Spinal meningeal melanocytoma

2004 ◽  
Vol 100 (3) ◽  
pp. 287-290 ◽  
Author(s):  
Tuncer Turhan ◽  
Kazim Oner ◽  
Taskin Yurtseven ◽  
Taner Akalin ◽  
Izzet Ovul
Keyword(s):  
Solid Tumor ◽  
Neurological Deficit ◽  
Therapeutic Option ◽  
Tumor Resection ◽  
Total Excision ◽  
Content Type ◽  
Meningeal Melanocytoma ◽  
Radiological Examinations ◽  
Fine Print

✓ The authors report on two patients with spinal meningeal melanocytoma and review the literature on this lesion. One case is particularly interesting because of the lesion's thoracic intramedullary localization. Meningeal melanocytoma is a benign but locally aggressive lesion and is very rarely associated with spinal localizations. This patient presented with paraparesis. Clinical and radiological examinations suggested the possibility of an intramedullary solid tumor. Thoracic laminectomy, posterior myelotomy, and tumor resection were performed; the mass was totally removed. The patient suffered no additional neurological deficit. During a 3-year follow-up period in which radiotherapy was not performed, the lesion did not recur. Total excision of the tumor is the best therapeutic option.

Nonprogressive calcified mass of the skull involving nine cranial nerves: 36-year follow-up

1974 ◽  
Vol 40 (6) ◽  
pp. 779-782
Author(s):  
Michael Scott
Keyword(s):  
Neurological Deficit ◽  
Cranial Nerves ◽  
Content Type ◽  
Unilateral Involvement ◽  
Fine Print ◽  
Progressive Enlargement

✓ A case is reported in which a calcified mass in the posterior and middle fossae produced unilateral involvement of nine cranial nerves but 36 years later showed no evidence of progressive enlargement or increase in neurological deficit.

Neurosurgical management of low-grade astrocytoma of the cerebral hemispheres

1984 ◽  
Vol 61 (4) ◽  
pp. 665-673 ◽  
Author(s):  
Edward R. Laws ◽  
William F. Taylor ◽  
Marvin B. Clifton ◽  
Haruo Okazaki
Keyword(s):  
Neurological Deficit ◽  
Important Variable ◽  
Surgical Removal ◽  
Low Grade ◽  
Survival Times ◽  
Duration Of Symptoms ◽  
Content Type ◽  
Long Duration ◽  
Fine Print

✓ The authors conducted a retrospective review of surgically treated, histologically proven cases of low-grade (Grade 1 or 2) astrocytomas. Follow-up analysis, with survival time as the end-point, was completed using multivariant statistical analysis. In the 461 cases of supratentorial low-grade astrocytoma in this study, age of the patient at the time of surgery was by far the most important variable in predicting length of survival. Other variables correlating with increasing survival times were: gross total surgical removal, lack of major preoperative neurological deficit, long duration of symptoms prior to surgery, seizures as a presenting symptom, lack of major postoperative neurological deficit, and surgery performed in recent decades. The multi-variant regression analysis showed that radiation therapy was of clear benefit, primarily in older patients with incompletely removed tumors. For purposes of establishing prognosis and testing the results, a “score” was developed to predict survival times, based on the most important variables. The data in this study provide a basis for the analysis of future modes of management of low-grade gliomas.

Evaluation of a new concept for the management of skull base chordomas and chondrosarcomas

2005 ◽  
Vol 102 (Special_Supplement) ◽  
pp. 165-170 ◽  
Author(s):  
Guenther Christian Feigl ◽  
Otto Bundschuh ◽  
Alireza Gharabaghi ◽  
Sam Safavi-Abassi ◽  
Amr El Shawarby ◽  
...  
Keyword(s):  
Skull Base ◽  
Tumor Volume ◽  
Tumor Resection ◽  
Volume Reduction ◽  
Recurrence Rates ◽  
Content Type ◽  
The Mean ◽  
Tumor Volume Reduction ◽  
Fine Print

Object. Chordomas and chondrosarcomas of the skull base are rare locally invasive tumors associated with high recurrence rates. The aim of this study was to evaluate the concept of microsurgical tumor volume reduction followed by early gamma knife surgery (GKS). Methods. Thirteen patients with 15 tumors were treated between October 2000 and June 2003. There were three patients (23.1%) with chordomas and 10 (76.9%) with chondrosarcomas. There were nine men and four women who ranged in age between 19 and 69 years. All patients first underwent maximal tumor resection. Within 2 to 10 months after surgery they were treated with GKS. The mean postoperative tumor volume treated with GKS was 9.7 cm3 (range 1.4–20.3 cm3). Follow-up computerized tomography and magnetic resonance imaging examinations with volumetric tumor analysis were performed every 6 months after GKS. The mean treatment dose was 17 Gy and the mean isodose was 52%. The mean follow-up duration was 17 months during which there was only one tumor recurrence at the margin of the radiation field. The mean volume reduction was 35.4%. Conclusions. Results of this treatment strategy are encouraging but the efficacy of this multimodal treatment combining surgery and early GKS requires a longer follow up.

Late malignant recurrence of childhood cerebellar astrocytoma

1972 ◽  
Vol 37 (4) ◽  
pp. 470-474 ◽  
Author(s):  
William R. Bernell ◽  
John J. Kepes ◽  
Elson P. Seitz
Keyword(s):  
Clinical Evidence ◽  
Total Excision ◽  
Content Type ◽  
Cerebellar Astrocytoma ◽  
Recurrent Tumors ◽  
Fine Print

✓ Two cases are presented in which childhood cerebellar astrocytomas recurred 20 and 23 years after gross total excision. Both recurrent tumors showed histological or clinical evidence of malignancy. The cases indicate that even two decades of symptom-free follow-up are not necessarily a guarantee of cure with this glioma.

Intracranial meningeal melanocytoma associated with ipsilateral nevus of Ota

2002 ◽  
Vol 96 (3) ◽  
pp. 619-623 ◽  
Author(s):  
Marie-Dominique Piercecchi-Marti ◽  
Hicham Mohamed ◽  
Agnes Liprandi ◽  
Daniele Gambarelli ◽  
Francois Grisoli ◽  
...  
Keyword(s):  
Malignant Melanoma ◽  
Blue Nevus ◽  
Complementary Treatment ◽  
Content Type ◽  
Meningeal Melanocytoma ◽  
Nevus Of Ota ◽  
Embryonic Origin ◽  
Neurocutaneous Syndrome ◽  
Fine Print

✓ In this report, the authors review the case of a man with a neurocutaneous syndrome. He presented with an intracerebral melanocytoma associated with a blue nevus of the scalp; its location and its appearance during childhood supported the diagnosis of a nevus of Ota. Meningeal melanocytomas are increasingly being diagnosed, but remain rare. Primary meningeal malignant melanoma is the first differential diagnosis to eliminate. Despite their common embryonic origin, the association of a melanocytoma with a nevus of Ota is rare. A nevus of Ota exhibits the same melanocytic proliferation and affects the trigeminal nerve territory. An ocular effect is not always observed. In contrast to an ocular lesion, a nevus of Ota rarely transforms into a malignant melanoma. It is found only among caucasians. During 4 years of follow-up review after surgery, the patient remained asymptomatic. Other than antiepileptic therapy, he received no complementary treatment and cerebral imaging revealed no evidence of recurrence.

Late course of preserved hearing and tinnitus after acoustic neurilemoma surgery

1992 ◽  
Vol 77 (5) ◽  
pp. 685-689 ◽  
Author(s):  
Atul Goel ◽  
Laligam N. Sekhar ◽  
Walter Langheinrich ◽  
Donald Kamerer ◽  
Barry Hirsch
Keyword(s):  
Tumor Recurrence ◽  
Tumor Resection ◽  
Internal Auditory Canal ◽  
Cochlear Nerve ◽  
Nerve Section ◽  
Preoperative Level ◽  
Content Type ◽  
Fine Print ◽  
Better Than

✓ The late course of preserved hearing and tinnitus following retrosigmoid transmeatal surgery for acoustic neurilemoma is reported. Over a period of 5 years, useful hearing was preserved in 15 patients after preservation was attempted in 42 patients. In five patients the hearing was better than the preoperative level; in three it was worse. Three patients developed delayed worsening and fluctuations of hearing in the surgically treated ear during a median follow-up period of 2½ years. While the exact reason for such worsening was not clear in two patients, in one patient it appeared that the muscle graft placed in the internal auditory canal after tumor resection resulted in fibrosis and compromise of the cochlear nerve. The causes of delayed worsening of hearing in the absence of tumor recurrence are analyzed, and possible treatment and methods of prevention of worsening are suggested. In six patients, tinnitus persisted after surgery in the ear with successful preservation of hearing, but hearing was not worsened and the tinnitus was not bothersome to the patient. In one patient with preoperative tinnitus, hearing was not preserved and tinnitus persisted sufficiently to necessitate re-exploration and cochlear nerve section.

Posterior subtemporal transtentorial approach to intraparenchymal lesions of the anteromedial region of the superior cerebellum

2005 ◽  
Vol 103 (5) ◽  
pp. 783-788 ◽  
Author(s):  
Joshua M. Ammerman ◽  
Russell R. Lonser ◽  
Edward H. Oldfield
Keyword(s):  
Tumor Resection ◽  
National Institutes Of Health ◽  
Surgical Approaches ◽  
Content Type ◽  
Surgical Access ◽  
Operative Findings ◽  
Transtentorial Approach ◽  
Complete Tumor ◽  
Fine Print

Object. To overcome the limitations associated with surgical approaches that have been described for accessing intraparenchymal lesions of the anteromedial region of the superior cerebellum, the authors used a posterior subtemporal transtentorial approach to remove tumors in this region. In this paper they describe the surgical technique that they used as well as the operative findings and clinical outcomes observed in patients who underwent resection of tumors in the anteromedial superior cerebellum. Methods. The consecutive patients with anteromedial superior cerebellar tumors who underwent resection performed using the posterior subtemporal transtentorial approach at the National Institutes of Health were included in this study. Clinical, neuroimaging, and operative results were analyzed. Three patients (two men and one woman) with anteromedial superior cerebellar tumors (two hemangioblastomas and one pilocytic astrocytoma) underwent resection via this approach. All the tumors were larger than 3 cm in diameter (range 3.1–3.5 cm). This approach provided excellent surgical access and permitted complete tumor resection in each case. The patients remained neurologically unchanged compared with preoperative baseline findings at the last follow-up examination (conducted at 4, 18, and 42 months postoperatively). One patient displayed a mild transient confusion immediately after surgery, but it resolved within 6 days. Conclusions. The posterior subtemporal transtentorial approach provides excellent access to the anteromedial superior cerebellar region. This approach permits resection of large lesions in this location, while avoiding many of the limitations associated with other approaches to this site.

Management of atlantoaxial metastases with posterior occipitocervical stabilization

2003 ◽  
Vol 98 (2) ◽  
pp. 165-170 ◽  
Author(s):  
Daryl R. Fourney ◽  
Julie E. York ◽  
Zvi R. Cohen ◽  
Dima Suki ◽  
Laurence D. Rhines ◽  
...  
Keyword(s):  
Tumor Resection ◽  
Spinal Metastases ◽  
Neurological Deficits ◽  
Rank Test ◽  
Cancer Center ◽  
Content Type ◽  
University Of Texas ◽  
Signed Rank Test ◽  
Fine Print

Object. The treatment of atlantoaxial spinal metastases is complicated by the region's unique biomechanical and anatomical characteristics. Patients most frequently present with pain secondary to instability; neurological deficits are rare. Recently, some authors have performed anterior approaches (transoral or extraoral) for resection of upper cervical metastases. The authors review their experience with a surgical strategy that emphasizes posterior stabilization of the spine and avoidance of poorly tolerated external orthoses such as the rigid cervical collar or halo vest. Methods. The authors performed a retrospective review of 19 consecutively treated patients with C-1 or C-2 metastases who underwent surgery at The University of Texas M. D. Anderson Cancer Center between 1994 and 2001. Visual analog pain scores were reduced at 1 and 3 months (p < 0.005, Wilcoxon signed-rank test); however, evaluation of pain at 6 months and 1 year was limited by the remaining number of surviving patients. Analgesic medication consumption was unchanged. There were no cases of neurological decline or sudden death secondary to residual or recurrent atlantoaxial disease during the follow-up period. One patient underwent revision of hardware at 11 months. The mean follow-up period was 8 months (range 1–32 months). Median survival determined by Kaplan—Meier analysis was 6.1 months (95% confidence interval 2.99–9.21). Conclusions. Occipitocervical stabilization provided durable pain relief and preservation of ambulatory status over the remaining life span of patients. Because of the palliative goals of surgery, the authors have not found an indication for anterior-approach tumor resection in these patients. Successful stabilization obviates the need for an external orthosis.

Primary cerebellar glioblastomas multiforme in children

1999 ◽  
Vol 90 (3) ◽  
pp. 546-550 ◽  
Author(s):  
Abhaya V. Kulkarni ◽  
Laurence E. Becker ◽  
Venita Jay ◽  
Derek C. Armstrong ◽  
James M. Drake
Keyword(s):  
Adjuvant Therapy ◽  
Tumor Resection ◽  
Immunohistochemical Analysis ◽  
Tumor Spread ◽  
Content Type ◽  
Craniospinal Radiation ◽  
Sick Children ◽  
Fine Print

✓ Primary cerebellar glioblastomas multiforme are exceedingly rare in children. The authors therefore retrospectively characterized the clinical behavior and pathological features of these tumors. A review of the database at the Hospital for Sick Children, Toronto, Canada revealed four patients with cerebellar tumors that displayed significant pleomorphism, hypercellularity, mitoses, and necrosis with pseudopalisading. The authors performed a detailed clinical, radiological, histological, and immunohistochemical analysis of the tumors in these four children (three boys and one girl; average age at presentation 7 years; range 21 months–15 years). Magnetic resonance imaging and computerized tomography most commonly revealed a large lesion with minimal edema, inhomogeneous contrast enhancement, and a discrete border. Tumor resection was subtotal in one patient and gross total in three patients. Immunostaining of the tumor cells with antisera to glial fibrillary acidic protein and vimentin was positive in varying degrees. Initial adjuvant therapy consisted of local radiation only (one patient), chemotherapy only (one patient), and radiation and chemotherapy (one patient). One patient received no adjuvant therapy. Tumor recurrence was documented in all patients: two local recurrences (at 3.5 and 7 months), one spinal recurrence (at 14 months), and one local recurrence with ventricular and spinal spread (at 8 months). Ultimately, three of the four patients developed leptomeningeal tumor spread. Patient follow up ranged from 8 to 17 months (mean 12.5 months). Three patients were dead at last follow up with a mean survival of 15 months.The prognosis for patients with cerebellar glioblastomas is extremely poor, and the tumor has a tendency for cerebrospinal fluid dissemination. The optimal management of patients harboring of these difficult-to-treat tumors, including the role of craniospinal radiation and chemotherapy, has not yet been achieved.

Aggressive surgical management of craniopharyngiomas in children

1992 ◽  
Vol 76 (1) ◽  
pp. 47-52 ◽  
Author(s):  
Harold J. Hoffman ◽  
Marcia De Silva ◽  
Robin P. Humphreys ◽  
James M. Drake ◽  
Mary Lou Smith ◽  
...  
Keyword(s):  
Weight Control ◽  
Total Excision ◽  
Content Type ◽  
Visual Deficits ◽  
Follow Up Study ◽  
Sick Children ◽  
Lost To Follow Up ◽  
Mean Time ◽  
Fine Print

✓ The cases of 50 patients with craniopharyngioma operated on at The Hospital for Sick Children in Toronto between January, 1975, and December, 1989, are reviewed. All patients were under 18 years of age (mean 9.39 years). Headaches, endocrine deficiences, and visual deficits were the most common symptoms on admission. Forty-five patients underwent what was considered by the surgeon to be total excision of their tumor, and five had subtotal excision. Tumors recurred in 17 patients (mean time of recurrence 32.6 months after surgery). One patient died in the postoperative period and three have been lost to follow-up study. Of the remaining 46 patients, 28 are leading a normal or nearly normal life, although all are receiving endocrine replacement and some have required help to overcome mild deficits in memory or visual acuity. Twelve patients are able to function reasonably well and attend school despite being hampered by intellectual or visual deficits or problems with weight control; four have a significant handicap, and two have died.

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