Intraventricular astroblastoma

2008 ◽  
Vol 1 (2) ◽  
pp. 152-155 ◽  
Author(s):  
Luca Denaro ◽  
Marina Gardiman ◽  
Milena Calderone ◽  
Marta Rossetto ◽  
Pietro Ciccarino ◽  
...  
Keyword(s):  
Adjuvant Therapy ◽  
Relevant Literature ◽  
Radical Resection ◽  
Cystic Mass ◽  
Gross Total Resection ◽  
Total Resection ◽  
Initial Surgery ◽  
History Of ◽  
Well Differentiated ◽  
Brain Gliomas

✓Astroblastoma is a rare primary brain neoplasm that accounts for 0.45–2.8% of brain gliomas. Intraventricular localization is extremely rare. The authors report a case of well-differentiated completely intraventricular astroblastoma in a 6-year-old girl and review the relevant literature. Their patient presented with a 5-week history of progressive nausea and vomiting. Magnetic resonance (MR) imaging revealed a large, well-demarcated, solid-cystic mass in the left temporooccipital ventricular horn. Macroscopic radical resection of the tumor was performed via the superior temporal sulcus. The postoperative course was uneventful and no adjuvant therapy was administered after surgery. No recurrence was detected at 9-months follow-up. Gross-total resection has the greatest impact on patient survival. In differentiated tumors, recurrence is usually local, and adjuvant therapy is recommended after repeated resection for the treatment of recurrence. In patients harboring anaplastic astroblastoma, gross-total resection and adjuvant therapy after the initial surgery seems to be the best choice. It is important to distinguish astroblastoma from ependymoma in clinical practice because of the differences in therapeutic approaches.

scholarly journals Microsurgical Gross Total Resection of a Large Residual/Recurrent Vestibular Schwannoma via Translabyrinthine Approach

2018 ◽  
Vol 79 (S 05) ◽  
pp. S387-S388
Author(s):  
Sima Sayyahmelli ◽  
Joseph Roche ◽  
Mustafa Baskaya
Keyword(s):  
Vestibular Schwannoma ◽  
Gross Total Resection ◽  
Subtotal Resection ◽  
Total Resection ◽  
Entry Zone ◽  
Stereotactic Radiation ◽  
Translabyrinthine Approach ◽  
History Of ◽  
Microsurgical Techniques ◽  
Facial Function

Although, gross total resection in large vestibular schwannomas is an ideal goal, subtotal resection is frequently performed due to lack of expertise, concerns for facial palsy, or overuse of stereotactic radiation. In this video, we present a 31-year-old man with a 7-year history of tinnitus, dizziness, and hearing loss. The patient had a subtotal resection of a 2.5 cm right-sided vestibular schwannoma via retrosigmoid craniotomy at an outside hospital. He was referred for further surgical resection due to the increased size of the tumor on surveillance magnetic resonance imagings (MRIs) and worsening symptoms. MRI showed a residual/recurrent large schwannoma with extension to the full length of the internal acoustic canal and brain stem compression. He underwent microsurgical gross total resection via a translabyrinthine approach. The facial nerve was preserved and stimulated with 0.15 mA at the brainstem entry zone. He awoke with House–Brackmann grade III facial function, with an otherwise uneventful postoperative course. In this video, microsurgical techniques and important resection steps for this residual/recurrent vestibular schwannoma are demonstrated, and nuances for microsurgical technique are discussed.The link to the video can be found at: https://youtu.be/a0ZxE41Tqzw.

scholarly journals Long-term efficacy of surgical resection with or without adjuvant therapy for treatment of secondary glioblastoma in adults

2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Ruoyu Huang ◽  
Guanzhang Li ◽  
Yiming Li ◽  
Yinyan Wang ◽  
Pei Yang ◽  
...  
Keyword(s):  
Survival Analysis ◽  
Prognostic Factors ◽  
Adjuvant Therapy ◽  
Clinical Outcomes ◽  
Cox Regression ◽  
Postoperative Radiotherapy ◽  
Gross Total Resection ◽  
Subtotal Resection ◽  
Total Resection ◽  
Secondary Glioblastoma

Abstract Background There are limited studies on treatment strategies and associated clinical outcomes in patients with secondary glioblastoma (sGBM). We sought to investigate the prognostic factors and treatment decisions in a retrospective cohort of patients with sGBM. Methods One hundred and seventy-one patients with sGBM who met the screening criteria were included in this study. Kaplan–Meier survival analysis and Cox survival analysis were used to detect prognostic factors. R (v3.5.0) and SPSS software (v25.0, IBM) were used to perform statistical analyses. Results The median overall survival was 303 days (range 23–2237 days) and the median progression-free survival was 229 days (range 33–1964 days) in patients with sGBM. When assessing the relationship between adjuvant treatment outcome and extent of resection (EOR), the results showed that patients underwent gross total resection can benefit from postoperative radiotherapy and chemotherapy, but not in patients underwent subtotal resection. In addition, we also found that aggressive adjuvant therapy can significantly improve clinical outcomes of IDH1-mutated patients but no significant prognostic value for IDH1-wildtyped patients. The univariate Cox regression analyses demonstrated that EOR, adjuvant therapy, and postoperative Karnofsky Performance Scores were prognostic factors for patients with sGBM, and multivariate COX analysis confirmed that adjuvant therapy and EOR were independent prognostic factors. Conclusions For patients with sGBM, aggressive postoperative adjuvant therapy after gross total resection was recommended. However, we did not detect a benefit in IDH1-wildtype patients in our cohort.

scholarly journals Gross total resection of intracisternal accessory nerve schwannomas using a familiar midline suboccipital subtonsilar approach

2019 ◽  
Vol 2019 (7) ◽  
Author(s):  
Elias Antoniades ◽  
Alkinoos Athanasiou ◽  
Panagiotis Sarlis ◽  
Ioannis Magras ◽  
Ioannis Patsalas
Keyword(s):  
Relevant Literature ◽  
Accessory Nerve ◽  
Gross Total Resection ◽  
Neurological Deficits ◽  
Cerebrospinal Fluid Leakage ◽  
Spinal Root ◽  
Total Resection ◽  
Suboccipital Craniotomy ◽  
Rare Lesion ◽  
Chronic Headaches

Abstract Background Intracisternal Accessory Nerve Schwannomas (ANS) constitute a rare clinical entity with only a few cases reported so far. Their symptoms are usually due to brainstem compression and not manifested until they render of great size. Secondary neuropathy and muscle atrophy are other late signs. The hitherto reported literature advocates a suboccipital craniotomy as a suitable approach. In most of the cases the spinal root was the location tumor arose from. Gross total resection was possible to be carried out in most cases with only sporadic tolerable postoperative deficits reported. Case description We hereby present three cases of patients with intracisternal ANS treated in the same fashion. Two patients were male and one female. Two patients complained of mainly chronic headaches and neck pain, whereas in the third patient the lesion was found incidentally. Only one patient suffered post-operatively cerebrospinal fluid leakage and wound healing complication, which was treated with revision surgery and administration of antibiotics. None of the patients had postoperative neurological deficits. Furthermore, we conducted a review of the relevant literature where we noted that there is no consensus yet with regards to the appropriate surgical approach. Conclusions Based on relevant anatomical studies, we advocate that suboccipital subtonsilar approach provides a wide corridor to the area of lesion allowing complete and safe resection of intracisternal ANS. We thus support that, in most cases, the neurosurgeon should consider using this familiar approach for treating this rare lesion.

Primary peritoneal mucinous cystadenocarcinoma mimicking possible recurrent ovarian mucinous cystadenoma: coincidental pathology or a spectrum of disease?

2021 ◽  
Vol 14 (7) ◽  
pp. e242478
Author(s):  
Claire Filippini ◽  
Sarah Smyth ◽  
Hooman Soleymani Majd ◽  
Catherine Johnson
Keyword(s):  
Magnetic Resonance ◽  
Young Patient ◽  
Management Strategies ◽  
Mucinous Cystadenoma ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Cystic Mass ◽  
Mucinous Cystadenocarcinoma ◽  
Surgical History ◽  
History Of ◽  
Well Differentiated

We present the case of a 32-year-old woman with a previous surgical history of benign mucinous cystadenoma resected in 2012 who underwent magnetic resonance cholangiopancreatography following her second pregnancy in 2020. This demonstrated a large cystic mass in the left subdiaphragmatic space. Histopathology confirmed a well-differentiated primary peritoneal mucinous cystadenocarcinoma displaying cells of a Mullerian origin. We subsequently discuss the aetiology of these conditions separately and explore the possibility of a connection between the two regarding origin or potential malignant transformation that may otherwise have occurred coincidentally in this young patient. We also acknowledge a paucity of evidence regarding subsequent management strategies.

Supratentorial Gliomas: Surgical Considerations and Immediate Postoperative Results Gross Total Resection versus Partial Resection

Neurosurgery ◽  
1987 ◽  
Vol 21 (1) ◽  
pp. 21-26 ◽  
Author(s):  
Ivan Ciric ◽  
Mario Ammirati ◽  
Nicholas Vick ◽  
Michael Mikhael
Keyword(s):  
Ct Scan ◽  
Neurological Status ◽  
Partial Resection ◽  
Gross Total Resection ◽  
Postoperative Results ◽  
Total Resection ◽  
Computed Tomographic ◽  
Supratentorial Gliomas ◽  
Neurological Morbidity ◽  
Well Differentiated

Abstract Forty-two patients with supratentorial gliomas not involving the basal ganglia (extraganglionic) were studied pre- and postoperatively with computed tomographic (CT) scans to evaluate the effect of the extent of surgical resection on the immediate postoperative results. Thirty-three patients (79%) had malignant astrocytic gliomas (glioblastoma or anaplastic astrocytoma), 4 patients (10%) had well-differentiated astrocytomas, and 5 (12%) had oligodendrogliomas. The median age was 58 years, and the median Karnofsky rating was 70. There was no operative mortality. Six patients (14%) had surgical complications. A gross total resection was defined as the absence of any abnormal enhancement on the postoperative CT scan. A nearly gross total resection had been accomplished when less than 10% of the preoperatively enhancing mass was still seen. A partial resection was indicated by the presence of more than 10% of the enhancing lesion on the postoperative CT scan. A gross total or nearly gross total resection was accomplished in 36 patients (86%), and an improved or stable postoperative neurological status was present in 35 of these patients (97%). In contrast, the rate of neurological morbidity after a partial resection was 40%. Supratentorial extraganglionic gliomas, regardless of their histological type, generally were well-circumscribed lesions except at the level of the ventricular wall, where glioblastomas and anaplastic astrocytomas blended with the subependymal white matter from which they seemed to arise. (Neurosurgery 21: 21-26, 1987)

Long-term Seizure Control Outcomes After Resection of Gangliogliomas

Neurosurgery ◽  
2012 ◽  
Vol 70 (6) ◽  
pp. 1406-1414 ◽  
Author(s):  
Derek G. Southwell ◽  
Paul A. Garcia ◽  
Mitchel S. Berger ◽  
Nicholas M. Barbaro ◽  
Edward F. Chang
Keyword(s):  
Tumor Progression ◽  
Seizure Control ◽  
Intractable Epilepsy ◽  
Gross Total Resection ◽  
Subtotal Resection ◽  
Seizure Outcome ◽  
Seizure Freedom ◽  
Total Resection ◽  
History Of

Abstract BACKGROUND: Gangliogliomas are rare glioneuronal tumors that typically cause refractory seizures during the first 3 decades of life. OBJECTIVE: To determine the prognosticators of seizure outcome after surgery for ganglioglioma. METHODS: We reviewed the cases of 66 patients who underwent resection of gangliogliomas at the University of California, San Francisco. Demographic, seizure history, and operative data were examined for statistical association with postoperative seizure outcomes. RESULTS: Of the 66 patients who underwent surgical resection of ganglioglioma, 49 patients (74%) presented with a history of seizures. Of those 49 patients, 50% presented with intractable epilepsy. Temporal lobe gangliogliomas were present in 76% of the patients who presented with a history of seizures. Electrocorticography was performed on 35% of the patients, and of those patients, 82% underwent extended lesionectomy to remove abnormally epileptogenic extralesional tissue. The median follow-up duration was 6.9 years, during which tumor progression occurred in 38% of patients who underwent subtotal resection and in 8% of patients who underwent gross total resection (P = .02). Overall, 85% of patients were seizure free (International League Against Epilepsy class I or II) 5 years after surgery. Subtotal resection was associated with poor seizure outcomes 1 year after resection (odds ratio = 14.6; 95% confidence interval = 2.4-87.7): rates of seizure freedom were 54% after subtotal resection, 96% after gross total resection, and 93% after gross total resection with intraoperative electrocorticography-guided extended lesionectomy. CONCLUSION: We report excellent long-term seizure control outcomes after surgery for gangliogliomas. Intraoperative electrocorticography may be a useful adjunct for guiding extended resection in certain pharmacoresistant epilepsy patients with gangliogliomas. Subtotal resection is associated with higher rates of tumor progression and nonoptimal seizure outcomes.

Surgical treatment of ectopic recurrence of craniopharyngioma

2009 ◽  
Vol 4 (2) ◽  
pp. 105-112 ◽  
Author(s):  
Robert E. Elliott ◽  
Yaron A. Moshel ◽  
Jeffrey H. Wisoff
Keyword(s):  
Surgical Treatment ◽  
Local Recurrence ◽  
Tumor Recurrence ◽  
Radical Resection ◽  
Gross Total Resection ◽  
Consecutive Series ◽  
Total Resection ◽  
Ectopic Recurrence ◽  
The Impact

Local recurrence following radical resection is one of the most common complications of pediatric craniopharyngioma. Only 28 cases of ectopic recurrence of craniopharyngioma have been reported in the literature, and only 13 cases occurred in patients originally treated as children. In this consecutive series of 86 children who underwent radical resection of primary and recurrent craniopharyngiomas, 4 patients (4.7%) experienced ectopic tumor recurrence, accounting for 27% of all recurrences after gross-total resection. The authors report on the successful surgical treatment of these 4 patients and the impact of ectopic craniopharyngioma recurrence on survival.

scholarly journals Dermatofibrosarcoma of the scalp

2019 ◽  
Vol 10 ◽  
pp. 221 ◽  
Author(s):  
Marcos Sangrador ◽  
Jimena González Olvera ◽  
Valeria Mendoza Ortiz
Keyword(s):  
Local Recurrence ◽  
Surgical Management ◽  
Dermatofibrosarcoma Protuberans ◽  
Gross Total Resection ◽  
High Grade ◽  
Rare Tumor ◽  
Parietal Region ◽  
Total Resection ◽  
History Of ◽  
The Right

A 25-year-old woman presented with a 4 months history of progressive pain and tumefaction in the right parietal region. Deformity of the scalp was evident, and a biopsy was taken, reporting a high- grade dermatofibrosarcoma. She underwent surgical management, achieving a gross total resection. Dermatofibrosarcoma protuberans is a rare tumor arising from the dermis. It tends to have an indolent course and local recurrence after excision.

Practical surgical indicators to identify candidates for radical resection of insulo-opercular gliomas

2014 ◽  
Vol 121 (5) ◽  
pp. 1124-1132 ◽  
Author(s):  
Tomohiro Kawaguchi ◽  
Toshihiro Kumabe ◽  
Ryuta Saito ◽  
Masayuki Kanamori ◽  
Masaki Iwasaki ◽  
...  
Keyword(s):  
Surgical Complications ◽  
Surgical Complication ◽  
Univariate Analysis ◽  
Progression Free Survival ◽  
Radical Resection ◽  
Gross Total Resection ◽  
Survival Times ◽  
Total Resection ◽  
Free Survival ◽  
Lenticulostriate Arteries

Object Maximum resection of gliomas with minimum surgical complications usually leads to optimum outcomes for patients. Radical resection of insulo-opercular gliomas is still challenging, and selection of ideal patients can reduce risk and obtain better outcomes. Methods This retrospective study included 83 consecutively treated patients with newly diagnosed gliomas located at the insulo-opercular region and extending to the sylvian fissure around the primary motor and somatosensory cortices. The authors selected 4 characteristics as surgical indicators: clear tumor boundaries, negative enhancement, intact lenticulostriate arteries, and intact superior extremity of the central insular sulcus. Results Univariate analysis showed that tumors with clear boundaries were associated with higher rates of gross-total resection than were tumors with ambiguous boundaries (75.7% vs 19.6%). Tumors with negative enhancement compared with enhanced tumors were associated with lower frequency of tumor progression (32.0% vs 81.8%, respectively) and lower rates of surgical complications (14.0% vs 45.5%, respectively). Tumors with intact lenticulostriate arteries were associated with higher rates of gross-total resection than were tumors with involved lenticulostriate arteries (67.3% vs 11.8%, respectively). Tumors with intact superior extremity of the central insular sulcus were associated with higher rates of gross-total resection (57.4% vs 20.7%, respectively) and lower rates of surgical complications (18.5% vs 41.4%, respectively) than were tumors with involved anatomical structures. Multivariate analysis showed that clear tumor boundaries were independently associated with gross-total resection (p < 0.001). Negative enhancement was found to be independently associated with surgical complications (p = 0.005), overall survival times (p < 0.001), and progression-free survival times (p = 0.004). Independent associations were also found between intact lenticulostriate arteries and gross-total resection (p < 0.001), between intact lenticulostriate arteries and progression-free survival times (p = 0.026), and between intact superior extremity of the central insular sulcus and gross-total resection (p = 0.043). Among patients in whom all 4 indicators were present, prognosis was good (5-year survival rate 93.3%), resection rate was maximal (gross-total resection 100%), and surgical complication rate was minimal (6.7%). Also among these patients, overall rates of survival (p = 0.003) and progression-free survival (p = 0.005) were significantly higher than among patients in whom fewer indicators were present. Conclusions The authors propose 4 simple indicators that can be used to identify ideal candidates for radical resection of insulo-opercular gliomas, improve the outcomes, and promote maximum resection without introducing neurological complications. The indicators are clear tumor boundaries, negative enhancement, intact lenticulostriate arteries, and intact superior extremity of the central insular sulcus.

Failed awake craniotomy: a retrospective analysis in 424 patients undergoing craniotomy for brain tumor

2013 ◽  
Vol 118 (2) ◽  
pp. 243-249 ◽  
Author(s):  
Erez Nossek ◽  
Idit Matot ◽  
Tal Shahar ◽  
Ori Barzilai ◽  
Yoni Rapoport ◽  
...  
Keyword(s):  
Medical Center ◽  
Brain Regions ◽  
Awake Craniotomy ◽  
Gross Total Resection ◽  
Total Resection ◽  
Failure Group ◽  
Communication History ◽  
Hospitalization Period ◽  
Successful Group ◽  
History Of

Object Awake craniotomy for removal of intraaxial tumors within or adjacent to eloquent brain regions is a well-established procedure. However, awake craniotomy failures have not been well characterized. In the present study, the authors aimed to analyze and assess the incidence and causes for failed awake craniotomy. Methods The database of awake craniotomies performed at Tel Aviv Medical Center between 2003 and 2010 was reviewed. Awake craniotomy was considered a failure if conversion to general anesthesia was required, or if adequate mapping or monitoring could not have been achieved. Results Of 488 patients undergoing awake craniotomy, 424 were identified as having complete medical, operative, and anesthesiology records. The awake craniotomies performed in 27 (6.4%) of these 424 patients were considered failures. The main causes of failure were lack of intraoperative communication with the patient (n = 18 [4.2%]) and/or intraoperative seizures (n = 9 [2.1%]). Preoperative mixed dysphasia (p < 0.001) and treatment with phenytoin (p = 0.0019) were related to failure due to lack of communication. History of seizures (p = 0.03) and treatment with multiple antiepileptic drugs (p = 0.0012) were found to be related to failure due to intraoperative seizures. Compared with the successful awake craniotomy group, a significantly lower rate of gross-total resection was achieved (83% vs 54%, p = 0.008), there was a higher incidence of short-term speech deterioration postoperatively (6.1% vs 23.5%, p = 0.0017) as well as at 3 months postoperatively (2.3% vs 15.4%, p = 0.0002), and the hospitalization period was longer (4.9 ± 6.2 days vs 8.0 ± 10.1 days, p < 0.001). Significantly more major complications occurred in the failure group (4 [14.8%] of 27) than in the successful group (16 [4%] of 397) (p = 0.037). Conclusions Failures of awake craniotomy were associated with a lower incidence of gross-total resection and increased postoperative morbidity. The majority of awake craniotomy failures were preventable by adequate patient selection and avoiding side effects of drugs administered during surgery.

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