Intraspinal hemangioblastomas: analysis of 92 cases in a single institution

2014 ◽  
Vol 21 (2) ◽  
pp. 260-269 ◽  
Author(s):  
Xiaofeng Deng ◽  
Kai Wang ◽  
Liang Wu ◽  
Chenlong Yang ◽  
Tao Yang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Characteristics ◽  
Preoperative Embolization ◽  
Imaging Findings ◽  
Single Institution ◽  
Total Resection ◽  
Surgical Strategies ◽  
X Ray ◽  
Logistic Analysis

Object Intraspinal hemangioblastomas are relatively uncommon benign tumors. The surgical strategies remain controversial, and the risk factors with regard to clinical outcome are unclear. The purpose of this study was to analyze the clinical characteristics, imaging findings, surgical strategies, and functional outcomes associated with intraspinal hemangioblastomas. Methods A series of 92 patients who underwent 102 operations for resection of 116 intraspinal hemangioblastomas at a single institution during 2007–2011 were consecutively enrolled in this study. Of these, 60 patients (65.2%) had sporadic hemangioblastomas and 32 (34.8%) had von Hippel-Lindau disease. Preoperatively, 13 patients underwent digital subtraction angiography (DSA), 15 patients underwent 3D CT angiography (3D CTA), and none underwent preoperative embolization. Clinical characteristics, imaging findings, and operative records were analyzed. The advantages and disadvantages of DSA and 3D CTA were compared. For identification of risk factors that affect prognosis, logistic analysis was performed. Results The male/female patient ratio was 1.8:1.0 (59 male and 33 female patients). Of the tumors, 41% were intramedullary, 37% were intramedullary-extramedullary, and 22% were primarily extramedullary. Three-dimensional CTA and DSA did not differ significantly in the ability to identify the feeding arteries (p = 1.000) and image qualities (p = 0.367). However, compared with 3D CTA, the effective x-ray dose of spinal DSA was 2.73 times higher and the mean amount of contrast media injected was 1.88 times higher. Spinal DSA was more time consuming (mean 120 minutes) than 3D CTA (scanning time < 1 minute). No complications were observed after 3D CTA; acute paraparesis developed in 1 patient after DSA. Gross-total resection was achieved for 109 tumors (94.0%), and resection was subtotal for 7 tumors. Mean duration of follow-up was 50 months (range 24–78 months). At the most recent follow-up visit, the functional outcome was improved for 38 patients (41.3%), remained stable for 40 (43.5%), and deteriorated for 14 (15.2%). Logistic analysis showed that subtotal resection was a risk factor affecting prognosis (p = 0.003, OR 12.833, 95% CI 2.429–67.806). Conclusions The authors' study suggests that safe and effective treatment of intraspinal hemangioblastomas can be achieved for most patients, even without preoperative embolization. Gross-total resection, when safe to perform, leads to better outcomes. Compared with spinal DSA, 3D CTA is a promising technique because it is noninvasive, takes less time to perform, requires lower x-ray doses and less contrast media, results in fewer complications, and offers high accuracy for delineating the feeding arteries.

scholarly journals Enchondroma of the spine: a report of eleven cases

2020 ◽  
Author(s):  
Dehuai Liu ◽  
Xiangbo Li ◽  
Kai Luo ◽  
Chengsen Lin ◽  
Xiangxiang Chen ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Clinical Characteristics ◽  
Tumor Resection ◽  
Total Resection ◽  
Surgical Strategies ◽  
Sacral Tumor ◽  
Second Surgery ◽  
The Common ◽  
Fatal Complications

Abstract Purpose To explore clinical characteristics, surgical strategies, and prognosis of spinal enchondroma. Methods We retrospectively analyzed eleven cases with primary benign spinal enchondroma who were treated in our institution between January 2008 and December 2016. Results Of the 11 patients included in our study, the average age was 43 years(range from 5–66 years). There were 7 men and 4 women. The lesions were mainly located in the lumbar and thoracic column with 5 cases and 4 cases respectively, and following by the cervical and sacral vertebrae with both 1 cases. Total tumor resection was used in 10 cases and curettage in one case. The average follow-up was 3.3 years(range from 2 to 6 years). Most of the cases had achieved satisfied therapeutic outcome with the symptoms disappeared. However, Case 9 developed into local recurrence and a second surgery was performed. Although the lesion have not recured any more after the second operation during the follow-up, the lower extremity paralysis had no improvement. Case 2 was sent to our hospital for the recurrence of the sacral tumor which was very closed to the common iliac artery.When the second operation was conducted, the artery was ruptured and the patient died from hemorrhagic shock. Conclusion To establish the diagnosis of spinal enchondroma is not always a simple job for the absence of specific clinical characteristics. The optimal treatment is total resection. Although spinal enchondroma is benign, a few cases can develop into local recurrence. Sacral enchondroma should be more vigilant for its fatal complications.

scholarly journals Enchondroma of the spine: a report of eleven cases

2020 ◽  
Author(s):  
Dehuai Liu ◽  
Boxiang Li ◽  
Hui Wang ◽  
Kai Luo ◽  
Chengsen Lin ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Clinical Characteristics ◽  
Tumor Resection ◽  
Total Resection ◽  
Surgical Strategies ◽  
Sacral Tumor ◽  
Second Surgery ◽  
The Common ◽  
Fatal Complications

Abstract Purpose To explore clinical characteristics, surgical strategies, and prognosis of spinal enchondroma. Methods We retrospectively analyzed eleven cases with primary benign spinal enchondroma who were treated in our institution between January 2008 and December 2016. Results Of the 11 patients included in our study, the average age was 43 years(range from 5–66 years). There were 7 men and 4 women. The lesions were mainly located in the lumbar and thoracic column with 5 cases and 4 cases respectively, and following by the cervical and sacral vertebrae with both 1 cases. Total tumor resection was used in 10 cases and curettage in one case. The average follow-up was 3.3 years(range from 2 to 6 years). Most of the cases had achieved satisfied therapeutic outcome with the symptoms disappeared. However, Case 9 developed into local recurrence and a second surgery was performed. Although the lesion have not recured any more after the second operation during the follow-up, the lower extremity paralysis had no improvement. Case 2 was sent to our hospital for the recurrence of the sacral tumor which was very closed to the common iliac artery.When the second operation was conducted, the artery was ruptured and the patient died from hemorrhagic shock. Conclusion To establish the diagnosis of spinal enchondroma is not always a simple job for the absence of specific clinical characteristics. The optimal treatment is total resection. Although spinal enchondroma is benign, a few cases can develop into local recurrence. Sacral enchondroma should be more vigilant for its fatal complications.

Clinical characteristics and risk factors of arrhythmia during follow‐up of patients with idiopathic ventricular fibrillation

2020 ◽  
Vol 31 (10) ◽  
pp. 2677-2686
Author(s):  
Niels K. Stampe ◽  
Camilla B. Jespersen ◽  
Charlotte Glinge ◽  
Henning Bundgaard ◽  
Jacob Tfelt‐Hansen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ventricular Fibrillation ◽  
Clinical Characteristics ◽  
Idiopathic Ventricular Fibrillation

Evolution of Surgical Approaches in the Treatment of Petroclival Meningiomas: A Retrospective Review

2007 ◽  
Vol 61 (suppl_5) ◽  
pp. ONS202-ONS211 ◽  
Author(s):  
Nicholas C. Bambakidis ◽  
U. Kumar Kakarla ◽  
Louis J. Kim ◽  
Peter Nakaji ◽  
Randall W. Porter ◽  
...  
Keyword(s):  
Survival Rates ◽  
Progression Free Survival ◽  
Surgical Approaches ◽  
Single Institution ◽  
Short Term ◽  
Total Resection ◽  
Free Survival ◽  
Petroclival Meningioma ◽  
Petroclival Meningiomas

Abstract Objective: We examined the surgical approaches used at a single institution to treat petroclival meningioma and evaluated changes in method utilization over time. Methods: Craniotomies performed to treat petroclival meningioma between September of 1994 and July of 2005 were examined retrospectively. We reviewed 46 patients (mean follow-up, 3.6 yr). Techniques included combined petrosal or transcochlear approaches (15% of patients), retrosigmoid craniotomies with or without some degree of petrosectomy (59% of patients), orbitozygomatic craniotomies (7% of patients), and combined orbitozygomatic-retrosigmoid approaches (19% of patients). In 18 patients, the tumor extended supratentorially. Overall, the rate of gross total resection was 43%. Seven patients demonstrated progression over a mean of 5.9 years. No patients died. At 36 months, the progression-free survival rate for patients treated without petrosal approaches was 96%. Of 14 patients treated with stereotactic radiosurgery, none developed progression. Conclusion: Over the study period, a diminishing proportion of patients with petroclival meningioma were treated using petrosal approaches. Utilization of the orbitozygomatic and retrosigmoid approaches alone or in combination provided a viable alternative to petrosal approaches for treatment of petroclival meningioma. Regardless of approach, progression-free survival rates were excellent over short-term follow-up period.

scholarly journals Longitudinally Increasing Elevated Asymmetric Flortaucipir Binding in a Cognitively Unimpaired Amyloid-Negative Older Individual

2021 ◽  
pp. 1-6
Author(s):  
Christopher G. Schwarz ◽  
David S. Knopman ◽  
Vijay K. Ramanan ◽  
Val J. Lowe ◽  
Heather J. Wiste ◽  
...  
Keyword(s):  
Risk Factors ◽  
Amyloid Pet ◽  
Imaging Findings ◽  
Tau Pet

We present the case of a cognitively unimpaired 77-year-old man with elevated, asymmetric, and longitudinally increasing Flortaucipir tau PET despite normal (visually negative) amyloid PET. His atypical tau PET signal persisted and globally increased in a follow-up scan five years later. Across eight years of observations, temporoparietal atrophy was observed consistent with tau PET patterns, but he retained the cognitively unimpaired classification. Altogether, his atypical tau PET signal is not explained by any known risk factors or alternative pathologies, and other imaging findings were not remarkable. He remains enrolled for further observation.

scholarly journals 31 Intracranial growing teratoma syndrome (IGTS): An international retrospective study

2018 ◽  
Vol 45 (S3) ◽  
pp. S13-S13
Author(s):  
George Michaiel ◽  
Douglas Strother ◽  
Nicholas Gottardo ◽  
Ute Bartels ◽  
Hallie Coltin ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Clinical Characteristics ◽  
Progressive Disease ◽  
Mature Teratoma ◽  
Male Gender ◽  
Cell Tumor ◽  
Total Resection ◽  
Beta Hcg ◽  
Median Serum

BACKGROUND: IGTS is a rare phenomenon of paradoxical germ cell tumor (GCT) growth during or following treatment despite normalization of tumor markers. We sought to evaluate the frequency, clinical characteristics and outcome of IGTS in patients in 21 North-American and Australian institutions. METHODS: Patients with IGTS diagnosed from 2000-2017 were retrospectively evaluated. RESULTS: Out of 739 GCT diagnoses, IGTS was identified in 33 patients (4.5%). IGTS occurred in 9/191 (4.7%) mixed-malignant GCTs, 4/22 (18.2%) immature teratomas (ITs), 3/472 (0.6%) germinomas/germinomas with mature teratoma, and in 17 secreting non-biopsied tumours. Median age at GCT diagnosis was 10.9 years (range 1.8-19.4). Male gender (84%) and pineal location (88%) predominated. Of 27 patients with elevated markers, median serum AFP and Beta-HCG were 70 ng/mL (range 9.2-932) and 44 IU/L (range 4.2-493), respectively. IGTS occurred at a median time of 2 months (range 0.5-32) from diagnosis, during chemotherapy in 85%, radiation in 3%, and after treatment completion in 12%. Surgical resection was attempted in all, leading to gross total resection in 76%. Most patients (79%) resumed GCT chemotherapy/radiation after surgery. At a median follow-up of 5.3 years (range 0.3-12), all but 2 patients are alive (1 succumbed to progressive disease, 1 to malignant transformation of GCT). CONCLUSION: IGTS occurred in less than 5% of patients with GCT and most commonly after initiation of chemotherapy. IGTS was more common in patients with IT-only on biopsy than with mixed-malignant GCT. Surgical resection is a principal treatment modality. Survival outcomes for patients who developed IGTS are favourable.

Risk Factors for Growth of Unruptured Intracranial Aneurysms: Follow-up Study by Serial 0.5–T Magnetic Resonance Angiography

Neurosurgery ◽  
2006 ◽  
Vol 58 (6) ◽  
pp. 1047-1053 ◽  
Author(s):  
Nobuhiko Miyazawa ◽  
Iwao Akiyama ◽  
Zentaro Yamagata
Keyword(s):  
Risk Factors ◽  
Subarachnoid Hemorrhage ◽  
Family History ◽  
Unruptured Aneurysms ◽  
Logistic Analysis ◽  
Aneurysm Size ◽  
History Of ◽  
Aneurysm Growth ◽  
Independent Risk Factors

Abstract OBJECTIVE: The independent risk factors for aneurysm growth were retrospectively investigated in 130 patients with unruptured aneurysms who were followed up by 0.5–T serial magnetic resonance angiography with stereoscopic images. METHODS: Age, sex, site of aneurysm, size of aneurysm, multiplicity of aneurysms, type of circle of Willis, length of follow-up period, cerebrovascular event, hypertension, diabetes, hyperlipidemia, smoking habit, and family history of subarachnoid hemorrhage were investigated using multiple logistic analysis. RESULTS: Fourteen patients (16 aneurysms) among the 130 patients (159 aneurysms) showed aneurysm growth (10.8%) during follow-up of 10 to 69 months (mean 29.3 ± 10.5 mo). Multiple logistic analysis disclosed that location on the middle cerebral artery (odds ratio [OR] 0.08, P &lt; 0.01), multiplicity of aneurysms (OR 68.5, P &lt; 0.01), aneurysm size of 5 mm or larger (OR 1.17, P = 0.05), and family history of subarachnoid hemorrhage (OR 10.9, P &lt; 0.01) were independent risk factors. CONCLUSION: Location on the middle cerebral artery, multiplicity, aneurysm size of 5 mm or larger, and family history of subarachnoid hemorrhage are independent risk factors for aneurysm growth. These results may help to determine the treatment choice for unruptured aneurysms.

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