Osteosarcoma of the skull base presenting as a petrocavernous pseudoaneurysm and masquerading as an intracranial abscess: illustrative case

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Nyomi R. Washington ◽  
John L. Kiley ◽  
Hans Bakken ◽  
Ryan Morton
Keyword(s):  
Differential Diagnosis ◽  
Skull Base ◽  
Malignant Neoplasm ◽  
Clinical Findings ◽  
Sinus Surgery ◽  
Endovascular Coiling ◽  
Illustrative Case ◽  
Intracranial Abscess ◽  
Intracranial Involvement ◽  
Aneurysmal Bone Cysts

BACKGROUND Telangiectatic osteosarcoma (TOS) is a rare and aggressive high-grade malignant neoplasm composed of blood-filled or empty cystic spaces resembling aneurysmal bone cysts. Uncommonly, TOSs can occur in the skull base. OBSERVATIONS The authors present a case of a TOS that presented as a petrocavernous carotid pseudoaneurysm and then masqueraded as an intracranial abscess. The prognosis for TOSs with intracranial involvement is typically unfavorable and inversely related to the degree of intracranial involvement. LESSONS Skull-based malignancies should be part of the differential diagnosis for a rapidly progressing lesion. Recovery of polymicrobial organisms during endoscopic sinus surgery should prompt reconsideration of the differential diagnosis. Postinflammatory changes from endovascular coiling have been described and can confound imaging and clinical findings.

scholarly journals Management of an Unusual Intranasal Foreign Body Abutting the Cribriform Plate: A Case Report and Review of Literature

2019 ◽  
Vol 12 ◽  
pp. 117955061985860
Author(s):  
Mingyang L Gray ◽  
Catharine Kappauf ◽  
Satish Govindaraj
Keyword(s):  
Foreign Body ◽  
Skull Base ◽  
Foreign Bodies ◽  
Cribriform Plate ◽  
Sinus Surgery ◽  
Csf Leak ◽  
Intracranial Involvement ◽  
History Of ◽  
Initial Imaging ◽  
The Right

A 35-year-old man with history of schizophrenia presented 3 weeks after placing a screw in his right nostril. Initial imaging showed a screw in the right ethmoid sinus with the tip penetrating the right cribriform plate. On exam, the patient was hemodynamically stable with purulent drainage in the right nasal cavity but no visible foreign body. While most nasal foreign bodies occur in children and are generally removed at the bedside, intranasal foreign bodies in adults tend to require further assessment. The foreign body in this case was concerning for skull base involvement and the patient was brought to the operating room (OR) with neurosurgery for endoscopic sinus surgery (ESS) and removal of foreign body. The screw was removed and the patient recovered with no signs of cerebrospinal fluid (CSF) leak postoperatively. Any concern for skull base or intracranial involvement should call for a full evaluation of the mechanism of injury and intervention in a controlled environment.

Endoscopic sinus surgery the art of new era

2018 ◽  
Vol 9 (SPL1) ◽  
Author(s):  
Wasam A Albusalih
Keyword(s):  
Skull Base ◽  
Endoscopic Sinus Surgery ◽  
Chronic Infection ◽  
Malignant Tumour ◽  
Sinus Surgery ◽  
Skull Base Tumor ◽  
Short Hospital Stay ◽  
Gland Tumor ◽  
New Era ◽  
Skull Base Defect

Endoscopic sinus surgery is one of the fastest technique for treatment of sinonasal diseases which includes acute and chronic infection and resection of benign and malignant tumour; soon it extend for management of more deep area and deal with lesions in the pterygopalatine and infratemporal fossae then extended for management of skull base tumor which include pituitary gland tumor clival tumor and skull base defect leading to csf rhinorrea and its complications…in this lecture i cited the success which achieved in Diwanyia teaching hospital in this growing branch of medicine and illustrate some of my procedures pre and postoperatively with brief discussion for each.Endoscopic sinus surgery and its extended applications now play a major role in management of sinonasal And Skull base diseases with minimum complications and short hospital stay without the need for external devastating approach.

Skull base aneurysmal bone cyst presenting with hydrocephalus: progressive residuum obliterated by Gamma Knife stereotactic radiosurgery in a pediatric patient

2020 ◽  
Vol 26 (1) ◽  
pp. 76-81
Author(s):  
George H. Tse ◽  
Feng Y. Jiang ◽  
Matthias W. R. Radatz ◽  
Saurabh Sinha ◽  
Hesham Zaki
Keyword(s):  
Skull Base ◽  
Stereotactic Radiosurgery ◽  
Gamma Knife ◽  
Pediatric Population ◽  
Bone Cyst ◽  
Disease Free Survival ◽  
Long Term Follow Up ◽  
Aneurysmal Bone Cysts ◽  
Gamma Knife Stereotactic Radiosurgery

Aneurysmal bone cysts (ABCs) are an uncommon entity predominantly encountered in the pediatric population. The skull is rarely involved, but these cysts have been reported to arise in the skull base. Traditional treatment has been with surgery alone; however, there is a gathering body of literature that reports alternative treatments that can achieve long-term disease-free survival. However, these therapies are predominantly directed at peripheral skeletal lesions. To the authors’ knowledge, this report is the first to describe long-term follow-up of the efficacy of Gamma Knife stereotactic radiosurgery for treatment of ABC residuum in the skull base that resulted in long-term patient stability and likely ABC obliteration.

Anatomic Variations of Ethmoid Roof and Risk of Skull Base Injury in Endoscopic Sinus Surgery: Statistical Correlations

2021 ◽  
pp. 194589242110205
Author(s):  
Gian Luca Fadda ◽  
Alessio Petrelli ◽  
Federica Martino ◽  
Giovanni Succo ◽  
Paolo Castelnuovo ◽  
...  
Keyword(s):  
Skull Base ◽  
Endoscopic Sinus Surgery ◽  
Horizontal Plane ◽  
Uncinate Process ◽  
Cribriform Plate ◽  
Sinus Surgery ◽  
Evaluation Methodology ◽  
Anatomic Variations ◽  
Imaging Evaluation ◽  
Plane Passing

Background Recent developments in endoscopic sinus surgery (ESS) have increased the need to investigate the complex anatomic variations in the ethmoid roof and skull base, to inform the surgeon about the risk of damaging these crucial areas during ESS. Objective To offer a detailed description of sinus anatomy focusing on the key surgical landmarks in ESS and frontal recess surgery to standardize a systematic approach during the preoperative sinuses imaging evaluation. Methodology: A total of 220 computed tomography (CT) scans were reviewed to obtain six sets of measurements: the depth of the cribriform plate (CP); the length of the lateral lamella of the cribriform plate (LLCP); the angle formed by the LLCP and the continuation of the horizontal plane passing through the CP; the position of the anterior ethmoidal artery (AEA) at the skull base; the extent of frontal sinus pneumatization (FSP); the type of superior attachment of the uncinate process (SAUP). Results The length of the LLCP was statistically significantly correlated with the different Keros classification types, the angle formed by the LLCP with the continuation of the horizontal plane passing through the CP, and with the AEA position at the skull base. The depth of the olfactory fossa was correlated with FSP. Conclusions According to the Keros and Gera classifications, the data obtained from these evaluations allow the assessment of anatomic-radiological risk profiles and can help identify those patients who are high risk for ethmoid roof injury.

An Isolated Vertebral Metastasis of Urachal Adenocarcinoma

2004 ◽  
Vol 128 (9) ◽  
pp. 1043-1045 ◽  
Author(s):  
Sophia Taylor ◽  
Patrizia Bacchini ◽  
Franco Bertoni
Keyword(s):  
Differential Diagnosis ◽  
Biopsy Specimen ◽  
Clinical Findings ◽  
Thoracic Vertebra ◽  
Partial Cystectomy ◽  
Rare Tumor ◽  
Vertebral Metastasis ◽  
Metastatic Patterns ◽  
Urachal Adenocarcinoma

Abstract We describe a case of urachal adenocarcinoma arising in a 30-year-old woman. The patient underwent partial cystectomy. Three years later, she presented with an isolated metastasis to a thoracic vertebra, which was treated by vertebral corporectomy. Histologic findings are described, and the clinical findings, management, and metastatic patterns of this rare tumor, as well as the differential diagnosis on a biopsy specimen, are discussed.

Pagetoid Bowen Disease

2000 ◽  
Vol 124 (3) ◽  
pp. 427-430 ◽  
Author(s):  
John D. Williamson ◽  
Maria I. Colome ◽  
Aysegul Sahin ◽  
Alberto G. Ayala ◽  
L. Jeffrey Medeiros
Keyword(s):  
Differential Diagnosis ◽  
Carcinoma In Situ ◽  
Clinical Evidence ◽  
Malignant Neoplasm ◽  
The Other ◽  
Paget Disease ◽  
Melanoma In Situ ◽  
Bowen Disease ◽  
Hmb 45

Abstract Bowen disease is a variant of squamous cell carcinoma in situ. In some cases a pagetoid growth pattern can be observed with cytologically atypical clear cells arranged singly and in nests. The differential diagnosis of pagetoid Bowen disease includes primarily Paget disease and malignant melanoma in situ, as well as other less common entities. Two cases of pagetoid Bowen disease are described, one in a 65-year-old man with a thigh lesion and the other in a 25-year-old man with a lesion in the penile/scrotal region. Neither patient had clinical evidence of an internal malignant neoplasm. In both cases, the neoplastic cells were positive for cytokeratin (CK) 7 and CK 19 and were negative for CK 18, CK 20, carcinoembryonic antigen, GCDFP-15, c-erbB2, S100, and HMB-45. In aggregate, these findings support the diagnosis of pagetoid Bowen disease. Previously, others have shown that CK 7 is an almost invariable marker of Paget disease. Thus, we report these two cases to illustrate that CK 7 can be expressed by pagetoid Bowen disease and should not be a cause of confusion in the differential diagnosis.

Clinical Findings and Differential Diagnosis of Cerebral Vein Thrombosis

1990 ◽  
pp. 171-186
Author(s):  
A. Hartmann ◽  
J. Wappenschmidt ◽  
L. Solymosi ◽  
F. Brassel
Keyword(s):  
Differential Diagnosis ◽  
Clinical Findings ◽  
Cerebral Vein ◽  
Cerebral Vein Thrombosis ◽  
Vein Thrombosis

scholarly journals Melanotic Neuroectodermal Tumor of Infancy

2018 ◽  
Vol 142 (11) ◽  
pp. 1358-1363 ◽  
Author(s):  
Brian S. Soles ◽  
Allecia Wilson ◽  
David R. Lucas ◽  
Amer Heider
Keyword(s):  
Differential Diagnosis ◽  
Local Recurrence ◽  
Soft Tissues ◽  
Malignant Neoplasm ◽  
Neck Region ◽  
Neuroectodermal Tumor ◽  
Growth Potential ◽  
Incomplete Resection ◽  
The Central Nervous System ◽  
Blue Cell

Context.— Melanotic neuroectodermal tumor of infancy, albeit rare and generally regarded as benign, is an important tumor to recognize because of its rapid growth, potential for local recurrence, and small round blue cell morphology, which can lead to misdiagnosis of a malignant neoplasm. Objective.— To review its clinical presentation and immunomorphologic findings, and discuss common entities in the differential diagnosis. Data Sources.— The study involved PubMed searches, including multiple review articles, case studies, retrospective studies, selected book chapters, and University of Michigan cases. Conclusions.— Melanotic neuroectodermal tumor of infancy most commonly occurs in the bones of the head and neck region during the first year of life, but it can also present in other locations, including the central nervous system, testes, ovaries, and subcutaneous soft tissues. Histologically, it is composed of a biphasic population of cells, consisting of epithelioid melanin-producing cells and primitive neurogenic cells in a fibrocollagenous stroma. These microscopic findings, especially in small biopsies, can lead to a broad differential diagnosis that includes malignant small round blue cell tumors and malignant melanoma. Melanotic neuroectodermal tumor of infancy commonly has an infiltrative growth pattern, and anatomic constraints often lead to incomplete resection and local recurrence, requiring multiple surgical operations. Because melanotic neuroectodermal tumor of infancy can mimic a more aggressive and aggressively treated malignancy, recognition of this rare tumor is very crucial for pathologists.

scholarly journals Extensive parapharyngeal and skull base neuroglial ectopia; a challenge for differential diagnosis and treatment: case report

2010 ◽  
Vol 128 (5) ◽  
pp. 302-305 ◽  
Author(s):  
Giulianno Molina de Melo ◽  
Gabrielle do Nascimento Holanda Gonçalves ◽  
Ricardo Antenor de Souza e Souza ◽  
Danilo Anunciatto Sguillar
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Skull Base ◽  
Infratemporal Fossa ◽  
Newborn Infants ◽  
Surgical Excision ◽  
Neck Mass ◽  
Oral Feeding ◽  
Feeding Difficulties ◽  
Complete Surgical Excision

CONTEXT: Neuroglial ectopia has been defined as a mass composed of differentiated neuroectodermal tissue isolated from the spinal canal or cranial cavity and remains rare. This lesion has to be considered in the differential diagnosis among newborn infants with classical symptoms of respiratory distress, neck mass and feeding difficulties. We present a rare case of extensive parapharyngeal and skull base neuroglial ectopia in 6-month-old girl who presented respiratory and feeding obstruction at birth. CASE REPORT: A six-month-old girl who presented upper respiratory and feeding obstruction at birth and was using tracheostomy and gastrostomy tubes was referred to our institution. Complete surgical excision of the mass consisted of a transcervical-transparotid approach with extension to the infratemporal fossa by means of a lateral transzygomatic incision, allowing preservation of all vital neurovascular structures. The anatomopathological examination showed a solid mass with nests of neural tissue, with some neurons embedded in poorly encapsulated fibrovascular stroma, without mitotic areas, and with presence of functioning choroid plexus in the immunohistochemistry assay. Neurovascular function was preserved, thus allowing postoperative decannulation and oral feeding. Despite the large size of the mass, the child has completed one year and six months of follow-up without complications or recurrence. Neuroglial ectopia needs to be considered in diagnosing airway obstruction among newborns. Surgical treatment is the best choice and should be performed on clinically stable patients. An algorithm to guide the differential diagnosis and improve the treatment was proposed.

scholarly journals Genetic testing for choroideremia

2017 ◽  
Vol 1 (s1) ◽  
pp. 26-28
Author(s):  
Andi Abeshi ◽  
Alessandra Zulian ◽  
Tommaso Beccari ◽  
Munis Dundar ◽  
Francesco Viola ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Clinical Trials ◽  
Optical Coherence Tomography ◽  
Differential Diagnosis ◽  
Clinical Utility ◽  
Scientific Literature ◽  
Genetic Test ◽  
Fundus Autofluorescence ◽  
Clinical Findings ◽  
Ophthalmological Examination

Abstract We studied the scientific literature and disease guidelines in order to summarize the clinical utility of the genetic test for choroideremia (CHM). CHM is an inherited X-linked recessive disorder associated with variations in the CHM gene. The overall prevalence of CHM varies from 1 in 50 000 to 1 in 100 000. Clinical diagnosis is based on clinical findings, ophthalmological examination, visual field, fundus autofluorescence, optical coherence tomography and electroretinography. The genetic test is useful for confirming diagnosis and for differential diagnosis, couple risk assessment and access to clinical trials.

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