Surgical treatment of spinal cord astrocytomas of childhood

1982 ◽  
Vol 57 (5) ◽  
pp. 685-689 ◽  
Author(s):  
Fred Epstein ◽  
Nancy Epstein
Keyword(s):  
Spinal Cord ◽  
Clinical Presentation ◽  
Therapeutic Option ◽  
Radical Resection ◽  
Surgical Experience ◽  
Total Removal ◽  
Content Type ◽  
The Past ◽  
Spinal Cord Astrocytoma

✓ This report describes the first author's surgical experience with a series of 19 consecutive cases of spinal cord astrocytoma treated over the past 2 years, with a follow-up period of 6 to 24 months. The clinical presentation, neurodiagnostic investigation, surgical technique, and results are analyzed. The authors conclude that radical resection (gross total removal of the tumor) is the optimal therapeutic option.

Trigeminal neurinomas: operative approach in eight cases

1989 ◽  
Vol 71 (4) ◽  
pp. 506-511 ◽  
Author(s):  
Toshihiro Yasui ◽  
Akira Hakuba ◽  
Soo Han Kim ◽  
Shuro Nishimura
Keyword(s):  
Operative Mortality ◽  
Tumor Resection ◽  
Radical Resection ◽  
Visual Disturbance ◽  
Middle Fossa ◽  
Increased Intracranial Pressure ◽  
Total Removal ◽  
Content Type ◽  
The Past ◽  
Trigeminal Neurinoma

✓ The authors report eight cases of trigeminal neurinoma managed over the past 13 years with radical resection at a single-stage operation. Three patients were male and five were female, ranging in age from 25 to 56 years (mean 41.5 years). One had von Recklinghausen's disease. The tumors were located mainly within the middle fossa in two cases and within the posterior fossa in two, and extended both supra- and infratentorially in four cases. Facial pain and hearing disturbance were the main symptoms, with various other symptoms such as focal seizures, hemiparesis, gait disturbance, increased intracranial pressure, and visual disturbance also being noted. All patients underwent radical tumor resection with either a transpetrosal transtentorial or orbitozygomatic infratemporal surgical approach; the approach depended on the topography of the tumor. Total removal was performed in all cases. Only one patient, treated early in the series, required a second operation to remove the tumor completely. In another case the tumor recurred 5 years after the operation. There has been no operative mortality, but injury or permanent damage to the trigeminal branches was inevitable in many cases. The surgical results were excellent in three patients and good in five.

Surgical management of holocord intramedullary spinal cord astrocytomas in children

1981 ◽  
Vol 54 (6) ◽  
pp. 829-832 ◽  
Author(s):  
Fred Epstein ◽  
Nancy Epstein
Keyword(s):  
Spinal Cord ◽  
Surgical Management ◽  
Therapeutic Approach ◽  
Pediatric Patients ◽  
Radical Resection ◽  
Neurological Recovery ◽  
Total Removal ◽  
Intramedullary Spinal Cord ◽  
Content Type ◽  
Fine Print

✓ This report describes the therapeutic approach to extensive multisegmental spinal cord astrocytomas in three pediatric patients. It is concluded that radical resection (gross total removal) is compatible with neurological recovery.

Radical resection of intramedullary spinal cord tumors in adults

1985 ◽  
Vol 63 (4) ◽  
pp. 492-499 ◽  
Author(s):  
Paul R. Cooper ◽  
Fred Epstein
Keyword(s):  
Spinal Cord ◽  
Neurological Deficit ◽  
Radical Resection ◽  
Spinal Cord Tumors ◽  
Intramedullary Tumors ◽  
Duration Of Symptoms ◽  
Intramedullary Spinal Cord ◽  
Content Type ◽  
The Past ◽  
Fine Print

✓ The management of patients with intramedullary spinal cord tumors is controversial. In the past, these tumors have often been treated with biopsy or subtotal removal followed by irradiation — a therapy that is usually associated with early tumor recurrence and progressive neurological impairment. In an attempt to improve on the outcome of patients with intramedullary tumors, the authors performed radical resection in most of the 29 adult patients who had surgery for these tumors within the past 30 months. The mean duration of symptoms was 9½ years, and all patients presented because of progressive neurological deficit. Patients were evaluated with metrizamide myelography-computerized tomography scanning and intraoperative ultrasound imaging to define the site of the tumor and cystic components. There were 14 ependymomas, 11 astrocytomas, two lipomas, and one case each of intramedullary fibrosis and astrogliosis. Solid tumor spanned a mean of five spinal cord segments and 16 tumors were associated with cysts. Twenty tumors were in the cervical and/or cervicothoracic regions. Total removal was achieved in 14 patients and “99% removal” in seven others. In 21 of 29 patients (72%), the neurological condition was stabilized or improved as a result of the operation. Postoperative deterioration occurred for the most part in patients who could not walk or who had minimal motor function at the time of operation, and these patients are no longer considered as operative candidates. Radical resection of intramedullary tumors can be achieved, with stabilization or improvement of neurological deficit in the majority of patients.

A STUDY OF CLINICAL PRESENTATION AND MANAGEMENT OF PITUITARY TUMORS

2021 ◽  
pp. 58-60
Author(s):  
Manthan Patel ◽  
Naimish Patel
Keyword(s):  
Clinical Presentation ◽  
Clinical Symptoms ◽  
Pituitary Tumors ◽  
Csf Leak ◽  
Total Removal ◽  
Diagnostic Investigation ◽  
Subtotal Removal ◽  
Visual Disturbances ◽  
Bitemporal Hemianopia

The study includes 25 cases of pituitary adenomas. Most common age group by pituitary tumors falls between 41-50 years of age. Male: Female incidence of these tumors is 1: 2.12. Most common clinical symptoms in our series are visual disturbances followed by headache. Optic nerve involvement is other common clinical nding presenting in form of decreased vision or loss of vision, eld defect or fundus changes. Commonest eld defect is bitemporal hemianopia. MRI is the diagnostic investigation of choice in pituitary tumors to dene extent, invasion and relationship to major vessels and nerves. Approximately half (44%) of the patients exhibited normal preoperative pituitary function in form of baseline hormone prole. Increased GH level (32%) followed by hyperprolactinemia (20%) are the most common endocrinologic abnormalities. Total/near total removal was done in 21 patients (84%) and subtotal removal done in 4 patients (16%). Adjuvant therapies were given in 5 patients. Two patients were given radiotherapy and 3 were given pharmacotherapy. Post operative complications were CSF leak, diabetes insipidus and meningitis. 20 patients (80%) had improvement in their symptoms including relief from headache, improvement in vision and endocrinal dysfunction. Post operatively visual functions improved in 13 patients (52%) and it remained stationary in 11 (44%) patients. Only one patient (4%) complained of worsening of his visual function and it was improved in follow up period

Myoepithelioma of the Skull

Neurosurgery ◽  
2012 ◽  
Vol 71 (4) ◽  
pp. E901-E904 ◽  
Author(s):  
Karen J. Fritchie ◽  
Mitchel D. Bauman ◽  
Quentin J. Durward
Keyword(s):  
Clinical Presentation ◽  
Histopathological Examination ◽  
Bone Lesion ◽  
Myoepithelial Cells ◽  
The Past ◽  
Lytic Bone Lesion ◽  
Initial Biopsy

Abstract BACKGROUND AND IMPORTANCE: Myoepithelioma of bone is a rare osseous tumor thought to be related to myoepithelial lesions found at other anatomic sites such as the salivary gland and skin. These tumors are composed of varying proportions of epithelial and myoepithelial cells and exhibit a spectrum of biologic behavior ranging from benign to malignant. We present the first reported case of myoepithelioma of the skull. CLINICAL PRESENTATION: A 20-year-old white woman presented with a persistent right parieto-occipital skull nodule, relating its presence to a fall on the site 2 years previously. The nodule had become painful in the past 2 months. Her past medical history and workup were otherwise unremarkable. The initial biopsy was inconclusive for diagnosis. The lytic bone lesion was subsequently resected, and histopathological examination showed a proliferation of epithelioid cells in a myxochondroid background. Fluorescence in situ hybridization studies revealed a rearrangement of the EWSR1 locus. The morphologic and molecular findings were consistent with the diagnosis of myoepithelioma of bone. CONCLUSION: Six months after surgery, the patient is doing well with no evidence of recurrence. This case illustrates the clinical presentation, histopathology, and molecular findings of a myoepithelioma of the skull with successful surgical treatment. Because myoepitheliomas with benign morphological appearance may rarely act aggressively, long-term clinical follow-up is warranted.

Epidural neural fibrolipoma of the thoracic vertebral canal

2012 ◽  
Vol 17 (5) ◽  
pp. 449-452 ◽  
Author(s):  
Paolo Missori ◽  
Sergio Pandolfi ◽  
Manila Antonelli ◽  
Maurizio Domenicucci
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Benign Tumor ◽  
Cord Compression ◽  
Thoracic Cavity ◽  
Medium Term ◽  
Total Removal ◽  
Compression Syndrome ◽  
Spinal Cord Compression Syndrome

Neural fibrolipoma is a benign tumor that most frequently infiltrates the median nerve. The authors describe a patient with spinal cord compression syndrome caused by a neural fibrolipoma. The tumor originated in the thoracic nerve at the T6–7 extradural level in the left conjugate foramen and extended into the thoracic cavity. Total removal was achieved by a combined posterior and costotransversectomy approach. Postoperatively, the patient's spinal cord compression syndrome resolved. No tumor recurrence has been observed in medium-term follow-up. This is the second case of an extradural spinal neural fibrolipoma to be reported in the literature.

scholarly journals Trichofolliculoma of the Nose: A Rare Disease

2013 ◽  
Vol 6 (3) ◽  
pp. 152-153
Author(s):  
AK Agarwal ◽  
JC Passey ◽  
Tripti Brar ◽  
Shilpi Dabas ◽  
Nikhil Arora
Keyword(s):  
Rare Disease ◽  
Rare Case ◽  
Clinical Presentation ◽  
Benign Lesion ◽  
Diagnosis And Treatment ◽  
Histopathological Diagnosis ◽  
Total Removal ◽  
Histopathological Findings ◽  
Plastic Reconstruction

ABSTRACT Purpose The author wants to present a rare case of trichofolliculoma of nose. Patients and methods Clinical presentation, radiology, histopathological findings and management of the case has been presented. Results Patient has been on regular follow-up and planned for plastic reconstruction. Conclusion Trichofolliculoma, a benign hamortomatous lesion that develops at any age, usually presenting as a skin-colored nodule, correct histopathological diagnosis and treatment therefore, can lead to total removal of the benign lesion. How to cite this article Brar T, Passey JC, Dabas S, Agarwal AK, Arora N. Trichofolliculoma of the Nose: A Rare Disease. Clin Rhinol An Int J 2013;6(3):152-153.

Intramedullary ependymoma of the spinal cord

1990 ◽  
Vol 72 (4) ◽  
pp. 523-532 ◽  
Author(s):  
Paul C. McCormick ◽  
Roland Torres ◽  
Kalmon D. Post ◽  
Bennett M. Stein
Keyword(s):  
Spinal Cord ◽  
Mr Imaging ◽  
Tumor Recurrence ◽  
Neurological Deficits ◽  
Functional Improvement ◽  
Consecutive Series ◽  
Intramedullary Spinal Cord ◽  
Content Type ◽  
Fine Print

✓ A consecutive series of 23 patients underwent operative removal of an intramedullary spinal cord ependymoma between January, 1976, and September, 1988. Thirteen women and 10 men between the age of 19 and 70 years experienced symptoms for a mean of 34 months preceding initial diagnosis. Eight patients had undergone treatment prior to tumor recurrence and referral. Mild neurological deficits were present in 22 patients on initial examination. The location of the tumors was predominantly cervical or cervicothoracic. Radiological evaluation revealed a wide spinal cord in all cases. Magnetic resonance (MR) imaging was the single most important radiological procedure. At operation, a complete removal was achieved in all patients. No patient received postoperative radiation therapy. Histological examination revealed a benign ependymoma in all cases. The follow-up period ranged from 6 to 159 months (mean 62 months) with seven patients followed for a minimum of 10 years after surgery. Fourteen patients underwent postoperative MR imaging at intervals ranging from 8 months to 10 years postoperatively. No patient has been lost to follow-up review and there were no deaths. No patient showed definite clinical or radiological evidence of tumor recurrence during the follow-up period. Recent neurological evaluation revealed functional improvement from initial preoperative clinical status in eight patients, no significant change in 12 patients, and deterioration in three patients. The data support the belief that long-term disease-free control of intramedullary spinal ependymomas with acceptable morbidity may be achieved utilizing microsurgical removal alone.

Fifty Years of Experience with Chordomas in Southeast Scotland

Neurosurgery ◽  
1985 ◽  
Vol 16 (2) ◽  
pp. 166-170 ◽  
Author(s):  
P. O'Neill ◽  
B.A. Bell ◽  
J.D. Miller ◽  
I. Jacobson ◽  
W. Guthrie
Keyword(s):  
Clinical Presentation ◽  
Surgical Intervention ◽  
Slow Growth ◽  
Multicenter Trial ◽  
Treatment Modalities ◽  
Therapeutic Approaches ◽  
Slow Growth Rate ◽  
The Past ◽  
New Therapeutic Approaches

Abstract We report the clinical presentation and management of 34 patients with a histologically proven chordoma, treated in the neurosurgical departments in Edinburgh and Dundee, over the past 50 years. Although these tumors are commonly regarded as being locally invasive with a variable, but generally slow growth rate, they can metastasize, and this may precede surgical intervention, as in one of our patients. Our cases are compared to those in previously published series, and a comprehensive review of the treatment modalities for tumors at various sites is presented. The optimal treatment to be recommended from our own experience, and that of others, is aggressive operation and radiotherapy. A combination of hyperthermia and chemotherapy has shown some promise, but remains untested, and highlights the need for a multicenter trial with long follow-up to allow the evaluation of new therapeutic approaches.

Primary polymorphous hemangioendothelioma of the spinal cord

2001 ◽  
Vol 95 (1) ◽  
pp. 93-95 ◽  
Author(s):  
Federico Roncaroli ◽  
Bernd W. Scheithauer ◽  
Savvas Papazoglou
Keyword(s):  
Spinal Cord ◽  
Vascular Tumor ◽  
Nerve Roots ◽  
Content Type ◽  
Sensorimotor Deficit ◽  
History Of ◽  
Intradural Extramedullary ◽  
Borderline Malignancy ◽  
Current Experience

✓ A case of polymorphous hemangioendothelioma of the spinal cord is described. This 55-year-old woman presented with an 18-month history of lower-extremity sensorimotor deficit. A magnetic resonance image revealed an enhancing, intradural, extramedullary nodule at the T1–2 level. On gross inspection, the lesion measured 3.5 cm and was firmly attached to spinal cord parenchyma and adjacent nerve roots. It was completely removed. Fourteen months after surgery the patient's neurological deficit had resolved. Polymorphous hemangioendothelioma is a rare vascular tumor of borderline malignancy. Most occur in lymph nodes. None has been reported to occur in the central and peripheral nervous system. Based on current experience, resection and close follow up seems the best therapeutic approach.

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