Extradural neurenteric cyst of the cerebellopontine angle

2004 ◽  
Vol 100 (6) ◽  
pp. 1091-1093 ◽  
Author(s):  
Tomohiro Inoue ◽  
Nobutaka Kawahara ◽  
Junji Shibahara ◽  
Tomohiko Masumoto ◽  
Kenichi Usami ◽  
...  
Keyword(s):  
Cerebellopontine Angle ◽  
Internal Auditory Canal ◽  
Bone Destruction ◽  
Petrous Bone ◽  
Neurenteric Cyst ◽  
Imaging Features ◽  
Pathological Findings ◽  
Mr Images ◽  
Content Type ◽  
Temporal Bone Tumor

✓ Neurenteric cyst is a developmental malformation found mainly in the spinal canal. The authors report on a 47-year-old man with a neurenteric cyst of the cerebellopontine angle (CPA) who presented with progressive hearing disturbance and facial palsy. The tumor was located extradurally with marked destruction of the petrous bone around the internal auditory canal and demonstrated irregular and heterogeneous high-intensity signals on T1- and T2-weighted on MR images, which is atypical for neurenteric cysts. The pathological findings in samples obtained after resection disclosed a single epithelial layer (a feature of neurenteric cyst), which was accompanied by marked xanthogranulomatous changes. Although several neurenteric cysts have been reported in the CPA, extradural lesions with unusual imaging features and marked bone destruction have not been reported previously. This benign developmental lesion should be considered, although it is extremely rare, in patients harboring an extradural temporal bone tumor around the CPA.

Differential Diagnosis of Sinonasal Lymphoma and Squamous Cell Carcinoma on CT, MRI, and PET/CT

2018 ◽  
Vol 159 (3) ◽  
pp. 494-500 ◽  
Author(s):  
Seok-Hyun Kim ◽  
Sue-Jean Mun ◽  
Hak-Jin Kim ◽  
Seon Lin Kim ◽  
Sung-Dong Kim ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Cell Lymphoma ◽  
Bone Destruction ◽  
B Cell Lymphoma ◽  
Imaging Features ◽  
Mr Images ◽  
Pet Ct ◽  
Adc Values

Objective The purpose of this study was to analyze computed tomography (CT) and magnetic resonance (MR) images and to evaluate the maximum standardized uptake value (SUV max) of positron emission tomography (PET)/CT parameters between sinonasal non-Hodgkin’s lymphoma (NHL) and squamous cell carcinoma (SCC), knowing the imaging features that distinguish sinonasal NHL from SCC. Study Design Case series with chart review. Setting University tertiary care facility. Subjects and Methods We analyzed the features on CT, MR imaging, and PET/CT of 78 patients diagnosed with sinonasal NHL or SCC histopathologically. The CT (n = 34), MRI (n = 25), and PET/CT (n = 33) images of 39 patients with sinonasal NHL and the CT (n = 38), MR (n = 28), and PET/CT (n = 31) images of 39 patients with SCC were evaluated. The sinonasal NHL was diagnosed as natural killer/T-cell lymphoma (n = 28) and diffuse large B-cell lymphoma (n = 11). Results Patients with sinonasal NHL had a larger tumor volume and higher tumor homogeneity than patients with SCC on T2-weighted and postcontrast MR images. Most of the sinonasal NHL and SCC showed a high degree of enhancement. The apparent diffusion coefficient (ADC) values and adjacent bone destruction were significantly lower in sinonasal NHL than in SCC. However, cervical lymphadenopathy, Waldeyer’s ring involvement, and PET/CT SUV max showed no significant differences between sinonasal NHL and SCC. Conclusion CT and MR images of sinonasal masses showing a bulky lesion, marked homogeneity, and low ADC values without adjacent bone destruction are more suggestive of sinonasal NHL than SCC.

Preservation of hearing in patients undergoing excision of acoustic neuromas and other cerebellopontine angle tumors

1985 ◽  
Vol 63 (2) ◽  
pp. 168-174 ◽  
Author(s):  
Charles H. Tator ◽  
Julian M. Nedzelski
Keyword(s):  
Tumor Size ◽  
Cerebellopontine Angle ◽  
Internal Auditory Canal ◽  
Hearing Preservation ◽  
Cochlear Nerve ◽  
Consecutive Series ◽  
Speech Discrimination ◽  
Content Type ◽  
Acoustic Neuromas ◽  
Fine Print

✓ Microsurgical techniques have made it possible to identify and preserve the cochlear nerve from its origin at the brain stem and along its course through the internal auditory canal in patients undergoing removal of small or medium-sized acoustic neuromas or other cerebellopontine angle (CPA) tumors. In a consecutive series of 100 patients with such tumors operated on between 1975 and 1981, an attempt was made to preserve the cochlear nerve in 23. The decision to attempt to preserve hearing was based on tumor size and the degree of associated hearing loss. In cases of unilateral acoustic neuroma, the criteria for attempted preservation of hearing were tumor size (2.5 cm or less), speech reception threshold (50 dB or less), and speech discrimination score (60% or greater). In patients with bilateral acoustic neuromas or tumors of other types, the size and hearing criteria were significantly broadened. All patients were operated on through a suboccipital approach. Hearing was preserved postoperatively in six (31.6%) of the 19 patients with unilateral acoustic neuromas, although the cochlear nerve was preserved in 16. Of the six patients with postoperative hearing, three retained excellent hearing, and the other three had only sound awareness and poor discrimination. Hearing was preserved in three cases with other CPA tumors, including an epidermoid cyst and small petrous meningiomas in the internal auditory canal. Of the two cases with bilateral tumors, hearing was preserved in one. Of the 23 patients in whom hearing preservation was attempted, nine (39.1%) had some postoperative hearing, which in six was equal to or better than the preoperative level. Thus, it is worthwhile to attempt hearing preservation in selected patients with CPA tumors.

High Jugular Bulb: Implications for Posterior Fossa Neurotologic and Cranial Base Surgery

1993 ◽  
Vol 102 (2) ◽  
pp. 100-107 ◽  
Author(s):  
Steven D. Rauch ◽  
Wen-Zhuang Xv ◽  
Joseph B. Nadol
Keyword(s):  
Temporal Bone ◽  
Posterior Fossa ◽  
Cerebellopontine Angle ◽  
Internal Auditory Canal ◽  
Petrous Bone ◽  
Jugular Bulb ◽  
Variable Position ◽  
High Jugular Bulb ◽  
Cranial Base Surgery ◽  
Bone Exposure

The suboccipital-retrosigmoid approach to the internal auditory canal and cerebellopontine angle is being used with increasing frequency for neurotologic surgery, including vestibular nerve section and resection of acoustic neuroma. It offers wide exposure of the cerebellopontine angle and the cranial nerve VII—VIII complex as it courses from the brain stem to the temporal bone. Exposure of the internal auditory canal can be achieved by removing its posterior bony wall. Safe utilization of this approach requires familiarity with the variable position of structures within the petrous bone, including the lateral venous sinus and jugular bulb. We report here a case in which bleeding resulted from injury to a high jugular bulb during surgical exposure of the internal auditory canal via the suboccipital route and discuss the regional anatomy of the jugular bulb based on study of 378 consecutive temporal bone specimens from the collection of the Massachusetts Eye and Ear Infirmary. High jugular bulb was defined as encroachment of the dome of the bulb within 2 mm of the floor of the internal auditory canal. Forty-six percent of scoreable specimens met this criterion. However, when donors less than 6 years of age were excluded, a high jugular bulb was identified in 63% of specimens. Relevance to neurotologic surgery of the posterior fossa is presented.

Neurinomas of the facial nerve

1975 ◽  
Vol 43 (5) ◽  
pp. 608-613 ◽  
Author(s):  
Fabian Isamat ◽  
Federico Bartumeus ◽  
Antonio M. Miranda ◽  
Jaime Prat ◽  
Luis C. Pons
Keyword(s):  
Facial Nerve ◽  
Cerebellopontine Angle ◽  
Petrous Bone ◽  
The Other ◽  
Bone Area ◽  
Content Type ◽  
Fine Print

✓ Three cases of neurinomas of the facial nerve are reported. Two of them originated from the labyrinthine portion of the nerve and the other from the vertical portion. Neurinomas of the first part of the facial nerve can be suspected preoperatively since they seem to give rise to specific clinical and radiological manifestations that can be distinguished from tumors of other portions of the nerve, the petrous bone area, or the cerebellopontine angle. The reported cases of neurinomas of the facial nerve are reviewed and analyzed.

scholarly journals Answer to quiz case: Temporal bone imaging

2015 ◽  
Vol 19 (1) ◽  
Author(s):  
Enrico Arkink ◽  
J. Frijns ◽  
Berit Verbist
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cerebellopontine Angle ◽  
Petrous Bone ◽  
Imaging Features ◽  
Bone Imaging ◽  
Resonance Imaging ◽  
Type Iii ◽  
Computed Tomographic ◽  
Temporal Bone Imaging ◽  
Incomplete Partition

Computed tomographic scanning of the petrous bone and magnetic resonance imaging sequences of the inner ear and cerebellopontine angle of a deaf patient were performed to find an explanation for his deafness, and to establish whether he would be a good candidate for cochlear implantation. The imaging features were considered pathognomonic for incomplete partition type III (IP type III). Further management and discussion of this deafness subtype are detailed.

scholarly journals Differential Diagnosis of Sinonasal Extramedullary Plasmacytoma, Non-Hodgkin’s Lymphoma, and Squamous Cell Carcinoma Using CT Scan and MRI

2021 ◽  
Vol 18 (2) ◽  
Author(s):  
Dong-Joo Lee ◽  
Sang Duk Hong ◽  
Myeong Sang Yu ◽  
Sung Jae Heo ◽  
Joo-Yeon Kim ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Mr Imaging ◽  
Cell Carcinoma ◽  
Tumor Volume ◽  
Cell Lymphoma ◽  
Bone Destruction ◽  
Extramedullary Plasmacytoma ◽  
Imaging Features ◽  
Mr Images ◽  
Waldeyer’S Ring

Background: The imaging features of sinonasal extramedullary plasmacytoma (EMP) are non-specific and similar to those of other lesions, such as sinonasal non-Hodgkin’s lymphoma (NHL) and squamous cell carcinoma (SCC). Objectives: To analyze the computed tomography (CT) and magnetic resonance (MR) images of patients with EMP, NHL, and SCC to identify the radiological characteristics differentiating sinonasal EMP from NHL and SCC. Patients and Methods: In this cross-sectional study, the CT and MR imaging features of 37 patients with sinonasal EMP, 46 patients with NHL, and 44 patients with SCC were analyzed. Sinonasal NHL was categorized into two distinct types, namely, natural killer/T-cell lymphoma (n = 32) and diffuse large B-cell lymphoma (n = 14). The tumor volume was determined by measuring the region of interest (ROI) in the PACS program. Besides, homogeneity, apparent diffusion coefficient (ADC) in the ADC maps, degree of enhancement, adjacent bone destruction, and invasion to Waldeyer’s ring and cervical or retropharyngeal lymph nodes were evaluated. Results: Although the tumor volume was larger in the EMP group as compared to the NHL and SCC groups, the difference was not statistically significant. The NHL group showed the highest tumor homogeneity on both CT and MR images. EMP was more heterogenous than NHL, with moderate signal intensity on T1-weighted MR images. On the other hand, EMP and NHL showed significantly lower ADCs as compared to SCC. The majority of patients with sinonasal EMP, NHL, and SCC showed an avid enhancement. Also, destructive tumor growth involving the adjacent bone was more frequent in SCC than in EMP or NHL. However, there were no significant differences among sinonasal EMP, NHL, and SCC in terms of invasion to Waldeyer’s ring and cervical or retropharyngeal lymph node metastasis. Conclusion: Marked heterogeneity on T1-weighted images, low ADCs, and lack of adjacent bone destruction were the CT and MR imaging features that favored the diagnosis of EMP over NHL or SCC.

Radiation therapy of a choroid plexus papilloma of the cerebellopontine angle with bone involvement

1981 ◽  
Vol 54 (2) ◽  
pp. 245-247 ◽  
Author(s):  
Mahmoud G. Naguib ◽  
Shelley N. Chou ◽  
Angeline Mastri
Keyword(s):  
Radiation Therapy ◽  
Choroid Plexus ◽  
Cerebellopontine Angle ◽  
Choroid Plexus Papilloma ◽  
Bone Destruction ◽  
Bone Involvement ◽  
Content Type ◽  
Fine Print ◽  
Plexus Papilloma

✓ A case is reported of cerebellopontine angle choroid plexus papilloma with overlying bone destruction. Its favorable response to radiation therapy following subtotal excision is described.

Transapical extension in difficult cerebellopontine angle tumours: preliminary report

2003 ◽  
Vol 117 (10) ◽  
pp. 788-792 ◽  
Author(s):  
Mario Sanna ◽  
Manoj Agarwal ◽  
Yogesh Jain ◽  
Alessandra Russo ◽  
Abdel Kader Taibah
Keyword(s):  
Vestibular Schwannoma ◽  
Cerebellopontine Angle ◽  
Cranial Nerves ◽  
Internal Auditory Canal ◽  
Petrous Bone ◽  
Vestibular Schwannomas ◽  
Type I ◽  
Posterior Surface ◽  
Prepontine Cistern ◽  
Anterior Extension

Difficult cerebellopontine angle (CPA) tumours namely large/giant vestibular schwannomas, vestibular schwannomas with a significant anterior extension and meningiomas of the posterior surface of the petrous bone extending anterior to the internal auditory canal (IAC) have always posed a problem for the otoneurosurgeon. Modifications of the enlarged translabyrinthine approach (ETLA) specifically aimed at dealing with these tumours are not reported. The aim of this paper is to introduce the transapical extension of ETLA which involves increased circumferential drilling around the IAC beyond 270°C. The extension allows enhanced surgical control over the tumour as well as the anterior aspect of the CPA including the prepontine cistern, the Vth and VIth cranial nerves. The extension is further classified into Type I and II depending upon the extent of drilling. Type I extension entails drilling around the IAC for 300–320° and is indicated for large/giant vestibular schwannomas (large vestibular schwannoma extrameatal diameter 3–3.9 cm, giant vestibular schwannoma extrameatal diameter [ges ]4 cm) and vestibular schwannomas with significant anterior extension. Type II extension involves complete drilling around the canal for 360° and is indicated for meningiomas of the posterior surface of the petrous bone extending anterior to the IAC.

Primary facial nerve tumors within the skull

1990 ◽  
Vol 72 (1) ◽  
pp. 1-8 ◽  
Author(s):  
T. T. King ◽  
A. W. Morrison
Keyword(s):  
Facial Nerve ◽  
Cerebellopontine Angle ◽  
Nerve Repair ◽  
Petrous Bone ◽  
Surgical Removal ◽  
Content Type ◽  
Radiological Features ◽  
Acoustic Nerve ◽  
Relationship Of ◽  
Characteristic Relationship

✓ In a series of 527 cerebellopontine angle tumors, there were 416 cases of acoustic nerve tumors and 14 cases of primary tumor of the facial nerve in the petrous bone or intracranial cavity. Six additional patients were presumed to have facial tumors, although they were not operated on. Of the 14 verified facial nerve tumors, all but two were neurinomas and 11 had important intracranial extensions into the middle and/or the posterior fossa. In most of these 14 cases, surgical removal was performed via the translabyrinthine route, which is advantageous in that it displays the characteristic relationship of the tumor to the facial nerve, and facilitates nerve repair. The clinical and radiological features of these facial nerve lesions are discussed and also the indications for surgical treatment which, as the unoperated cases illustrate, is not always necessary.

scholarly journals Cerebellopontine angle meningioma extending into internal auditory canal presenting with unilateral facial weakness and sensorineural hearing loss: Case presentation with review of literature

2017 ◽  
Vol 5 (1) ◽  
pp. 34-40
Author(s):  
Ravinder Kumar ◽  
Gagan Jaiswal ◽  
Abhishek Bhargava ◽  
Jyoti Kundu
Keyword(s):  
Hearing Loss ◽  
Cerebellopontine Angle ◽  
Management Strategies ◽  
Internal Auditory Canal ◽  
Petrous Bone ◽  
Tumour Resection ◽  
Facial Weakness ◽  
Medical College ◽  
Unilateral Headache ◽  
Dural Tail

Tumour types other than schwannomas are uncommonly encountered in the cerebellopontine angle, and unusual lesions extending into the internal auditory canal are even rarer. We herein present a case of a 50-year-old woman with a right cerebellopontine angle meningioma (measuring 34mm x 35mm x 36mm), arising from the posterior surface of the petrous bone or the petrotentorial junction, secondarily involving the internal auditory canal. Contrast enhanced MRI showed typical appearance of a meningioma, with calcifi ed fl at surface against the petrous bone, a hemispheric or ice-cream-cone shape sign, adjacent hyperostosis, and ‘dural tail’ extending from the tumour. Initial clinical evaluation revealed continued presence of a stable neurological defi cit such as unilateral headache, hearing loss, reduced taste sensation, positive corneal and conjunctival refl ex along with right facial weakness (House-Brackmann grade III) signalling towards the involvement of V, VII and VIII cranial nerve. The variation in the anatomy of the faciocochlear nerve bundle in relation to the tumour has to be kept in mind, and preservation of these vital neural structures should be the goal in every case. Tumour resection was performed through a suboccipital-retrosigmoidal approach with a good outcome. Ours is an unusual case report analysing the diagnostic and therapeutic issues, surgical management strategies and treatment outcomes related to this rare disease entity.Journal of Kathmandu Medical College Vol. 5, No. 1, Issue 15, Jan.-Mar., 2016, Page: 34-40

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