Extraspinal ependymomas

1979 ◽  
Vol 51 (3) ◽  
pp. 383-391 ◽  
Author(s):  
Robert A. Morantz ◽  
John J. Kepes ◽  
Solomon Batnitzky ◽  
Byron J. Masterson
Keyword(s):  
Anterior Approach ◽  
Ependymal Cell ◽  
Review Of The Literature ◽  
Tumor Removal ◽  
Nerve Roots ◽  
Content Type ◽  
The Third ◽  
Complete Tumor Removal ◽  
Pilonidal Cyst ◽  
Complete Tumor

✓ Spinal ependymomas may rarely arise from heterotopic ependymal cell clusters and thus occur in an extraspinal location. Presentation of three cases and a review of the literature reveal that these tumors have characteristic radiographic and clinical features. They occur mainly in patients in the third decade of life, and present either in the soft tissue posterior to the sacrum or in the pelvis. In the case of posterior tumors, the patient exhibits a mass which is usually mistaken for a pilonidal cyst. Patients whose tumor is pelvic in location present with sphincter disturbances or dysfunction of the sacral nerve roots. Conventional and computerized tomographic studies will reveal erosion of the sacrum. Myelography will demonstrate an extradural mass indenting the thecal sac from below. The protein in the cerebrospinal fluid will be normal. A combined posterior and anterior approach with the goal of complete tumor removal is the procedure of choice. If this is not feasible, then radiation therapy should be employed. Because of the increased incidence of systemic metastases, the average postoperative survival is approximately 10 years.

A critical comparison of neurosurgical and otolaryngological approaches to acoustic neuromas

1978 ◽  
Vol 48 (1) ◽  
pp. 1-12 ◽  
Author(s):  
Michael V. Ditullio ◽  
Dennis Malkasian ◽  
Robert W. Rand
Keyword(s):  
Pathological Process ◽  
Tumor Removal ◽  
Content Type ◽  
Critical Comparison ◽  
Complete Tumor Removal ◽  
Suboccipital Craniectomy ◽  
Acoustic Neuromas ◽  
Technical Requirements ◽  
Careful Comparison ◽  
Complete Tumor

✓ Neurosurgeons have traditionally advocated the transmeatal suboccipital craniectomy as the procedure of choice in treating acoustic neuromas of all sizes. With this technique, complete tumor removal was achieved in 91% of our patients. Facial motor activity was fully preserved in 59% and it was only partially deficient in an additional 29%. Conversely, recent otological reports have proposed a more flexible attitude in which the size of the tumor dictates the form of surgical therapy. In that scheme, the universally applicable and clinically proven suboccipital craniectomy is replaced by a series of procedures (translabyrinthine, middle fossa, transsigmoidal), each of which differs in its anatomical and technical requirements. This necessity for several operations seems to stem from the failure of any particular approach either to provide adequate visualization of the entire pathological process, or to afford maximum opportunity for complete tumor removal. By employing these various techniques, total capsular removal has been generally achieved in only 71% of cases. A careful comparison and analysis of these individual procedures reaffirms the superiority of the posterior fossa approach.

An unusual complication of Dura Film as a dural substitute

1984 ◽  
Vol 60 (5) ◽  
pp. 1076-1079 ◽  
Author(s):  
Carlos M. Ongkiko ◽  
Jeffrey T. Keller ◽  
Frank H. Mayfield ◽  
Stewart B. Dunsker
Keyword(s):  
Acute Subdural Hematoma ◽  
Unusual Complication ◽  
Graft Material ◽  
Review Of The Literature ◽  
Tumor Removal ◽  
Acute Hemorrhage ◽  
Content Type ◽  
Dural Substitute ◽  
Connective Tissue Capsule ◽  
Tissue Capsule

✓ Two cases are presented in which the patients developed an unusual complication following the use of an artificial dural substitute, silicone-coated Dacron (Dura Film). Both patients had undergone removal of a tumor and involved dura. The first patient developed a very thick connective-tissue capsule of the graft material which simulated a recurrent tumor. The second patient developed an acute hemorrhage initially thought to be an acute subdural hematoma beneath the artificial dura 9 weeks after tumor removal and implantation of the graft. A review of the literature and proposed mechanisms of these complications are presented.

scholarly journals Fluorescein Sodium Use during Spinal Ependymoma Resection

2017 ◽  
Vol 3 (3) ◽  
pp. 123-134
Author(s):  
Zhenxing Sun ◽  
Dan Yuan ◽  
Yaxing Sun ◽  
Zhanquan Zhang ◽  
James Wang ◽  
...  
Keyword(s):  
Removal Rate ◽  
Sensory Function ◽  
Fluorescent Light ◽  
Surgical Removal ◽  
Fluorescein Sodium ◽  
Tumor Removal ◽  
Intramedullary Tumors ◽  
Complete Tumor Removal ◽  
Complete Tumor

Spinal ependymomas (SEs) are common adult intramedullary tumors; however, determining the absolute boundary between the tumor and the tumor residual may be difficult. We assessed outcomes following the use of fluorescein sodium (FS) during surgical removal of SEs. We performed a retrospective analysis of 112 patients with SEs who were treated at Beijing Tsinghua Changgung Hospital between December 2014 and December 2016. Each patient received intravenous FS (3–4 mg/kg) to determine the SE boundaries during surgery. Tumor removal efficiencies and tumor residuals were assessed using magnetic resonance imaging (MRI) at 10 days and 3 months after surgical recovery; McCormick's spinal function classification was also performed at the 3-month follow-up. The complete tumor removal rate was 92% (103/112). Ninety-four patients underwent tumor removal under fluorescent light, which provided distinctive tumor fluorescence. Tumor removal under white light was performed in 18 patients; fluorescent images were invisible or indistinctive in these 18 patients. At the 3-month follow-up, sensory function (85.8% (91/106)) and movement (84.3% (86/102)) were improved in patients with pre-surgical dysfunction; urination and defecation functions were improved in 66.7% (16/24). The McCormick spinal cord functional classifications, at the 3-month follow-up, showed significant differences in the percentages of patients with disease classified to each grade (I–IV), compared with preoperative classifications (each, P < 0.05). There was no MRI evidence of tumor relapse or residuals at the 3-month follow-up. FS use during the surgical treatment of SE enables complete tumor removal and detection of tumor residuals.

Meningioma Involving Meckel's Cave: Transpetrosal Surgical Anatomy and Clinical Considerations

2002 ◽  
Vol 111 (9) ◽  
pp. 850-854 ◽  
Author(s):  
Daniel I. Choo ◽  
David L. Steward ◽  
Myles L. Pensak
Keyword(s):  
Facial Pain ◽  
Skull Base Surgery ◽  
Surgical Anatomy ◽  
Tumor Removal ◽  
Meckel’S Cave ◽  
Complete Tumor Removal ◽  
Meckel's Cave ◽  
Intimate Knowledge ◽  
Clinical Considerations ◽  
Complete Tumor

Meningiomas originating in Meckel's cave (MC) are uncommon lesions that represent 1% of all intracranial meningiomas. Innovations in skull base surgery have enabled resection of these lesions with less morbidity, but require an intimate knowledge of both lesional pathology and regional microneuroanatomy. To review the surgical and clinical considerations involved in the management of MC meningiomas, we retrospectively reviewed data from patients who underwent transpetrosal resection of primary MC meningiomas between 1984 and 1998. Of 146 patients who underwent transpetrosal removal of meningiomas, 7 were believed to have tumors originating in MC. All 7 patients presented with trigeminal dysfunction, facial pain, and/or headache. Complete tumor removal was achieved in 5 of the 7 patients. Facial hypoesthesia or anesthesia, paralysis of cranial nerve VI, and ophthalmoplegia were among the postoperative complications encountered. Meningiomas of MC represent treatable lesions whose diagnosis requires prompt imaging of patients with trigeminal dysfunction and symptoms of facial pain and headache.

Spinal Meningiomas: Review of 174 Operated Cases

Neurosurgery ◽  
1989 ◽  
Vol 25 (2) ◽  
pp. 153-160 ◽  
Author(s):  
Carlo L. Solero ◽  
Maurizio Fornari ◽  
Sergio Giombini ◽  
Giovanni Lasio ◽  
Giuseppe Oliveri ◽  
...  
Keyword(s):  
Neurological Impairment ◽  
Neurological Deficits ◽  
Long Term Results ◽  
Tumor Removal ◽  
Microsurgical Technique ◽  
Complete Tumor Removal ◽  
Spinal Meningiomas ◽  
Subtotal Removal ◽  
Complete Tumor

Abstract The long-term results obtained in a series of 174 patients operated on for spinal meningiomas are critically analyzed. This series was similar to those of other authors with regard to age, sex, location of the tumors, and clinical presentation. Before surgery, about 70% of the patients were included in Groups I and II (mild neurological impairment), and about 30% of the patients were classified in Groups III and IV (significant to severe neurological impairment, up to paraplegia). Complete tumor removal was achieved in 96.5% of the patients, and surgical mortality was about 1%. Microsurgical technique, which was adopted in the last 29 cases, proved to be very effective in reducing undue damage to the spinal cord and in minimizing the postoperative neurological deficits. Of the 174 patients who underwent surgery, 156 underwent late follow-up study for an average of 15 years (2 patients died in the immediate postoperative period, and 16 patients were lost to follow-up). Twenty-nine patients died of causes unrelated to the spinal meningioma; of the remaining 126 patients, 92% were categorized in Groups I and II, and only 8% in Groups III and IV. The rate of recurrence was 6% (9 patients) among the 150 patients who had complete tumor removal, and the rate of regrowth was 17% (1 patient with anaplastic meningioma) among the 6 patients treated by subtotal removal. The early diagnosis of the disease and the use of microsurgical technique appeared as the most relevant factors for further improvement of the surgical results.

Sudden deterioration and death in patients with benign tumors of the third ventricle area

1986 ◽  
Vol 64 (2) ◽  
pp. 216-223 ◽  
Author(s):  
John W. Ryder ◽  
B. K. Kleinschmidt-DeMasters ◽  
Ted S. Keller
Keyword(s):  
Risk Factors ◽  
Sudden Death ◽  
Third Ventricle ◽  
Benign Tumors ◽  
Close Monitoring ◽  
Review Of The Literature ◽  
Content Type ◽  
The Third ◽  
Colloid Cysts ◽  
The Subject

✓ Although sudden deterioration and death is a widely recognized complication in patients with benign tumors of the third ventricle area, the exact incidence of this dreaded occurrence is unknown and the reports in the literature on the subject are largely anecdotal. Neither risk factors nor the etiology of the sudden death have been analyzed. The vast majority of these benign tumors are colloid cysts, and the presence and degree of ventricular dilatation and herniation associated with these tumors as cited in the reports are quite variable. The authors report a case of sudden death in a 27-year-old woman with a subependymoma of the left lateral and third ventricles. A review of the literature is included in an attempt to discern identifiable risk factors for sudden death in patients with tumors of the third ventricle area. Since this potential complication is known to exist in patients with otherwise benign tumors amenable to surgical resection, the authors recommend either prompt removal of the tumor on discovery or close monitoring of the patient if surgery is to be delayed.

Primary polymorphous low-grade adenocarcinoma of the bronchus: Complete tumor removal with bronchoscopic resection

Lung Cancer ◽  
2009 ◽  
Vol 63 (2) ◽  
pp. 301-304 ◽  
Author(s):  
Viboon Boonsarngsuk ◽  
Thitiporn Suwatanapongched ◽  
Mana Rochanawutanon ◽  
Montian Ngodngamthaweesuk ◽  
Piemsak Prakardvudhisarn
Keyword(s):  
Low Grade ◽  
Tumor Removal ◽  
Complete Tumor Removal ◽  
Complete Tumor

Lipoma with dumb-bell extradural extension through the intervertebral foramen into the spinal canal

2005 ◽  
Vol 2 (1) ◽  
pp. 69-71 ◽  
Author(s):  
Jin Soo Park ◽  
Isao Shirachi ◽  
Kimiaki Sato ◽  
Noriyuki Ando ◽  
Kensei Nagata
Keyword(s):  
Vertebral Artery ◽  
Spinal Canal ◽  
Anterior Approach ◽  
Posterior Approach ◽  
Intervertebral Foramen ◽  
Nerve Roots ◽  
Content Type ◽  
First Report ◽  
Fine Print

✓ The authors present the case of a 60-year-old woman with a neck lipoma that developed dumb-bell extradural extension, causing radiculopathy. To the best of the authors' knowledge, this is the first report of a lipoma originating in the neck with dumb-bell extradural extension through the intervertebral foramen and into the spinal canal. The lipoma was first excised from the foramen via a posterior approach to allow decompression of the nerve roots. The remaining lipomatous tissue was then resected via an anterior approach to avoid the region around the vertebral artery.

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