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Abhilasha Siyag, Tej P Soni, Anil K Gupta, Lalit M Sharma, Naresh Jakhotia, Shantanu Sharma
Plasmacytoma of the skull-base is a rare entity. Differential diagnosis includes chordoma, osteosarcoma, carcinoma nasopharynx, meningioma, metastatic carcinoma, lymphoma, and multiple myeloma. Accurate and precise diagnosis is extremely important for plasmacytoma of the skull-base as its treatment and prognosis is different from other skull-base lesions. A 41-year-old man presented with concerns of headache, diplopia, and left eye strabismus. A magnetic resonance image (MRI) of his brain showed a large expansile mass measuring 51 mm involving the clivus and central skull-base...
January 15, 2018: Curēus
Olabisi R Sanusi, Omar Arnaout, Rudy J Rahme, Craig Horbinski, James P Chandler
OBJECTIVE: Chordomas are rare tumors of notochordal origin that are known to be locally aggressive and are often treated with surgical resection followed by adjuvant radiotherapy. The accepted standard of treatment for chordomas of the mobile spine which includes en-bloc resection with wide margins cannot be easily applied to the chordomas of the skull base given their proximity to critical neurovascular structures. We describe our experience with the role of surgery and adjuvant radiation in the treatment of chordomas over 16 years...
March 12, 2018: World Neurosurgery
Thomas Coquet, Michel Lefranc, Louis Chenin, Pascal Foulon, Éric Havet, Johann Peltier
In this anatomy report, we describe the first case of abducens nerve duplication limited to the sphenopetroclival venous gulf and the cavernous sinus. The objective point of division of the two duplicated roots was localized at the gulfar face of the dural porus, just distal to the unique cisternal trunk of the abducens nerve, as it pierced the petroclival dural mater. In the gulfar segment, both roots traveled through a variant of Dorello's canal called the "petrosphenoidal canal" and remained separated through the posterior half of the cavernous sinus...
March 15, 2018: Surgical and Radiologic Anatomy: SRA
Ahmed T Ahmed, Omar Abdel-Rahman, Mohamed Morsi, Karim Mustafa, Paola Testini, Ilyas S Aleem, M Hassan Murad, Ahmad Nassr
STUDY DESIGN: Systematic review and meta-analysis of observational studies. OBJECTIVE: The aim of the study is to evaluate different treatment modalities in the management of sacrococcygeal chordoma. SUMMARY OF BACKGROUND DATA: Chordomas are primary malignant bone tumors associated with considerable morbidity and mortality. METHODS: We searched MEDLINE, EMBASE, Cochrane Central-Register of Controlled Trials, and Scopus from inception to July 2015...
March 13, 2018: Spine
Olivier van Wulfften Palthe, Kyung-Wook Jee, Jos A M Bramer, Francis J Hornicek, Yen-Lin E Chen, Joseph H Schwab
BACKGROUND: Effects of high-dose radiation using protons and photons on bone are relatively unexplored, but high rates of insufficiency fractures are reported, and the causes of this are incompletely understood. Imaging studies with pre- and postradiation scans can help one understand the effect of radiation on bone. QUESTIONS/PURPOSES: The purpose of this study was to assess the effects of high-dose radiation on the trabecular density of bone in the sacrum using CT-derived Hounsfield units (HU)...
March 2018: Clinical Orthopaedics and related Research
Alexandre Bossi Todeschini, Alaa S Montaser, Douglas A Hardesty, Ricardo L Carrau, Daniel M Prevedello
Endoscopic endonasal approaches (EEA) have gained popularity and acceptance in skull base surgery over the last two decades. So-called expanded EEA allow access in the sagittal plane from the frontal sinus to the odontoid process. The endoscopic endonasal transclival approach allows a unique trajectory into the midline clivus and skull base that is unachievable from traditional craniotomy approaches to lesions such as chondrosarcomas, chordomas, and posterior fossa meningiomas. In this review, we will assess the benefits and drawbacks to using an endoscopic endonasal approach versus transcranial approach to these challenging lesions, assess the anatomical limits of endoscopic endonasal transclival surgery, and discuss the published literature on the topic...
March 8, 2018: Journal of Neurosurgical Sciences
Daniele Marchioni, Angelo Musumeci, Cristoforo Fabbris, Stefano De Rossi, Davide Soloperto
BACKGROUND: The clivus is a region characterized by complex anatomy, with vascular and neural structures that are located in close proximity. Different pathologies can affect this area, and traditional surgical approaches were open approaches. Recently, the endoscopic transnasal technique has been introduced, and currently represents a good alternative for the surgical management of these lesions. This is a preliminary report on patients treated endoscopically for clival lesions by the authors' Skull Base Team...
March 8, 2018: European Archives of Oto-rhino-laryngology
Ming-Xiang Zou, Guo-Hua Lv, Xiao-Bin Wang, Jing Li
No abstract text is available yet for this article.
March 2, 2018: Journal of Neurosurgery
Silky Chotai, Yi Liu, Songtao Qi
The lesions involving cavernous sinus (CS) and lateral sellar region includes tumors, vascular lesions, infection, inflammation, and trauma. Tumors associated with CS cause significant distortion of the microanatomy posing an additional surgical challenge to the neurosurgeons. The surgical approach and microsurgical anatomy with respect to the origin and growth of the tumor within the CS region have not been comprehensively described in recent years. We conducted a review of literature concerning CS and associated tumors, complied through MEDLINE/OVID and using cross-references of articles on PubMed with the keywords cavernous sinus, CS tumors, pituitary adenoma, meningioma, schwannoma, chordoma, CS hemangiomas, extradural, interdural, intradural, skull base, gamma knife radiosurgery, endoscopic endonasal approach...
January 2018: Asian Journal of Neurosurgery
Scott L Zuckerman, Mark H Bilsky, Ilya Laufer
BACKGROUND: Chordomas are rare, primary bone tumors that arise from the axial skeleton. Our objective was to analyze trends in radiation and surgery over time and determine location-based survival predictors for chordomas of the skull base, mobile spine, and sacrum. METHODS: A retrospective cohort study of the Surveillance Epidemiology and End Results (SEER) database from 1973-2013 was conducted. All patients had histologically confirmed chordomas. The principal outcome measure was overall survival (OS)...
February 24, 2018: World Neurosurgery
Norihiro Aibe, Yusuke Demizu, Nor Shazrina Sulaiman, Yoshirou Matsuo, Masayuki Mima, Fumiko Nagano, Kazuki Terashima, Sunao Tokumaru, Tomokatsu Hayakawa, Masaki Suga, Takashi Daimon, Gen Suzuki, Yamazaki Hideya, Kei Yamada, Ryohei Sasaki, Nobukazu Fuwa, Tomoaki Okimoto
PURPOSE: To evaluate the efficacy and safety of definitive proton beam therapy (PBT) for primary sacral chordoma. METHODS AND MATERIALS: We conducted a retrospective analysis of the clinical outcomes of eligible patients with primary sacral chordoma who had undergone definitive PBT with 70.4 Gy (relative biological effectiveness) in 32 fractions at our institution from September 2009 to October 2015. Local progression-free survival, distant metastasis-free survival, disease-free survival, cause-specific survival, and overall survival were evaluated...
March 15, 2018: International Journal of Radiation Oncology, Biology, Physics
Chien-Hui Lee, Chao-Bao Luo
The internal carotid artery is the most commonly affected artery in pseudoaneurysm presenting with epistaxis. Basilar arterial pseudoaneurysm is usually associated with intracranial haemorrhage. We report a basilar artery pseudoaneurysm after endoscopic surgery for clival chordoma, leading to epistaxis. The mechanism of epistaxis and strategy of embolisation are discussed.
February 27, 2018: British Journal of Neurosurgery
Angela R Shih, Gregory M Cote, Ivan Chebib, Edwin Choy, Thomas DeLaney, Vikram Deshpande, Francis J Hornicek, Ruoyu Miao, Joseph H Schwab, G Petur Nielsen, Yen-Lin Chen
Chordoma is a rare malignant tumor of bone with high morbidity and mortality. Recently, aggressive pediatric poorly differentiated chordoma with SMARCB1 loss has been described. This study summarizes the clinicopathologic features of poorly differentiated chordoma with SMARCB1 loss in the largest series to date. A search of records between 1990-2017 at MGH identified 19 patients with poorly differentiated chordoma. Immunohistochemical stains were evaluated. Kaplan-Meier survival statistics and log-rank (Mantel Cox) tests compared survival with other subtypes...
February 26, 2018: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
Murat Kutlay, Abdullah Durmaz, İlker Özer, Cahit Kural, Çağlar Temiz, Serdar Kaya, İlker Solmaz, Mehmet Daneyemez, Yusuf Izci
OBJECTIVE: With the use of multiple endoscopic endonasal surgical corridors, extended endoscopic endonasal approaches (EEEAs) are now being used to treat a wide range of ventral skull base lesions. Our aim was to present our experience with EEEAs to the ventral skull base lesions. PATIENTS AND METHODS: The study group consisted of 106 patients (57 men and 49 women) who underwent surgery for skull base lesions using EEEAs from 2010 to 2017. The EEEA was most commonly used for giant pituitary macroadenomas, sinonasal malignancies, cerebrospinal fluid (CSF) leaks, meningiomas, craniopharyngiomas, and fibro-osseous lesions...
February 21, 2018: Clinical Neurology and Neurosurgery
Wenhao Hu, Jiayi Yu, Yong Huang, Fanqi Hu, Xuesong Zhang, Yan Wang
The inflammatory microenvironment plays a critical role in the development and progression of malignancies. In the present study, we aimed to evaluate the prognostic value of lymphocyte-related inflammation and immune-based prognostic scores in patients with chordoma after radical resection, including the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR), and systemic immune-inflammation index (SII). A total of 172 consecutive patients with chordoma who underwent radical resection were reviewed...
February 21, 2018: Translational Oncology
Jun Won Kim, Chang-Ki Hong, Yoon Jin Cha, Se Hoon Kim, Chang-Ok Suh, Kyu-Sung Lee
BACKGROUND: Chordomas are rare tumors showing locally aggressive nature and high rates of local recurrences. Distant metastases are infrequently reported and cardiac metastases are extremely rare. CASE DESCRIPTION: A 32-year-old woman had been diagnosed with a large chordoma involving the clivus. She received a total removal of the tumor and adjuvant intensity-modulated radiotherapy. Four and a half years after the surgery, she presented with multifocal lesions in the ventricles and the right atrium, although an open thoracotomy revealed chronic inflammation...
February 14, 2018: World Neurosurgery
Clémence Delteil, Nausicaa Malissen, Romain Appay, Quentin Magis, Sébastien Aubert, Corinne Bouvier, Marie-Aleth Richard, Nicolas Macagno
Chordoma cutis represents an unusual clinical presentation of a rare neoplasm. The involvement of skin or sub-cutaneous soft tissues can be the consequence of local infiltration or metastasis; the latter may occur several years following the initial diagnosis of chordoma and therefore, may pose a diagnosis challenge when the clinical history of the patient is unknown. The clinical forms, morphology, immuno-histochemical profile and the main differential diagnoses of chordoma cutis are presented here through an anatomoclinical case...
February 12, 2018: Annales de Pathologie
Ankang Gao, Jie Bai, Jingliang Cheng, Xiao Cheng, Shujian Li, Zanxia Zhang, Yong Zhang
Background It is difficult to distinguish between invasive pituitary adenomas (IPAs) and skull base chordomas based on tumor location and clinical manifestations. Purpose To investigate the value of the apparent diffusion coefficient (ADC), T2-weighted (T2W) imaging, and dynamic contrast enhancement (DCE) in differentiating skull base chordomas and IPAs. Material and Methods Data for 21 patients with skull base chordomas and 27 patients with IPAs involving the paranasal sinus were retrospectively reviewed, and all diagnoses were pathologically confirmed...
January 1, 2018: Acta Radiologica
Melissa A LoPresti, Jonathan N Sellin, Franco DeMonte
Objectives  To review developmental surgical anatomy and technical nuances related to pediatric skull base surgery. Design  Retrospective, single-center case series with literature review. Setting  MD Anderson Cancer Center. Participants  Patients undergoing pediatric skull base surgery. Main Outcome Measures  Review developmental anatomy of the pediatric skull base as it relates to technical nuance of various surgical approaches and insight gained from a 25-year institutional experience with this unique patient population...
February 2018: Journal of Neurological Surgery. Part B, Skull Base
E R Gatfield, D J Noble, G C Barnett, N Y Early, A C F Hoole, N F Kirkby, S J Jefferies, N G Burnet
AIMS: To evaluate the long-term outcomes of patients with chordoma and low-grade chondrosarcoma after surgery and high-dose radiotherapy. MATERIALS AND METHODS: High-dose photon radiotherapy was delivered to 28 patients at the Neuro-oncology Unit at Addenbrooke's Hospital (Cambridge, UK) between 1996 and 2016. Twenty-four patients were treated with curative intent, 17 with chordoma, seven with low-grade chondrosarcoma, with a median dose of 65 Gy (range 65-70 Gy)...
February 2, 2018: Clinical Oncology: a Journal of the Royal College of Radiologists
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