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The Journal of Craniofacial Surgery Oct 2021Skull base vagal nerve schwannoma (VNS) is relatively uncommon and poses a challenge to surgeons. Although schwannomas are benign and slowly growing neoplasms arising...
Skull base vagal nerve schwannoma (VNS) is relatively uncommon and poses a challenge to surgeons. Although schwannomas are benign and slowly growing neoplasms arising from Schwann cells, they may cause significant dysfunction by causing the surrounding structures compression or infiltrating vital structures such as the skull base, the orbit, and the cranial nerves. These tumors are resistant to radiotherapy and chemotherapy. Complete surgical removal is the optimal treatment modality, with recurrence being rare. The authors report a case of a 58-year-old man with an extensive VNS involving the left jugular foramen and parapharyngeal space. The clinical presentation, surgical management, and outcomes of VNS are discussed.
Topics: Humans; Magnetic Resonance Imaging; Male; Middle Aged; Neoplasm Recurrence, Local; Neurilemmoma; Skull Base; Skull Base Neoplasms
PubMed: 34705371
DOI: 10.1097/SCS.0000000000007850 -
Neurosurgical Review Jan 2018Hemangiomas are benign, slow-growing tumors composed of sinusoidal blood vessels. Skeletal hemangiomas are uncommon and are mostly vertebral, followed by cranial in... (Review)
Review
Hemangiomas are benign, slow-growing tumors composed of sinusoidal blood vessels. Skeletal hemangiomas are uncommon and are mostly vertebral, followed by cranial in location. Cranial hemangiomas are very rarely encountered in children. Authors report a 12-year girl who presented with a painless enlarging mass over the parietal scalp for 3 months. Imaging revealed a left parietal intraosseous lytic mass with a sunburst appearance. Enbloc removal and cranioplasty was performed, and histopathology was suggestive of hemangioma. We reviewed the literature on pediatric cranial intraosseous hemangiomas (PCIH) (age ≤18 years) by searching online database. Including ours, a total of 24 cases were analyzed. Mean age was 10.2 years (range 4 months-17 years). Eight were in the first decade and 16 were in the second decade. Male:female ratio was 12:12 (1:1). A painless palpable mass was the commonest presenting feature. Parietal and frontal bones were most commonly involved. Intracranial extension was noted in cases. Mean size of the lesion was 5 cm (range 1-12 cm). Twenty-two underwent primary surgical removal while two had additional pre-operative embolization. Surgical procedures were craniectomy alone (n-3), craniectomy + cranioplasty (n-6), tumor excision + remodeling (n-3), and tumor debulking (n-2). Histopathology was cavernous type in majority of cases. Mean follow-up duration was 11.8 months (range 2-38 months). There were no recurrences. One patient died due to systemic infection. Ours is the first review exclusively on PCIH. Although rare, they need to be considered in the differential diagnosis of lytic skull lesions in children. Enbloc removal with cranioplasty is the preferred treatment in vault hemangiomas, while embolization followed by debulking would suffice in large cranial base lesions.
Topics: Child; Diagnosis, Differential; Hemangioma; Humans; Neoplasm Recurrence, Local; Skull; Skull Neoplasms
PubMed: 27558363
DOI: 10.1007/s10143-016-0779-7 -
The British Journal of Radiology Jan 2020This study aims to assess the CT and MRI features of calvarium and skull base osteosarcoma (CSBO).
OBJECTIVE
This study aims to assess the CT and MRI features of calvarium and skull base osteosarcoma (CSBO).
METHODS
The CT and MRI features and pathological characteristics of 12 cases of pathologically confirmed CSBO were analyzed retrospectively.
RESULTS
12 patients (age range 9-67 years; 3 male, 9 female) were included in the study. Tumours occurred in skull base (7, 58.3%), temporal (4, 33.3%) and frontal (1, 8.3%). Among all, six patients received radiotherapy for nasopharyngeal carcinoma. According to pathology, 11 out of 12 tumours were high-grade (91.7%). On CT, all the tumours had soft tissue mass penetrated into cortical bone with invasion of surrounding soft tissue. Six tumours were shown to have lytic density and six were mixed density. Matrix mineralization was present in 10 cases (83.3%). On MRI, tumours presented as soft-tissue masses measuring 5.9 ± 2.4 (3.9-8.0) cm. Five tumours showed low signal intensities on weighted imaging with seven having heterogeneous signal intensities. One showed low signal intensity on weighted imaging, two showed high signal intensities and nine heterogeneous signal intensities. All the tumours showed low signal intensities on diffusion-weighted imaging. On contrast enhanced images, seven cases showed heterogeneous enhancement, three showed peripheral enhancementand and two showed homogeneous enhancement. Dural tail sign were detected in nine cases.
CONCLUSION
CSBO is rare, and is commonly associated with previous radiation exposure. A presumptive diagnosis for osteosarcoma should be considered when calvarium and skull base tumours with osteoid matrix and duraltail sign are found.
ADVANCES IN KNOWLEDGE
CT and MR features of CSBO have not been reported. The study helps to identify CSBO and other sarcomas.
Topics: Adolescent; Adult; Aged; Child; Contrast Media; Female; Humans; Image Interpretation, Computer-Assisted; Magnetic Resonance Imaging; Male; Middle Aged; Osteosarcoma; Retrospective Studies; Skull Base Neoplasms; Skull Neoplasms; Tomography, X-Ray Computed
PubMed: 31746635
DOI: 10.1259/bjr.20190653 -
Advances in Oto-rhino-laryngology 2020Benign tumors of the anterior cranial base may originate from intracranial, cranial, or extracranial sites. Intracranial tumors such as meningiomas may secondarily... (Review)
Review
Benign tumors of the anterior cranial base may originate from intracranial, cranial, or extracranial sites. Intracranial tumors such as meningiomas may secondarily involve the cranial base and extend into the sinuses or nasal cavity. Bony tumors arising from the cranium include benign fibro-osseous lesions such as osteoma, fibrous dysplasia, and ossifying fibroma. The most common extracranial tumors that may extend to the skull base include angiofibroma and inverted papilloma. Symptoms are nonspecific and diagnosis is often delayed. In most cases, a diagnosis can be established based on the clinical presentation and radiographic features. Some small asymptomatic tumors may be observed for growth (meningioma, osteoma), whereas others should be treated due to continued destructive growth (angiofibromas) or potential for malignancy (inverted papilloma). Surgery remains the predominant treatment modality for benign tumors of the anterior cranial base. The major advance in recent decades has been the adoption of endoscopic techniques. Advances in endoscopic transnasal surgery have dramatically altered the surgical landscape, enabling the removal of tumors of the anterior cranial base with minimal morbidity. Due to decreased morbidity in comparison to transfacial or transcranial approaches, endoscopic transnasal surgery has lowered the threshold for surgery for benign tumors and can be applied to adult as well as pediatric populations. Anatomical limits include the anterior cranial base from the frontal sinus to the sella and optic canals and laterally to the mid-plane of the orbital roofs. Large dural defects can be reliably reconstructed using local (nasoseptal) and regional (extracranial pericranial) vascularized flaps.
Topics: Humans; Magnetic Resonance Imaging; Natural Orifice Endoscopic Surgery; Neoplasm Staging; Plastic Surgery Procedures; Skull Base; Skull Base Neoplasms; Tomography, X-Ray Computed
PubMed: 32731223
DOI: 10.1159/000457930 -
Oral and Maxillofacial Surgery Clinics... Aug 2024Craniofacial fibro-osseous lesions represent a diverse spectrum of pathologic conditions where fibrous tissue replaces healthy bone, resulting in the formation of... (Review)
Review
Craniofacial fibro-osseous lesions represent a diverse spectrum of pathologic conditions where fibrous tissue replaces healthy bone, resulting in the formation of irregular, woven bone. They are more commonly diagnosed in young people, with treatment strategies dependent on clinical behavior and skeletal maturity. This article discusses the examples of craniofacial fibro-osseous lesions, based on the latest classifications, along with their diagnostic criteria and management.
Topics: Humans; Child; Diagnosis, Differential; Fibrous Dysplasia of Bone; Facial Bones; Fibroma, Ossifying; Craniofacial Fibrous Dysplasia; Skull Neoplasms
PubMed: 38705816
DOI: 10.1016/j.coms.2024.03.004 -
Otolaryngologic Clinics of North America Apr 2017A wide variety of tumors present in the sinonasal and ventral skull base. Patients often have nonspecific symptoms initially and present with advanced tumors, affecting... (Review)
Review
A wide variety of tumors present in the sinonasal and ventral skull base. Patients often have nonspecific symptoms initially and present with advanced tumors, affecting the orbit and other adjacent structures. Evaluation of these malignancies with modern imaging techniques can define tumor invasion, but biopsy is often required to establish a diagnosis because most have a nonspecific appearance. A thorough understanding of the anatomy is the key to treatment planning, and a multidisciplinary approach determines the optimal strategy.
Topics: Female; Humans; Magnetic Resonance Imaging; Neoplasm Grading; Neoplasm Staging; Nose Neoplasms; Orbit; Skull Base; Skull Base Neoplasms; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 28314398
DOI: 10.1016/j.otc.2016.12.002 -
The Journal of Craniofacial SurgeryA 37-year-old male patient was complaining from painless forehead swelling, which started 5 years ago. Brain computed tomography scan and magnetic resonance imaging...
A 37-year-old male patient was complaining from painless forehead swelling, which started 5 years ago. Brain computed tomography scan and magnetic resonance imaging showed a large extradural mass compressing the both frontal lobes with skull bone infiltration, hyperostosis and enlargement. The patient was operated in 2 stages. In the first stage, the authors achieved separation for the tumor from the scalp and skull. In the second stage after 1 week, the authors continued with circumferential dural opening around the tumor and separation of the tumor from brain tissue. Duroplasty was performed by autologous fascia latta and skin flap was closed primarily. The specimen was received grossly as huge mass weighing 1530 g and measuring 39 × 16 × 12 cm. Histopathologic examination showed grade I meningioma extending beyond the skull to the surrounding soft tissue.
Topics: Male; Humans; Child; Adult; Meningioma; Meningeal Neoplasms; Tomography, X-Ray Computed; Skull Neoplasms; Hyperostosis; Skull; Magnetic Resonance Imaging
PubMed: 35761446
DOI: 10.1097/SCS.0000000000008663 -
The British Journal of Oral &... May 2017
Topics: Humans; Intraoperative Complications; Margins of Excision; Osteoma, Osteoid; Reflex, Trigeminocardiac; Skull Neoplasms; Zygoma
PubMed: 27989357
DOI: 10.1016/j.bjoms.2016.11.006 -
Journal of Neuro-oncology Nov 2016A better understanding of surgical anatomy, marked improvement in illumination devices, provision of improved hemostatic agents, greater availability of more precise... (Review)
Review
A better understanding of surgical anatomy, marked improvement in illumination devices, provision of improved hemostatic agents, greater availability of more precise surgical instruments, and better modalities for skull base reconstruction have led to an inevitable evolution of skull base neurosurgery. For the past few decades, many skull base neurosurgeons have worked relentlessly to improve the surgical approach and trajectory for the expansion of operative corridor. With the advent of newer techniques and their rapid adaptation, it is foundational, especially for young neurosurgeons, to understand the basics and nuances of modifications of traditional neurosurgical approaches. The goal of this topic review is to discuss the evolution of, concepts in, and technical nuances regarding the operative corridor expansion in the field of skull base surgery for intracranial meningioma as they pertain to achieving optimal functional outcome.
Topics: Craniotomy; Humans; Meningeal Neoplasms; Meningioma; Microsurgery; Osteotomy; Skull Neoplasms
PubMed: 27439458
DOI: 10.1007/s11060-016-2197-7 -
AJR. American Journal of Roentgenology Oct 2015The aim of this article is to describe the imaging features of the most common benign or malignant skull vault lesions, which may be focal, multifocal, or diffuse. (Review)
Review
OBJECTIVE
The aim of this article is to describe the imaging features of the most common benign or malignant skull vault lesions, which may be focal, multifocal, or diffuse.
CONCLUSION
Imaging features, in association with the age, history, and clinical symptoms of the patient, make it possible to propose a course of action: simple survey, pathologic confirmation, or complete surgical resection.
Topics: Contrast Media; Humans; Magnetic Resonance Imaging; Skull Neoplasms; Tomography, X-Ray Computed
PubMed: 26397334
DOI: 10.2214/AJR.14.13415