Meningeal Melanocytoma of the Middle Cranial Fossa: A Case Report

2020 ◽  
Vol 13 (1) ◽  
pp. 71-75
Author(s):  
Iliya V. Valkov ◽  
Milan N. Mladenovski
Keyword(s):  
Middle Cranial Fossa ◽  
Histopathological Diagnosis ◽  
Meningeal Melanocytoma ◽  
S 100 ◽  
The Central Nervous System ◽  
Cranial Fossa ◽  
Ultrastructural Characteristics ◽  
The Right ◽  
Slow Growing

Summary The term meningeal melanocytoma was first introduced by Limas and Tio in 1972 to figure out lesions of the central nervous system that, under light microscope view, have meningioma characteristics, and ultrastructural characteristics of melanocyte neoplasm, respectively. Meningeal melanocytomas (MM) represent 0.06-0.1% of brain tumors. The annual incidence is about 1 per 10 million. This type of neoplasm is rarely seen in clinical practice. A few cases have been reported in the literature. A 62-year-old man was admitted, complaining of trigeminal pain in the area of the I and II branches of CN V on the left of his face. He underwent two surgeries in a row. First, malignant melanoma, and then meningeal melanocytoma were histologically verified. Neurological examination demonstrated hyperpigmented left iris, neuralgic pain in I and II branches of CN V, latent central hemiparesis and hemihypesthesia for the right extremities, positive Babinski reflex on the right, positive axial pathological reflexes, and partial motor aphasia. Primary intracranial meningeal melanocytoma is difficult to diagnose preoperatively because of the tumor’s non-specific clinical and neuroradiological characteristics. So electron microscopy and immunohistochemical additional diagnostic confirmation are mandatory. Immunohistochemical findings - the presence of S-100 protein, vimentin, and antimelanocyte antigen HMB-45, no reaction for EMA and ultrastructural (melanosomes in different maturation, contacts type zonula adherens) are all in favour of the histopathological diagnosis of MM. Meningeal melanocytoma is a slow-growing tumor, biologically benign, and attempts for surgical radicalism are recommended. It is not entirely clear whether a malignant transformation of these tumors is possible. The role of chemotherapy also remains questionable and has not been documented as effective.

Giant-cell tumor of the middle cranial fossa

1987 ◽  
Vol 66 (6) ◽  
pp. 924-928 ◽  
Author(s):  
J. Max Findlay ◽  
David Chiasson ◽  
Alan R. Hudson ◽  
Mario Chui
Keyword(s):  
Giant Cell Tumor ◽  
Giant Cell ◽  
Adjuvant Radiotherapy ◽  
Middle Cranial Fossa ◽  
Cell Tumor ◽  
Content Type ◽  
Cranial Fossa ◽  
The Right ◽  
Fine Print

✓ The authors report the case of a 23-year-old man with a giant-cell tumor of the right middle cranial fossa floor. His presentation and management are described, and some aspects of this rare neoplasm of the skull base are reviewed. The role of adjuvant radiotherapy is discussed.

Cribriform Adenocarcinoma of the Minor Salivary Gland (CAMSG); A Separate and Malignant Entity

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S24-S24
Author(s):  
H Laharwani ◽  
T Woods ◽  
J Jackson ◽  
V Manucha ◽  
I Velasco
Keyword(s):  
Salivary Gland ◽  
Cell Carcinoma ◽  
Skull Base ◽  
Minor Salivary Gland ◽  
Middle Cranial Fossa ◽  
Salivary Gland Neoplasm ◽  
Left Neck ◽  
S 100 ◽  
The Face ◽  
Cranial Fossa

Abstract Introduction/Objective Cribriform adenocarcinoma of the minor salivary gland (CAMSG) is a recently described salivary gland neoplasm (SGN) that WHO includes under the polymorphous adenocarcinoma (PAC) subheading. CAMSG is reported to occur mostly in the base of the tongue and lingual tonsils. Methods We present a case of CAMSG of buccal mucosa in a 48-year old woman who presented with pain and swelling on the left side of the face that started after tooth extraction. Imaging revealed a large expansile mass (5.8 x 4.3 x 6.1 cm) originating in the left mandibular angle extending into masticator space, maxillary sinus, pterygopalatine fossa, sphenoid, middle cranial fossa, orbit and skull base. Ameloblastoma, primary intraosseous carcinoma, and squamous cell carcinoma were considered. Incisional biopsy revealed a tumor comprised of round to ovoid cells with clear to vesicular nuclei (ground-glass appearance) and occasional mitosis present in irregular solid, cribriform, and microcystic patterns in a hyalinized stroma with the presence of abundant mucin within lobules and stroma. Results Differential diagnosis of secretory carcinoma, hyalinizing clear cell carcinoma, and less likely PAC and mucoepidermoid carcinoma were considered, all inconsistent with the imaging findings. The tumor cells were positive for S100 and negative for CD117, ki67, p63, CD117, and TTF-1. Based on a prominent cribriform pattern, vesicular nuclei, and S-100 expression, a diagnosis of cribriform adenocarcinoma of minor salivary gland origin was rendered. The patient subsequently underwent left partial maxillectomy, left partial mandibulectomy, and resection of the skull base and left neck dissection and was staged as pT4bN0, with negative margins and vascular invasion. The patient underwent radiation therapy and at 6- month follow up was alive and healthy. Clinically and histologically CAMSG overlaps with tumors of both salivary and non-salivary gland origin. Conclusion Recognition of CAMSG as a distinct entity will help in accurate diagnosis and categorization in the WHO classification of SGNs.

Facial Nerve Neuroma

1994 ◽  
Vol 73 (10) ◽  
pp. 721-752 ◽  
Author(s):  
Jack L. Pulec
Keyword(s):  
Facial Nerve ◽  
Signs And Symptoms ◽  
Middle Cranial Fossa ◽  
Nerve Graft ◽  
Surgical Removal ◽  
Optimal Conditions ◽  
Anatomic Site ◽  
Cranial Fossa ◽  
Slow Growing ◽  
Facial Function

Facial nerve neuromas are uncommon, slow-growing neoplasms that may occur anywhere along the course of the facial nerve from the brainstem to the facial muscles. The signs and symptoms are characteristic and vary with the anatomic site of origin. Surgery should not be attempted until a complete and thorough diagnostic examination has been completed. The surgeon should be prepared to perform a middle-cranial fossa or translabyrinthine approach in all cases, and must expect to do a nerve graft. The results of 37 patients treated by the author reveal that, under optimal conditions, patients who have had a facial nerve graft, can be expected to regain an average of 80 % facial nerve strength in almost every case. All patients who have had a facial nerve graft will have some degree of synkinesis. No graft was required in 3 patients, and a hypoglossal facial anastomosis was used for one. Facial function was completely normal in 2 patients, 16 had 80 – 90 % return, 5 patients had 50 – 80 % return, 4 had 20 – 50% return, one had no recovery at all and 9 recent patients have not reached the time for their expected recovery. Early diagnosis, prompt surgical removal and VII - VII Nerve graft for facial paralysis of ten or fewer years duration offers patients the best opportunity to avoid a permanent facial palsy.

Location of the middle cranial fossa dural plate in patients with chronic otitis media

2014 ◽  
Vol 128 (1) ◽  
pp. 60-63 ◽  
Author(s):  
S Genc ◽  
M G Genc ◽  
I B Arslan ◽  
A Selcuk
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Middle Cranial Fossa ◽  
Control Group ◽  
Adjacent Structures ◽  
Cranial Fossa ◽  
The Mean ◽  
Bone Scans ◽  
The Right ◽  
And Control

AbstractAim:This study aimed to determine whether or not the middle cranial fossa dural plate is located lower (i.e. more caudally) in patients with chronic otitis media, relative to adjacent structures.Methods:The authors retrospectively investigated computed tomography temporal bone scans of 267 ears of 206 patients who had undergone surgery with a diagnosis of chronic otitis media, together with scans of 222 ears of 111 patients without chronic otitis media. The depth of the middle cranial fossa dural plates was recorded.Results:The mean depth of the middle cranial fossa dural plate was 4.59 mm in the study group and 2.71 mm in the control group (p < 0.001). The middle cranial fossa dural plate was located lower in the right ear in both the study and control groups.Conclusion:The middle cranial fossa dural plate was located lower in patients with chronic otitis media, and in the right ears of both patients and controls. Surgeons should take this low location into consideration, and take extra care, during relevant surgery on patients with chronic otitis media.

Endoscopic treatment of middle cranial fossa arachnoid cysts in children

2012 ◽  
Vol 9 (3) ◽  
pp. 231-238 ◽  
Author(s):  
Nasser M. F. El-Ghandour
Keyword(s):  
Middle Cranial Fossa ◽  
Arachnoid Cysts ◽  
Cyst Size ◽  
Intraoperative Bleeding ◽  
Initial Surgery ◽  
Significant Clinical Improvement ◽  
Recovery Times ◽  
Cranial Fossa

Object Arachnoid cysts located in the middle cranial fossa are common, comprising about half of all intracranial arachnoid cysts. The management of these cysts is challenging, and the optimal surgical treatment is controversial. This study evaluates the role of endoscopy in the treatment of middle cranial fossa arachnoid cysts (MCFACs) in children, focusing on some factors or technical aspects that might influence the outcome. Methods Thirty-two children with symptomatic MCFACs were the subject of this study. The group included 23 boys and 9 girls, with a mean age of 3.6 years. All patients underwent operations using a purely endoscopic cystocisternostomy procedure through a transtemporal approach. Results Significant clinical improvement occurred in 28 cases (87.5%). Postoperative MR imaging showed a reduction in cyst size in 23 cases (71.9%), whereas in the remaining 9 cases (28.1%), the cyst size was unchanged. Minor intraoperative bleeding occurred in 3 cases (9.4%), which stopped spontaneously without any postoperative sequelae. Ipsilateral subdural hygroma occurred in 2 cases (6.3%) and resolved within a few weeks without surgery; transient oculomotor palsy occurred in 1 case (3.1%). During follow-up (mean 4.6 years), 3 patients (9.4%) experienced recurrence of symptoms and an increase in cyst size. Interestingly, all 3 patients who had recurrence had also experienced intraoperative bleeding at initial surgery. At a second endoscopic procedure, the fenestration was found to be closed in all 3 patients. Conclusions Endoscopic cystocisternostomy is recommended in the treatment of MCFACs in children because it is simple, minimally invasive, and effective. It maintains the basic strategy of cyst fenestration into the basal cisterns without the invasiveness of open craniotomy. This procedure reduces operative and recovery times and is associated with low morbidity and mortality rates.

Endoscopic balloon dilation as an adjunct to extended endoscopic approaches to the skull base

2012 ◽  
Vol 116 (6) ◽  
pp. 1215-1218 ◽  
Author(s):  
Jeffrey C. Bedrosian ◽  
Victor Garcia-Navarro ◽  
Edward D. McCoul ◽  
Vijay K. Anand ◽  
Theodore H. Schwartz
Keyword(s):  
Balloon Dilation ◽  
Middle Cranial Fossa ◽  
Petrous Apex ◽  
Invasive Technique ◽  
Surgical Removal ◽  
Endoscopic Drainage ◽  
Endoscopic Endonasal ◽  
Access Method ◽  
Cranial Fossa

Cholesterol granulomas (CGs) are benign, expanding cystic lesions surrounded by a thick fibrous capsule and filled with fluid, formed by the degradation of blood elements. The goal of surgery is to open the granuloma widely, creating a well-drained cavity. The endonasal endoscopic approach for this extradural lesion is a minimal access method for surgical removal or fenestration. The role of balloon dilation in creating a wide fenestration has not been previously described. The authors describe a patient with a recurrent petrous apex CG who underwent an endoscopic, endonasal, transmaxillary transpterygoid approach to the petrous apex. A balloon sinuplasty catheter was used to dilate the surgical fenestration to maintain continued patency. The authors report on their first experience using balloon dilation combined with endoscopic drainage of the petrous apex. The excellent surgical outcome of this minimally invasive technique holds promise for future endonasal approaches to the middle cranial fossa.

scholarly journals Histological Characteristics of Ligaments between Middle Ear and Temporomandibular Joint

2009 ◽  
Vol 03 (04) ◽  
pp. 280-284 ◽  
Author(s):  
Metin Sencimen ◽  
Altan Varol ◽  
Baris Baykal ◽  
Hasan Ayberk Altug ◽  
Necdet Dogan ◽  
...  
Keyword(s):  
Temporomandibular Joint ◽  
Middle Ear ◽  
Structural Characteristics ◽  
Middle Cranial Fossa ◽  
Elastic Fibers ◽  
Compensatory Mechanism ◽  
Functional Tests ◽  
Histological Characteristics ◽  
Cranial Fossa

ABSTRACTObjectives: To examine histological aspects of the ligaments between the middle ear and temporomandibular joint and suppose a theoretical role of their structural characteristics on mobility of mallear ossicle.Methods: The ligaments were obtained by microdissection of middle cranial fossa on both sites of 15 cadavers fixed in formalin solution and were sectioned longitudinally (7-10 µm thickness). The sections were stained with Verhoff’s Van Gieson’s stain (VVG) for demonstration of elastic fibers and visualized at X2.5 and X10 magnifications under light microscopy.Results: Anterior mallear ligament (AML) and sphenomandibular ligaments (SML) were consisted of collagen fibres in analyzed specimens. The discomallear ligament (DML) was constituted of rich collagenous fibres. One specimen of DML harvested between petrotympanic fissure and retrodiscal-capsular intersection site contained elastic fibers dispersed in cotton-bowl appearance between collagen fibers. In the light of functional tests performed in previous studies, it could be extrapolated that presence of elastic fibers in the DML may prevent excessive forces conducted to mallear head by elongation of elastic fibers.Conclusions: Collagenous fibres have no ability to stretch along their axis which may lack compensatory mechanism to prevent mallear head mobility. (Eur J Dent 2009;3:280-284)

Meningeal melanocytoma of the middle cranial fossa (the Meckel′s cave)

2015 ◽  
Vol 63 (2) ◽  
pp. 260 ◽  
Author(s):  
Yanming Ren ◽  
Anqi Xiao ◽  
Xia Wu ◽  
Yuekang Zhang
Keyword(s):  
Middle Cranial Fossa ◽  
Meningeal Melanocytoma ◽  
Cranial Fossa

Bilateral traumatic facial paralysis associated with unilateral abducens palsy: a case report

2005 ◽  
Vol 119 (2) ◽  
pp. 144-147 ◽  
Author(s):  
Tuncay Ulug ◽  
S Arif Ulubil
Keyword(s):  
Facial Nerve ◽  
Facial Paralysis ◽  
Motor Vehicle ◽  
Bone Fractures ◽  
Middle Cranial Fossa ◽  
Geniculate Ganglion ◽  
Abducens Palsy ◽  
Middle Cranial Fossa Approach ◽  
Cranial Fossa ◽  
The Right

Bilateral traumatic facial paralysis is a very rare clinical condition. Abducens palsy, associated with bilateral traumatic paralysis, is even rarer and has not been well described in the literature. In this report, a 24-year-old male, who developed immediate bilateral facial and right abducens paralyses following a motor vehicle accident, is presented. The patient was referred for neurotologic evaluation 22 days after the injury. Electroneurography (ENoG) demonstrated 100 per cent degeneration at the first examination and, correspondingly, electromyography showed no regeneration potentials. Using high-resolution computed tomography (HRCT), a longitudinal fracture on the right and a mixed-type fracture on the left were identified. The patient had good cochlear reserve on both sides. The decision for surgery was based not on ENoG, because of the delayed referral of the patient, but on the HRCT, which showed clear fracture lines on both sides. The middle cranial fossa approach for decompression of the right facial nerve was performed on the 55th day following the trauma, and a combined procedure using the middle cranial fossa and transmastoid approaches was applied for decompression of the left facial nerve on the 75th day following the trauma. On the right, there was dense fibrosis surrounding the geniculate ganglion and the proximal tympanic segment whereas, on the left, bone fragments impinging on the geniculate ganglion, dense fibrosis surrounding the geniculate ganglion, and a less extensive fibrotic tissue surrounding the pyramidal segment were encountered. There were no complications or hearing deterioration. At the one-year follow up, the patient had House-Brackmann (HB) grade 1 recovery on the right, and HB grade 2 recovery on the left side, and the abducens palsy regressed spontaneously. The middle cranial fossa approach and its combinations can be performed safely in bilateral temporal bone fractures as labyrinthine sparing procedures if done on separate occasions.

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