Surgical excision of extensive sacrococcygeal chordomas assisted by occlusion of the abdominal aorta

2010 ◽  
Vol 12 (5) ◽  
pp. 490-496 ◽  
Author(s):  
Liu Xue-Song ◽  
You Chao ◽  
Yang Kai-Yong ◽  
Huang Si-Qing ◽  
Zhang Heng
Keyword(s):  
Abdominal Aorta ◽  
Postoperative Radiotherapy ◽  
Balloon Dilation ◽  
Surgical Excision ◽  
Neurological Dysfunction ◽  
Pelvic Cavity ◽  
Large Tumor ◽  
Electrophysiological Monitoring ◽  
Complex Anatomy

Object An extensive sacrococcygeal chordoma is considered a challenge for neurosurgeons. Because of the complex anatomy of the sacral region, the risk of uncontrollable intraoperative hemorrhage, and the typically large tumor size at presentation, complete resections are technically difficult and the tumor recurrence rate is high. The aim of this study was to assess the value of using occlusion of the abdominal aorta by means of a balloon dilation catheter and electrophysiological monitoring when an extensive sacrococcygeal chordoma is removed. Methods Between 2004 and 2008, 9 patients underwent resection of extensive sacrococcygeal chordomas in the authors' department with the aid of occlusion of the abdominal aorta and electrophysiological monitoring. All of these operations were performed via the posterior approach. The records of the 9 patients were reviewed retrospectively. Results Wide resections were performed in 6 cases and marginal excisions in the other 3. Five patients underwent postoperative radiotherapy. Intraoperative hemorrhage was controlled at 100–400 ml. Postoperatively, none of the patients had any new neurological dysfunction, and 2 patients regained normal urinary and bowel function. The mean follow-up period was 31.4 months (range 10–57 months). No patient developed local recurrence or had metastatic spread of tumor during follow-up. Conclusions Occlusion of the abdominal aorta and electrophysiological monitoring are useful methods for assisting in resection of sacrococcygeal chordoma. They can reduce intraoperative hemorrhage and entail little chance of tumor cell contamination. They can also help surgeons to protect the organs in the pelvic cavity and neurological function. Use of these methods could give patients better quality of life.

Neurilemmoma of the Nasal Cavity and Paranasal Sinuses

2021 ◽  
pp. 014556132110079
Author(s):  
Xindi He ◽  
Ying Wang
Keyword(s):  
Nasal Cavity ◽  
Paranasal Sinuses ◽  
Benign Tumor ◽  
Postoperative Radiotherapy ◽  
Surgical Excision ◽  
Complete Resection ◽  
Sinus Surgery ◽  
Complete Surgical Excision ◽  
The Mean

Objectives: Neurilemmoma in the nasal cavity and paranasal sinuses is very rare. The study aimed to improve the understanding of neurilemmoma in the nasal cavity and paranasal sinuses. Materials and Methods: The clinical data of 10 patients with neurilemmoma in the nasal cavity and paranasal sinuses treated from January 2014 to June 2019 in our hospital were retrospectively studied. Results: There were 6 females and 4 males patients in our study. The mean age was 49.5 years (range 37-77 years), and the most common clinical symptom was unilateral nasal obstruction. The site of tumor included the nasal cavity, maxillary sinus, ethmoid sinus, and sphenoid sinus. There were 2 cases with malignant neurilemmoma. Nine patients underwent functional endoscopic sinus surgery (FESS); however, 1 patient underwent FESS combined with the lateral rhinotomy for complete resection of the tumor. Two patients with malignant neurilemmoma received postoperative radiotherapy. The mean follow-up was 3.82 years (range 2-7 years). There were no incidences of tumor recurrence during the study period. Conclusions: Neurilemmoma in the nasal cavity and paranasal sinuses is a mainly benign tumor. Complete surgical excision by FESS is the only treatment option for neurilemmoma in the nasal cavity and paranasal sinuses; while malignant neurilemmoma needs postoperative radiotherapy.

scholarly journals A series Cases study of Carcinomas derived from myoepithelial cells in head and neck regions

2020 ◽  
Author(s):  
Danni Cheng ◽  
Yufang Rao ◽  
Ke Qiu ◽  
Jianqing Qiu ◽  
Yijun Dong ◽  
...  
Keyword(s):  
Head And Neck ◽  
Surgical Resection ◽  
Postoperative Radiotherapy ◽  
Surgical Excision ◽  
Myoepithelial Cells ◽  
Single Institution ◽  
Complete Surgical Excision ◽  
The Mean ◽  
Systemic Therapies

Abstract Background and Objectives: Carcinomas derived from myoepithelial cells in head and neck regions (CMCHN) are rare. The aim of this study was to demonstrate the clinical behaviors and treatment outcomes of these tumors.Methods: A retrospective review of fifteen CMCHN cases between 2002 and 2019 in a single institution was performed. Results: All of the fifteen patients (100%) underwent primary surgical resection. Eleven patients (73.3%) received conventional postoperative radiotherapy and four (26.7%) received systemic chemotherapy. Consequently, six patients (40%) had frequently recurrence after surgical resection, and seven patients (46.7%) received second or even third operations. Up to the time of last follow-up, only one patient died and the mean survival time was 15.8 years.Conclusions: Currently, complete surgical excision with or without systemic therapy is preferred, but it has limited efficacy on reducing the risk of recurrence. Thus, more effective systemic therapies are required and the researches on the mechanism of CMCHN recurrence should be encouraged.

Transcatheter management of mid-aortic syndrome secondary to myofibroma presenting in infancy with severe left ventricular dysfunction: a case report

2015 ◽  
Vol 26 (4) ◽  
pp. 799-801
Author(s):  
Ryan Callahan ◽  
Jacqueline Kreutzer ◽  
Mark Debrunner
Keyword(s):  
Case Report ◽  
Abdominal Aorta ◽  
Left Ventricular Dysfunction ◽  
Ventricular Dysfunction ◽  
Balloon Dilation ◽  
Left Ventricular ◽  
Percutaneous Intervention ◽  
Severe Left Ventricular Dysfunction ◽  
Thoracic And Abdominal

AbstractIn this study, we summarise a case of a myofibroma causing mid-aortic syndrome due to obstruction of the distal thoracic and abdominal aorta leading to severe left ventricular dysfunction. The patient was managed with percutaneous intervention via balloon dilation and stent placement. On follow-up, the patient has normalisation of ventricular function, is off anti-hypertensives, and is being monitored for re-stenosis.

scholarly journals SURGERY OF JUGULAR FORAMEN LESIONS - AN INSTITUTIONAL EXPERIENCE

2020 ◽  
Vol VOLUME 8 (ONE) ◽  
pp. 1-11
Author(s):  
Simple Patadia
Keyword(s):  
Cranial Nerve ◽  
Postoperative Radiotherapy ◽  
Infratemporal Fossa ◽  
Surgical Excision ◽  
Jugular Foramen ◽  
Histopathological Diagnosis ◽  
Eighth Cranial Nerve ◽  
Lower Cranial Nerve ◽  
Temporal Bones

Jugular foramen tumors are rare skull base tumors having complex neurovascular anatomy. Most common being paragangliomas, lower cranial nerve schwannomas and meningiomas. Being the conduit for important neuro-vascular structures, potential complications following surgery are a frequent source of morbidity. Retrospective study done from March 2008 to September 2014. All patients underwent highresolution computer tomography (HRCT) of temporal bones and magnetic resonance imaging (MRI) with angiography in pre-operative period. Surgical approach and pre-operative endovascular intervention depended on the site and extent of the lesion. Extent of tumor removal was determined at the time of surgery. Patients with incomplete excisions in postoperative imaging were subjected to radiotherapy depending on histo-pathological diagnosis. Total of 22 patients of jugular foramen lesion were operated. Histopathological diagnosis included paraganglioma(n=18), schwannomas(n=2), p l a s m a c y t o m a ( n = 1 ) , s q u a m o u s c e l l carcinoma(n=1). Eighth cranial nerve was the most common involved nerve preoperatively (100%). Infratemporal Fossa approach, along with its modication, and conservative jugulopetrosectomy approach were used for surgical excision as per the extent of tumor. Complete excision was done in 73% (n=16), and postoperative radiotherapy was given to rest of the patients. The most common postoperative complication was lower cranial nerve decit in immediate post op period(n=15, 68%) (new onset n= 3, 13% and n=12, 55% had preoperative paresis), on follow up lower cranial nerve palsy improved in 50% in follow up (n=7). Most common tumor of the jugular foramen was paraganglioma followed by lower cranial nerve schwannoma. Surgical management depends on the extent of tumor. Multidisciplinary approach provides better patient outcome. Histopathological diagnosis aids to give targeted radiotherapy to the local site, and hence surgical excision of JFT(Jugular foramen tumor) is recommended.

Spinal cord ependymoma: Retrospective analysis of treatment outcomes of 14 patients

2004 ◽  
Vol 4 (4) ◽  
pp. 155-160 ◽  
Author(s):  
R. Zaucha ◽  
K. Sosińska-Mielcarek ◽  
I. Zander ◽  
P. Szewczyk ◽  
J. Jassem
Keyword(s):  
Spinal Cord ◽  
Retrospective Analysis ◽  
Postoperative Radiotherapy ◽  
Primary Tumour ◽  
Surgical Excision ◽  
Subtotal Resection ◽  
Term Survival ◽  
Primary Surgery ◽  
Rare Tumours

Spinal cord ependymomas are relatively rare tumours and their management is not well established. This retrospective analysis was performed to examine the outcome of patients treated for this malignancy at our institution between 1982 and 2004.Hospital charts of 14 consecutive patients (10 men and four women) aged 8 to 58 years (median 32 years) were retrospectively analysed. This series included nine extramedullary and five intramedullary well differentiated (eight – G1, six – G2) ependymomas. All patients were treated with primary surgery. Postoperative radiotherapy was administered in 12 patients after subtotal excision. Total dose ranged from 35Gy in 17 fractions to 50.4Gy in 28 fractions. One patient experienced spinal axis failure despite complete resection of the primary tumour and was managed with salvage radiotherapy and chemotherapy following surgical excision of the relapse. There have been no radiotherapy-related serious side effects.One patient was lost to follow-up. Of the remaining 13 patients, at a median follow-up of 5.5 years (3 months to 20 years), 12 were alive including 11 without progression.Conclusion: In our group of patients radiotherapy following subtotal resection or used as a single modality was well tolerated and resulted in 92% long-term survival.

Mechanical thrombectomy using a Solitaire stent retriever in the treatment of pediatric acute ischemic stroke

2019 ◽  
Vol 23 (3) ◽  
pp. 363-368 ◽  
Author(s):  
Bing Zhou ◽  
Xiao-Chuan Wang ◽  
Jun-Yi Xiang ◽  
Ming-Zhao Zhang ◽  
Bo Li ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Mechanical Thrombectomy ◽  
Balloon Dilation ◽  
Stent Retriever ◽  
National Institutes Of Health ◽  
Clinical Prognosis ◽  
Nihss Score ◽  
Grade 3

OBJECTIVEMechanical thrombectomy using a Solitaire stent retriever has been widely applied as a safe and effective method in adult acute ischemic stroke (AIS). However, due to the lack of data, the safety and effectiveness of mechanical thrombectomy using a Solitaire stent in pediatric AIS has not yet been verified. The purpose of this study was to explore the safety and effectiveness of mechanical thrombectomy using a Solitaire stent retriever for pediatric AIS.METHODSBetween January 2012 and December 2017, 7 cases of pediatric AIS were treated via mechanical thrombectomy using a Solitaire stent retriever. The clinical practice, imaging, and follow-up results were reviewed, and the data were summarized and analyzed.RESULTSThe ages of the 7 patients ranged from 7 to 14 years with an average age of 11.1 years. The preoperative National Institutes of Health Stroke Scale (NIHSS) scores ranged from 9 to 22 with an average of 15.4 points. A Solitaire stent retriever was used in all patients, averaging 1.7 applications of thrombectomy and combined balloon dilation in 2 cases. Grade 3 on the modified Thrombolysis In Cerebral Infarction scale of recanalization was achieved in 5 cases and grade 2b in 2 cases. Six patients improved and 1 patient died after thrombectomy. The average NIHSS score of the 6 cases was 3.67 at discharge. The average modified Rankin Scale score was 1 at the 3-month follow-up. Subarachnoid hemorrhage after thrombectomy occurred in 1 case and that patient died 3 days postoperatively.CONCLUSIONSThis study shows that mechanical thrombectomy using a Solitaire stent retriever has a high recanalization rate and excellent clinical prognosis in pediatric AIS. The safety of mechanical thrombectomy in pediatric AIS requires more clinical trials for confirmation.

scholarly journals Angiosarcoma of sigmoid colon with intraperitoneal bleeding: case report and literature review

2011 ◽  
Vol 93 (6) ◽  
pp. e91-e93 ◽  
Author(s):  
Tse-Hua Lo ◽  
Mu-Shiun Tsai ◽  
Tzu-An Chen
Keyword(s):  
Sigmoid Colon ◽  
Alimentary Tract ◽  
Surgical Excision ◽  
Sigmoid Colectomy ◽  
Epithelioid Cells ◽  
Spindle Cells ◽  
Choice Of Treatment ◽  
Intraperitoneal Bleeding ◽  
Immunohistochemical Studies

Primary angiosarcomas arising from the alimentary tract are rare and only a few cases have been reported in the literature. We report a case of an angiosarcoma of the sigmoid colon with intraperitoneal bleeding but not rectal bleeding. A 21-year-old female patient received a laparotomy and a mass lesion over the sigmoid colon was found with active bleeding. A sigmoid colectomy was performed as a curative resection. Grossly, the sigmoid colon contained a kidney shaped, hemorrhagic tumour from the submucosal layer extension to the antimesenteric side. Intraluminally, the mucosa of the colon was intact. Microscopic examination revealed a high grade angiosarcoma composed of fascicles of spindle cells and solid sheets of epithelioid cells. Immunohistochemical stains revealed a positive result for CD31 and the endothelial nature of the malignancy was confirmed. Smooth muscle antigens, desmins, cytokeratins AE1/AE3 and CD117 were all negative. The patient is still alive without evidence of recurrence or metastasis at a three-year follow-up appointment. Owing to the availability of immunohistochemical studies, some atypical sarcomas would now be correctly classified as angiosarcomas. Since no optimal adjuvant treatment is effective, curative surgical excision is still the best choice of treatment.

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