receive postoperative radiation therapy; both cases so treated have no evidence of disease on follow-up imaging studies 61 and 135 months postoperatively. One other child who had stable disease postoperatively died of shunt malfunction 18 months after tumor excision. Serial radiographic studies in the other 15 patients have shown no evidence of disease in three, stable residual disease in eight, and tumor enlargement 12, 28, 40, and 84 months postoperatively in four (median follow-up period 113 months). Each of the four patients with tumor regrowth underwent repeat tumor excision. Two of these children received perioperative radiation therapy at the time of disease progression and both showed reduction in tumor volume 28 and 65 months after their second operation. In contrast, both patients who did not receive radiotherapy at the time of disease progression had further tumor enlargement 48 and 84 months after their second operation and underwent a third tumor resection; one received postoperative radiation therapy and has no evidence of disease 58 months after his third operation and the other child has stable disease 27 months postoperatively. Histological examination of tumor specimens obtained at second and third operations showed no change from the appearance of the tumor on the initial resection. The authors conclude that the majority of dorsally exophytic brain-stem gliomas can be managed successfully with subtotal excision and, if necessary, cerebrospinal fluid diversion. The small percentage of tumors in this series that showed recurrent growth remained benign histologically. In these patients, repeat tumor resection and radiotherapy appeared to be effective in maintaining long-term disease control.

scholarly journals Divisional Reconstruction Strategy: The Repair of Perineal Skin Defect After Tumor Resection

2020 ◽  
pp. 145749692090398
Author(s):  
J.-G. Xu ◽  
M.-L. Wu ◽  
H.-Y. Dai ◽  
Y.-C. Wang ◽  
C.-Y. Xue
Keyword(s):  
Tumor Recurrence ◽  
Physiological Function ◽  
Tumor Resection ◽  
Skin Defect ◽  
Skin Area ◽  
Scar Contracture ◽  
Defect Area ◽  
Perineal Skin ◽  
Reconstruction Strategy

Background and Aims: The unique anatomical and physiological function of the perineum region makes it difficult to be repaired after tumor resection. We aim to evaluate the efficacy of PSC divisional reconstruction strategy in the reconstruction of perineal skin defect. Materials and Methods: This study includes patients undergoing perineal skin defect reconstruction with PSC strategy—P (penis), S (scrotum), C (circum-penoscrotal skin) divisional reconstruction strategy. Results: From August 2013 to August 2018, 47 patients were enrolled in the surgical procedure. The defect area after resection measured 2 cm × 2.5 cm, minimum, and 12 cm × 18 cm, maximum. Among them, the cases involved one, two, and three zones are 12, 10, and 25, respectively. The skin defects were divisionally repaired. All flaps were well survived without complications or scar contracture. No tumor recurrence happened. Conclusion: The application of PSC divisional reconstruction strategy is a promising way to repair wounds in circum-penoscrotal skin area. Moreover, this strategy is easy to process and shows no significant complications during follow-up period.

scholarly journals Predictors of Functional Outcome after Spinal Ependymoma Resection

2018 ◽  
Vol 09 (03) ◽  
pp. 354-358 ◽  
Author(s):  
Ivan Domazet ◽  
Ivan Paŝalić ◽  
Jakob Nemir ◽  
Vjerislav Peterković ◽  
Miroslav Vukić
Keyword(s):  
Functional Outcome ◽  
Tumor Recurrence ◽  
Histological Grade ◽  
Tumor Resection ◽  
Important Predictor ◽  
Mass Reduction ◽  
Tumor Mass ◽  
Spinal Ependymoma ◽  
Spinal Region

ABSTRACT Aim: Spinal ependymomas are among the most common intramedullary neoplasms in both adults and children. While surgical resection is the golden treatment standard, the role chemotherapy and radiotherapy have in patients with spinal ependymomas remains unclear. The aim of this study is to determine the predictors of functional outcome following spinal ependymoma resection to single out patients that may require adjuvant therapy. Methods: We conducted a retrospective study on patients that underwent spinal ependymoma resection in our institution in a 10-year period. Magnetic resonance imaging of the spine was used to set the diagnosis of an intradural/intramedullary neoplasm. All patients underwent either gross tumor resection or tumor mass reduction. Histological diagnosis and histopathological grading of spinal ependymoma were done for all collected samples. Patients’ general and neurological examination were performed early after the surgery (within the 1st week) and in a 6-month follow-up. Results: A total of 51 intradural and intramedullary ependymoma resection surgeries on 43 patients were performed. There were slightly more male patients (57%) and the average patient age was 41 years. About 76.5% of patients presented with a tumor affecting one vertebrae level, while 23.5% presented with tumors expanding over two or more spinal regions. Gross tumor resection was achieved in 80% of cases, while 25% of procedures were performed on a recurring ependymomas. Most of the tumors (57%) were classified as G2 histological grade, while 8% were anaplastic ependymomas. In 80% of cases, early postoperative patient status was either better or equivalent to the preoperative one, while in a 6-month follow-up, up to 60% of cases showed a significant improvement over the preoperative status. Different demographic and clinical parameters were not proven to be predictors of postsurgical patient outcome including age, gender, and initial neurological presentation. Interestingly, most tumor characteristics were also not associated with postoperative functional outcome (histological grade, number of vertebrae levels affected, whether it is a primary or recurrent tumor). Even the scope of surgical procedure did not affect the functional outcome. The spinal region affected by the tumor was proven to be a predictor of early postoperative outcome (ρ = 0.346, P = 0.033), with lumbar spine being associated with the best outcomes. As expected, the scope of the surgery and whether gross tumor resection or tumor mass reduction was performed were the only significant predictors of tumor recurrence (ρ = 0.391, P = 0.005). Conclusions: Spinal ependymoma resection is an efficient procedure that improves the patient outcomes. Spinal region affected by the tumor is likely to be the most important predictor of functional outcome, while the procedure scope seems to be the most important predictor of tumor recurrence.

Extended Anterior Inferior Approach to Endoscopic Medial Maxillectomy for Maxillary Sinus Lesions

2021 ◽  
pp. 194589242110253
Author(s):  
Alice E. Huang ◽  
Christopher M. Low ◽  
Janalee K. Stokken
Keyword(s):  
Maxillary Sinus ◽  
Tumor Recurrence ◽  
Tumor Resection ◽  
Nasolacrimal Duct ◽  
Surgical Morbidity ◽  
Advantages And Disadvantages ◽  
Case Series Study ◽  
Patient Reported ◽  
Medial Maxillectomy

Background Myriad open and endoscopic approaches are employed to resect maxillary sinus lesions, each with associated advantages and disadvantages. The inferior and anterior portion of the sinus remains a challenging space to access. Objectives To describe the extended anterior inferior approach to endoscopic medial maxillectomy (EAMM) as a novel and valuable addition to a stepwise approach for minimizing surgical morbidity without compromising tumor outcomes. To report the outcomes of patients treated with this approach. Methods A retrospective case series study of 9 patients who underwent EAMM between 2016 and 2019 at a tertiary care referral center was performed. The endoscopic technique is described. The duration of follow-up ranged from 1 to 53 months. Intraoperative steps, including transection of the nasolacrimal duct and execution of an intraoperative dacryocystorhinostomy, were reviewed. Postoperative outcomes, including patient symptoms at follow-up and tumor recurrence, were recorded. Results Adequate exposure with gross total tumor resection or margin-negative tumor resection was achieved in all cases. Sparing of the nasolacrimal duct was achieved in 2 patients. No patients reported persistent epiphora, empty nose syndrome, or changes in cosmesis such as alar or nasal tip collapse. One patient reported unilateral V2 hypoesthesia at 6 months postoperatively that had resolved by his next follow-up 18 months after surgery. Postoperative tumor surveillance was achieved by endoscopic examinations in all patients and there was no evidence of tumor recurrence at a median follow-up of 22 months. Conclusions The EAMM provides improved access to the inferior–posterior–medial maxillary sinus. This approach minimizes the risk of hypoesthesia and change in cosmesis present in other approaches, and obviates division of the nasolacrimal duct for inferior, posterior–medial attached lesions. This progressive escalation of approach for maxillary sinus lesions minimizes injury to nasal and nasolacrimal structures without compromising tumor outcomes.

scholarly journals Dorsal epidural “Spindle Cell Lipoma” in a pregnant female

2021 ◽  
Vol 12 ◽  
pp. 162
Author(s):  
Valerio di Norcia ◽  
Luigi Valentino Berra ◽  
Luca D’Angelo ◽  
Antonio Santoro
Keyword(s):  
Thoracic Spine ◽  
Tumor Recurrence ◽  
Spindle Cell ◽  
Clinical Course ◽  
Malignant Degeneration ◽  
Spindle Cell Lipoma ◽  
Tumor Excision ◽  
Progressive Paraparesis ◽  
Lipomatous Tumors

Background: Spindle cell lipoma (SCL) constitutes just 1.5% of all lipomatous tumors. They typically occur in the upper back and shoulders. Here, we report a 37-year-old female presenting with a SCL in the dorsal epidural thoracic spine, during her 9th month of pregnancy. Case Description: A 37-year-old female presented with a subacute (2 months) progressive paraparesis during her 9th month of pregnancy. The MR showed a dorsal epidural mass at the D8 level. Following a cesarean section, the patient underwent a laminectomy for tumor excision. Microscopically, the lesion proved to be a SCL. At 5-year follow-up, there was no tumor recurrence. Conclusion: SCL represents a variant of benign lipomas that may occur in the dorsal thoracic spine. Gross total excision may be followed by a benign clinical course without recurrence or malignant degeneration. Very atypical SCLs need closer follow-up to avoid the misdiagnosis of liposarcoma.

scholarly journals Melanotic Neuroectodermal Tumor of Infancy in the Maxilla

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Daniel Falbo Martins de Souza ◽  
Daniel Isaac Sendyk ◽  
Juliana Seo ◽  
Eduardo Vasques da Fonseca ◽  
Maria da Graça Naclério-Homem ◽  
...  
Keyword(s):  
Tumor Recurrence ◽  
Surgical Excision ◽  
Optimal Outcome ◽  
Recurrence Rates ◽  
Anterior Maxilla ◽  
Tumor Excision ◽  
Complete Surgical Excision ◽  
Neuroectodermal Tumors ◽  
One Year

Melanotic neuroectodermal tumors of infancy (MNTIs) are rare fast-growing tumors with high recurrence rates. These tumors, which originate in the neural crest, commonly occur in the anterior maxilla of children under the age of one. Here, we describe an MNTI case in a two-month-old girl with increasing swelling in the left cheek. MNTI was diagnosed in this case following tomography and biopsy. The patient's histological and immunohistochemical profile indicated a remarkable combination of neural, melanocytic, and epithelial cell differentiation. One year following tumor excision, a follow-up examination revealed that the child exhibited no tumor recurrence. Approximately 260 cases of MNTI have been reported since this type of tumor was first described. In the present case, early diagnosis minimized the difficulties and risks associated with treatment and facilitated an optimal outcome. Despite complete surgical excision, careful followup is recommended. In addition, maxillary functional orthopedics and reconstruction may be necessary in cases of MNTI.

scholarly journals Neurosurgical treatment of low-grade cerebellar astrocytoma in children and adolescents: a single consecutive institutional series of 100 patients

2013 ◽  
Vol 11 (3) ◽  
pp. 245-249 ◽  
Author(s):  
Bernt Johan Due-Tønnessen ◽  
Tryggve Lundar ◽  
Arild Egge ◽  
David Scheie
Keyword(s):  
Children And Adolescents ◽  
Barthel Index ◽  
Tumor Recurrence ◽  
Tumor Resection ◽  
Long Term Results ◽  
Low Grade ◽  
Cerebellar Astrocytoma ◽  
Persistent Hydrocephalus

Object The objective of this study was to delineate the long-term results of surgical treatment of pediatric low-grade cerebellar astrocytoma. Methods One hundred consecutive children and adolescents (0–19 years old) who underwent primary tumor resection for a low-grade cerebellar astrocytoma during the years 1980–2011 were included in this retrospective study on surgical morbidity, mortality rate, academic achievement, and/or work participation. Gross motor function and activities of daily living were scored according to the Barthel Index. Results Of the 100 patients, 61 children were in the 1st decade, and 39 were 10–19 years old. The male/female ratio was 1.13:1 (53 males, 47 females). No patients were lost to follow-up. There were no deaths in this series and all 100 patients are currently alive. In 29 patients, the follow-up duration was less than 10 years, in 37 it was between 10 and 19 years, and in 34 it was between 20 and 31 years. The Barthel Index was 100 (normal) in 97 patients, 90 in 2 patients, and 40 in the last patient. A total of 113 tumor resections were performed. Two patients underwent further tumor resection due to MRI-confirmed residual tumor demonstrated on the immediate postoperative MR image (obtained the day after the initial procedure). Furthermore, 9 children underwent repeat tumor resection after MRI-confirmed progressive tumor recurrence up to 10 years after the initial operation. Two of these patients also underwent a third resection, without subsequent radiation therapy, and have experienced 8 and 12 years of tumor-free follow-up thereafter, respectively. A total of 15% of the patients required treatment for persistent hydrocephalus. Conclusions Low-grade cerebellar astrocytoma is a surgical disease, in need of long-term follow-up, but with excellent long-term results. Nine percent of the children in this study underwent repeated surgery due to progressive tumor recurrence, and 15% were treated for persistent hydrocephalus.

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