Trigeminal neurinomas with extracranial extension: analysis of 28 surgically treated cases

2010 ◽  
Vol 113 (5) ◽  
pp. 1079-1084 ◽  
Author(s):  
Atul Goel ◽  
Abhidha Shah ◽  
Dattatraya Muzumdar ◽  
Trimurti Nadkarni ◽  
Aadil Chagla
Keyword(s):  
Posterior Fossa ◽  
Tumor Resection ◽  
Radical Resection ◽  
Middle Fossa ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Additional Surgery ◽  
Lateral Orbitotomy ◽  
Transcranial Approach

Object The object of this paper was to review the authors' experience with 28 cases of trigeminal neurinomas having an extracranial extension. Methods The authors analyzed 28 cases of trigeminal neurinoma in which there was an extracranial extension of the tumor. All patients were treated in their department between the years 1989 and 2009. Results There was tumor extension along the ophthalmic division of the nerve in 4 cases, along the maxillary division in 5, and along the mandibular division in 13. In 6 tumors there was diffuse extracranial extension and the exact extracranial division of nerve involvement could not be ascertained. In 10 cases, the tumor had a multicompartmental location—in the posterior fossa, the middle fossa, and the extracranial compartment. Tingling paraesthesiae, numbness, and diffuse pain in the distribution of the trigeminal nerve were common symptoms and were present in 90% of patients. The extracranial component had a well-defined perineural/meningeal membrane cover that was continuous with the middle fossa dura mater and isolated the tumor tissue from the adjoining critical structures. In 7 out of 10 cases, even the posterior fossa component of the tumor was entirely “interdural” (within the confines of the dura). The maximum dimension of the tumor was > 4 cm in 22 cases. A limited “transcranial” approach with (12 cases) or without (16 cases) zygomatic osteotomy was found suitable for resection of these tumors. In 4 cases a lateral orbitotomy was performed. Total tumor resection was performed in 20 cases and partial resection in 8. The duration of follow-up ranged from 6 months to 19 years. Two patients required additional surgery for symptomatic recurrence. Conclusions Extracranial extensions of trigeminal neurinomas have a well-defined meningeal covering. In most cases resection was performed via a minimally invasive cranial avenue (a “reverse skull base approach”). Radical resection was associated with an excellent long-term outcome.

Primary Calvarial Ewing Sarcoma: A Case Series

2021 ◽  
Author(s):  
Sandeep Mohindra ◽  
Manjul Tripathi ◽  
Aman Batish ◽  
Ankur Kapoor ◽  
Ninad Ramesh Patil ◽  
...  
Keyword(s):  
Ewing Sarcoma ◽  
Tumor Resection ◽  
Case Series ◽  
Radical Excision ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Intradural Tumor ◽  
Age Range

Abstract Background Calvarial Ewing tumor is a relatively rare differential among bony neoplasms. We present our experience of managing primary calvarial Ewing sarcoma (EWS), highlighting their clinical and radiological findings. Method In a retrospective analysis, we evaluated our 12-year database for pathologically proven EWS. A literature search was conducted for the comparative presentation and update on the management and outcome. Result From January 2008 to December 2020, we managed eight patients (male:female = 5:3; age range 6 months to 19 years, mean 11.5 years) harboring primary calvarial EWS. All cases underwent wide local excision; two patients required intradural tumor resection, while one required rotation flap for scalp reconstruction. Mean hospital stay was 8 days. All patients received adjuvant chemo- and radiotherapy. Three patients remained asymptomatic at 5 years of follow-up, while two patients died. Conclusion Primary calvarial EWS is a rare entity. It usually affects patients in the first two decades of life. These tumors can be purely intracranial, causing raised intracranial pressure symptoms, which may exhibit rapidly enlarging subgaleal tumors with only cosmetic deformities or symptoms of both. Radical excision followed by adjuvant therapy may offer a favorable long-term outcome.

Long-term outcomes in children with glioblastoma

2010 ◽  
Vol 6 (2) ◽  
pp. 145-149 ◽  
Author(s):  
Kyung Sun Song ◽  
Ji Hoon Phi ◽  
Byung-Kyu Cho ◽  
Kyu-Chang Wang ◽  
Ji Yeoun Lee ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Progression Free Survival ◽  
Radical Resection ◽  
Tumor Location ◽  
Recurrent Glioblastoma ◽  
Subtotal Resection ◽  
Long Term Outcomes ◽  
Term Outcome ◽  
Long Term Outcome

Object Glioblastoma is the most common primary malignant brain tumor; however, glioblastoma in children is less common than in adults, and little is known about its clinical outcome in children. The authors evaluated the long-term outcome of glioblastoma in children. Methods Twenty-seven children were confirmed to have harbored a glioblastoma between 1985 and 2007. The clinical features and treatment outcomes were reviewed retrospectively. All patients underwent resection; complete resection was performed in 12 patients (44%), subtotal resection in 12 patients (44%), and biopsy in 3 patients (11%). Twenty-four patients (89%) had radiation therapy, and 14 (52%) patients received chemotherapy plus radiation therapy. Among the latter, 5 patients had radiation therapy concurrent with temozolomide chemotherapy. Four patients with small-size recurrent glioblastoma received stereotactic radiosurgery. Results The median overall survival (OS) was 43 months, and the median progression-free survival was 12 months. The OS rate was 67% at 1 year, 52% at 2 years, and 40% at 5 years. The median OS was significantly associated with tumor location (52 months for superficially located tumors vs 7 months for deeply located tumors; p = 0.017) and extent of removal (106 months for completely resected tumors vs 11 months for incompletely resected tumors; p < 0.0001). Conclusions The prognosis of glioblastoma is better in children than in adults. Radical resection followed by concurrent chemoradiation therapy may be the initial treatment of choice.

Posterior fossa craniotomy for trapped fourth ventricle in shunt-treated hydrocephalic children: long-term outcome

2011 ◽  
Vol 7 (1) ◽  
pp. 52-63 ◽  
Author(s):  
Suhas Udayakumaran ◽  
Naresh Biyani ◽  
David P. Rosenbaum ◽  
Liat Ben-Sira ◽  
Shlomi Constantini ◽  
...  
Keyword(s):  
Posterior Fossa ◽  
Subarachnoid Space ◽  
Fourth Ventricle ◽  
Late Complication ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Posthemorrhagic Hydrocephalus ◽  
Spinal Subarachnoid Space ◽  
Trapped Fourth Ventricle

Object Trapped fourth ventricle (TFV) is a rare late complication of postinfectious or posthemorrhagic hydrocephalus. This entity is distinct from a large fourth ventricle because TFV entails pressure in the fourth ventricle and posterior fossa due to abnormal inflow and outflow of CSF, causing significant symptoms and signs. As TFV is mostly found in children who were born prematurely and have cerebral palsy, diagnosis and treatment options are a true challenge. Methods Between February 1998 and February 2007, 12 children were treated for TFV in Dana Children's Hospital by posterior fossa craniotomy/craniectomy and opening of the TFV into the spinal subarachnoid space. The authors performed a retrospective analysis of relevant data, including pre- and postoperative clinical characteristics, surgical management, and outcome. Results Thirteen fenestrations of trapped fourth ventricles (FTFVs) were performed in 12 patients. In 6 patients with prominent arachnoid thickening, a stent was left from the opened fourth ventricle into the spinal subarachnoid space. One patient underwent a second FTFV 21 months after the initial procedure. No perioperative complications were encountered. All 12 patients (100%) showed clinical improvement after FTFV. Radiological improvement was seen in only 9 (75%) of the 12 cases. The follow-up period ranged from 2 to 9.5 years (mean 6.11 ± 2.3 years) after FTFV. Conclusions Fenestration of a TFV via craniotomy is a safe and effective option with a very good long-term outcome and low rate of morbidity.

Long-term outcome in patients treated for benign dural arteriovenous fistulas of the posterior fossa

2010 ◽  
Vol 53 (7) ◽  
pp. 493-500 ◽  
Author(s):  
Andrea Bink ◽  
Joachim Berkefeld ◽  
Lubov Kraus ◽  
Christian Senft ◽  
Ulf Ziemann ◽  
...  
Keyword(s):  
Posterior Fossa ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Arteriovenous Fistulas ◽  
Dural Arteriovenous Fistulas

Surgical treatment of low-grade gliomas in the intraoperative magnetic resonance imager

1998 ◽  
Vol 4 (4) ◽  
pp. E10 ◽  
Author(s):  
Claudia Martin ◽  
Eben Alexander ◽  
Terry Wong ◽  
Richard Schwartz ◽  
Ferenc Jolesz ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Image Guidance ◽  
Intraoperative Imaging ◽  
Radical Resection ◽  
Low Grade ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Low Grade Gliomas ◽  
Surgical Field

Radical resection of low-grade gliomas can decrease the incidence of recurrence, the time to tumor progression, and the incidence of malignant transformation. The authors present a series of 25 patients who underwent craniotomy and resection of low-grade tumor in an intraoperative magnetic resonance (MR) imager. This is an open configuration 0.5-tesla imager developed by The Brigham and Women's Hospital and General Electric, in which a patient can be placed to undergo surgery. Gross-total removal was accomplished under real-time image guidance. These intraoperative images allow definitive localization and targeting of the lesions and accommodate anatomical changes that may occur during surgery. The authors consistently found that the extent of abnormality seen on the intraoperatively obtained films of resection was larger than that apparent in the surgical field of view alone. Intraoperative imaging made accurate surgical identification of these abnormal areas and subsequent resection possible. Patients with tumors adjacent to or within motor or language cortex underwent resection while awake, with monitoring of neurological function. In these cases, an aggressive resection without increased neurological morbidity was accomplished using the image guidance in conjunction with serial testing. A 1-month postoperative MR image was obtained in all patients. These correlated with the final intraoperative images obtained after the resection was completed. Only one patient had a mild postoperative deficit that remained at the 1-month follow-up examination. As the long-term outcome in patients with low-grade gliomas has been shown to correspond to the degree of resection, surgical resection in which intraoperative MR imaging guidance is used can be an invaluable modality in the treatment of these tumors.

Functional Long-Term Outcome of a Free Jejunal Transplant Reconstruction following Chemoradiotherapy and Radical Resection for Hypopharyngeal and Proximal Oesophageal Carcinoma

2004 ◽  
Vol 21 (5-6) ◽  
pp. 426-433 ◽  
Author(s):  
Henrik Bergquist ◽  
Hasse Ejnell ◽  
Ingemar Fogdestam ◽  
Hans Mark ◽  
Claes Mercke ◽  
...  
Keyword(s):  
Radical Resection ◽  
Oesophageal Carcinoma ◽  
Term Outcome ◽  
Long Term Outcome

scholarly journals Long-term outcome of indwelling colon observed seven years after radical resection for rectosigmoid cancer: A case report

2021 ◽  
Vol 9 (19) ◽  
pp. 5252-5258
Author(s):  
Zi-Xuan Zhuang ◽  
Ming-Tian Wei ◽  
Xu-Yang Yang ◽  
Yang Zhang ◽  
Wen Zhuang ◽  
...  
Keyword(s):  
Case Report ◽  
Radical Resection ◽  
Term Outcome ◽  
Rectosigmoid Cancer ◽  
Long Term Outcome

Intraspinal epidermoid and dermoid cysts—tumor resection with multimodal intraoperative neurophysiological monitoring and long-term outcome

2020 ◽  
Vol 162 (11) ◽  
pp. 2895-2903
Author(s):  
Sebastian Siller ◽  
Rupert Egensperger ◽  
Andrea Szelenyi ◽  
Joerg-Christian Tonn ◽  
Stefan Zausinger ◽  
...  
Keyword(s):  
Tumor Resection ◽  
Intraoperative Neurophysiological Monitoring ◽  
Neurophysiological Monitoring ◽  
Term Outcome ◽  
Long Term Outcome
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