Occipital posterior interhemispheric supratentorial approach for resection of midbrain cavernous malformation

Approaches to the pineal region are various, and each has its advantages and disadvantages. The authors present a case of a 50-year-old woman who presented with progressive hemiparesis and vertical gaze palsy; she was diagnosed with a midbrain cavernous malformation. The patient underwent an occipital posterior interhemispheric supratentorial transpineal approach with gross-total resection. On long-term follow-up, her symptoms significantly improved. The authors review the regional anatomy and present the operative video. They also discuss the various approaches with their indications, advantages, and disadvantages. The video can be found here: https://stream.cadmore.media/r10.3171/2021.4.FOCVID2133.

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Meningiomas of pineal region in children

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2007000600016 ◽

2007 ◽

Vol 65 (4a) ◽

pp. 1000-1006 ◽

Cited By ~ 9

Author(s):

Hamilton Matushita ◽

Fernando Campos Pinto ◽

José Píndaro Pereira Plese

Keyword(s):

Clinical Presentation ◽

Complete Removal ◽

Pineal Region ◽

Total Resection ◽

Long Term Follow Up ◽

One Year ◽

Velum Interpositum ◽

Transtentorial Approach

Meningiomas are uncommon tumors in children and either more rarely encountered in the pineal region. We report two cases of meningioma of the pineal region in children. One of these cases was a five years-old girl and the other a one year-old boy. No specific clinical presentation or tomographic examinations findings was identified before treatment, suggestive of a diagnosis of menigioma. The clinical and laboratory features were very similar to the most common tumors of the pineal region. Prior to the surgery, the histology of these tumors was not suspected. Both patients underwent direct surgery and complete removal was achieved by a suboccipital transtentorial approach. The tumors originated from velum interpositum in both cases. At the follow up, one case presented with recurrence six years later, and she underwent a reoperation with total resection without morbidity. Long-term follow up presented no other recurrences.

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Papillary Tumors of the Pineal Region: Case Report

Neurosurgery ◽

10.1227/01.neu.0000255443.44365.77 ◽

2007 ◽

Vol 60 (5) ◽

pp. E953-E955 ◽

Cited By ~ 41

Author(s):

Elias Dagnew ◽

Lauren A. Langford ◽

Frederick F. Lang ◽

Franco DeMonte

Keyword(s):

Subcommissural Organ ◽

Obstructive Hydrocephalus ◽

Unknown Origin ◽

Original Description ◽

Distant Recurrence ◽

Pineal Region ◽

Ependymal Cells ◽

Long Term Follow Up

Abstract OBJECTIVE The pineal region is a rare intracranial site for metastasis. We report three patients initially considered to have metastatic papillary adenocarcinoma to the pineal region. On review, these papillary, keratin-positive neoplasms meet the criteria for papillary tumor of the pineal region (PTPR). CLINICAL PRESENTATION These neoplasms occurred in three women (age range, 37–55 yr). Imaging studies demonstrated well-circumscribed lesions in the pineal region. All patients presented with obstructive hydrocephalus and symptoms attributable to hydrocephalus and tectal compression. INTERVENTION All three patients underwent near total microsurgical resection of the pineal region neoplasm, followed by adjuvant radiotherapy. The two patients with long-term follow-up (56–60 mo) have remained clinically stable without evidence of local or distant recurrence. The first two patients were initially diagnosed as having papillary metastatic carcinoma of unknown origin. The third patient was treated after the recent description of PTPR and met the histopathological diagnostic criteria. Retrospective pathological review of the previous two patients resulted in designation as PTPR. CONCLUSION The morphological features of the tumors in our series, along with the clinical presentations, are similar to those in the original description of the PTPR. Our findings agree with the original hypothesis that the cells composing the PTPR are similar to ependymal cells of the subcommissural organ, thus furthering the hypothesis that the PTPR derives from a specialized ependymocyte associated with the subcommissural organ. The two patients with long-term follow-up (56–60 mo) have remained clinically stable without evidence of local or distant recurrence.

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Long-term follow-up of a papillary tumor of the pineal region: addendum to a case report

Journal of Neuro-Oncology ◽

10.1007/s11060-016-2246-2 ◽

2016 ◽

Vol 130 (3) ◽

pp. 601-603 ◽

Cited By ~ 1

Author(s):

Laura Lippa ◽

Anna Maria Di Giacomo ◽

Alfonso Cerase

Keyword(s):

Case Report ◽

Pineal Region ◽

Papillary Tumor ◽

Long Term Follow Up

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Patient Outcome at Long-term Follow-up after Aggressive Microsurgical Resection of Cranial Base Chondrosarcomas

Neurosurgery ◽

10.1227/01.neu.0000215892.65663.54 ◽

2006 ◽

Vol 58 (6) ◽

pp. 1090-1098 ◽

Cited By ~ 51

Author(s):

Fotios Tzortzidis ◽

Foad Elahi ◽

Donald C. Wright ◽

Nancy Temkin ◽

Sabareesh K. Natarajan ◽

...

Keyword(s):

Cranial Base ◽

Gross Total Resection ◽

Cerebrospinal Fluid Leakage ◽

Subtotal Resection ◽

Incomplete Resection ◽

Total Resection ◽

Long Term Follow Up ◽

Microsurgical Resection

Abstract OBJECTIVE: To evaluate patient clinical outcome and survival at long-term follow-up after aggressive microsurgical resection of chondrosarcomas of the cranial base. METHODS: Over a 20-year period, 47 patients underwent 72 operative procedures for resection of cranial base chondrosarcomas. Thirty-three patients were previously untreated, whereas 14 patients previously had undergone surgery or radiation. Twenty-three patients had a single operation and 24 underwent staged (more than one) operations because of extensive disease. Patients who underwent subtotal resection also underwent radiotherapy or radiosurgery. Patients were evaluated at follow-up clinically and by imaging studies. RESULTS: Gross total resection was accomplished in 29 (61.7%) patients, and subtotal resection was accomplished in 18 patients (38.3%). The resection was better in patients who underwent a primary operation (gross total resection, 68.8 versus 46.7%) rather than a reoperation. Patients who underwent incomplete resection underwent postoperative radiotherapy, which included proton beam radiotherapy (15.6%), radiosurgery (68%), and fractionated radiation (15.6%). There were no operative deaths. Postoperative complications (cerebrospinal fluid leakage, quadriparesis, infections, cranial nerve palsies, etc.) were observed in 10 patients (18%). The follow-up ranged from 2 to 255 months, with an average of 86 months. At the conclusion of study, 36 (76.6%) patients were alive, and 21 (44.7%) patients were alive without disease. Recurrence-free survival was 32% at 10 years in all patients, 42.3% in primary patients and 13.8% in those who underwent reoperation. The Karnofsky performance score was 82.4 ± 9.8 before surgery, 85 ± 12.5 at 1 year after surgery, and 85.3 ± 5.8 at the latest follow-up. Two patients died as a result of radiotherapy complications (malignancy, radiation necrosis). CONCLUSION: Cranial base chondrosarcomas can be managed well by complete surgical resection or by a combination of surgery and radiotherapy. The study cannot comment about the efficacy of radiotherapy. Approximately half of the patients survived without recurrence at long-term follow-up (>132 mo). The functional status of the surviving patients was excellent at follow-up.

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Pineocytomas: a long-term follow up study of four cases in Helsinki Neurosurgery

Journal of Case Reports in Medicine ◽

10.25149/case-reports.v8i1.162 ◽

2019 ◽

Vol 8 (1) ◽

pp. 5

Author(s):

Joham Choque-Velasquez ◽

Julio C Resendiz-Nieves ◽

Behnam Rezai Jahromi ◽

Roberto Colasanti ◽

Rahul Raj ◽

...

Keyword(s):

Good Prognosis ◽

Gross Total Resection ◽

Benign Lesions ◽

Total Resection ◽

Term Outcome ◽

Long Term Outcome ◽

Long Term Follow Up ◽

Microsurgical Resection

Background: Pineocytomas are rare benign lesions with a relatively good prognosis if gross total resection can be achieved. Report of cases: We present a retrospective review of four patients with histologically confirmed pineocytomas consecutively operated on after 1997. All of our patients were alive at a mean follow-up of 224,5 months (range 204-246). A gross total resection was accomplished in all cases. The cornerstones for the surgical resection of pineocytomas are reported. Conclusions: A proper management of pineocytomas, based on the gross total microsurgical resection of the lesion, results in an excellent long term outcome of these pineal lesions.

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A Pineal Region Germ Cell Tumor With Rapid Enlargement After a Long-term Follow-up

Neurosurgery ◽

10.1227/neu.0b013e318284708a ◽

2013 ◽

Vol 72 (4) ◽

pp. E687-E693 ◽

Cited By ~ 5

Author(s):

Shinya Jinguji ◽

Masafumi Fukuda ◽

Keisuke Nagasaki ◽

Yukihiko Fujii

Keyword(s):

Germ Cell ◽

Germ Cell Tumor ◽

Pineal Region ◽

Cell Tumor ◽

Rapid Enlargement ◽

Long Term Follow Up

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Hemangiopericytomas of the skull base

Neurosurgical FOCUS ◽

10.3171/2011.2.focus119 ◽

2011 ◽

Vol 30 (5) ◽

pp. E10 ◽

Cited By ~ 7

Author(s):

Clemens M. Schirmer ◽

Carl B. Heilman

Keyword(s):

Skull Base ◽

Pertinent Literature ◽

Total Resection ◽

Secondary Resection ◽

Free Interval ◽

Initial Surgery ◽

Long Term Follow Up ◽

Cns Neoplasms

Object Intracranial hemangiopericytomas are frequently located along the dural sinuses along the skull base and represent rare, aggressive CNS neoplasms that are difficult to distinguish from meningiomas based on both imaging and gross characteristics. The authors of this study describe 3 patients with these lesions and review the pertinent literature. Methods Two men and 1 woman, whose median age at the time of the initial presentation was 37 years (range 20–53 years), constitute this series. They underwent multimodal treatment consisting of resection, embolization, radiation therapy, and in 1 case chemotherapy. Results Two of the 3 patients treated were alive after a mean follow-up of 93 months (range 4–217 months). One patient died 217 months after the initial diagnosis. The longest tumor progression–free interval after the initial or secondary resection was 43 months (range 4–84 months). Conclusions Hemangiopericytomas have been reclassified as mesenchymal nonmeningothelial tumors. They have an inevitable tendency to recur locally and metastasize distally. The mainstay of therapy remains an aggressive attempt to achieve gross-total resection at the initial surgery. Postoperative adjuvant radiotherapy should be offered to all patients, regardless of the degree of resection achieved. Diligent long-term follow-up is paramount as local recurrences and distal metastases can develop sometimes years after the initial treatment.

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