Cases reported "Skull Base Neoplasms"

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1/30. paraganglioma in the frontal skull base--case report.

    A 56-year-old female presented with a paraganglioma in the left anterior cranial fossa who manifesting as persistent headache. Computed tomography and magnetic resonance imaging showed a solid, enhanced tumor with a cystic component located medially. The tumor was attached to the left frontal base and the sphenoid ridge. angiography demonstrated a hypervascular tumor fed mainly by the left middle meningeal artery at the left sphenoid ridge. The preoperative diagnosis was meningioma of the left frontal base. The tumor was totally resected via a left frontotemporal craniotomy. Histological examination revealed the characteristic cellular arrangement of paraganglioma generally designated as the "Zellbaren pattern" on light microscopy. Only 10 patients with supratentorial paraganglioma have been reported, seven located in the parasellar area. The origin of the present tumor may have been the paraganglionic cells which strayed along the middle meningeal artery at differentiation.
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ranking = 1
keywords = sella
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2/30. Primary osteogenic sarcoma involving sella-sphenoid sinus--case report.

    A 38-year-old male presented with an extremely rare primary osteogenic sarcoma, unassociated with Paget's disease or late effects of radiation, involving the sella and sphenoid sinus region. Complete excision of the tumor was achieved through an extended frontobasal approach. Postoperatively, six cycles of combination chemotherapy (adriamycin, ifosphamide, and cisplatin) followed by a total of 55 Gy local radiotherapy in 33 fractions was given. Primary osteogenic sarcoma should be considered in the differential diagnosis of the central skull base tumors. Osteogenic sarcoma, in general, has a bad prognosis, and should be managed aggressively with multimodality treatment including gross total surgical resection, combination chemotherapy, and radiotherapy.
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ranking = 5
keywords = sella
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3/30. prolactinoma with preferential infrasellar extension: a report of two cases.

    The authors describe two male patients with prolactinomas which were incidentally found either during the course of a complete work up for headache or after minor head trauma. Since these tumours were located mainly in the sphenoid bone and did not show any upward growth to the suprasellar region, they were initially thought to be a primary skull base tumour; however, the serum prolactin levels of these patients were 1,179 ng/ml and 3,260 ng/ml, respectively. The authors thus emphasise the need to recognise this peculiar infrasellar growth pattern of prolactinoma.
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ranking = 6
keywords = sella
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4/30. The treatment of skull base meningiomas--combining surgery and radiosurgery.

    While the operative results for treating skull base meningiomas have improved due to modern microsurgical techniques, surgery is still accompanied by a high morbidity rate. Over the last 6 years, we operated on 50 patients with intracranial meningiomas, 23 of which were skull-based lesions. Among these patients with skull base meningiomas, seven (30%) were treated with both surgery and radiosurgery.All patients received standard operative procedures. Five patients received subtotal resections and two patients received partial resections. No mortalities occurred in our series. Following the operations, the clinical status improved in six patients, while only one patient (with a tuberculum sellae meningioma) experienced deterioration of a preexisting visual disturbance. radiosurgery was performed at a mean of 4.3 months after the operations. One patient was treated by a two-staged radiosurgery regimen in light of the patient's large tumour volume (57.5 cm(3)). The treatment volume of the series ranged from 0.3 to 29.6 cm(3)(mean 11.6 cm(3)), and the minimum dose for the tumours was from 8 Gy to 12 Gy (mean, 11.6 Gy). Tumour regression was observed in three patients (43%) during the follow up period for radiosurgery (mean: 28 months). No patients revealed tumour growth in the follow up period or suffered symptomatic radiation injury. The clinical status remained unchanged in each of the seven patients after radiosurgery. Although we treated only seven patients with skull base meningiomas using surgery combined with radiosurgery, and the follow up period has been short, we believe that such combination treatment may be a very useful option in selected patients.
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keywords = sella
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5/30. Transsphenoidal surgery utilizing computer-assisted stereotactic guidance.

    Computer-assisted guidance technology represents the next step in the application of stereotactic techniques to skull base surgery. Use of this 3-D technique reduces operative time and complications as the technique allows a more direct approach with precise real-time anatomical guidance. We present seven cases of transsphenoidal parasellar surgery where this technique has been employed. The pathology included lesions of the sella turcica, parasellar region and the petrous apex.
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ranking = 13.690641379499
keywords = sella turcica, sella
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6/30. photophobia as the presenting visual symptom of chiasmal compression.

    Five patients with a chief visual complaint of photophobia were subsequently found to have compressive lesions of the optic chiasm. visual acuity and visual field deficits were often subtle. magnetic resonance imaging scanning revealed large suprasellar masses, including three pituitary adenomas, a craniopharyngioma, and a clivus chordoma. photophobia resolved in all patients following treatment of the tumors. A compressive lesion of the optic chiasm should be considered in patients who experience persistent photophobia unexplained by ocular abnormalities.
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ranking = 1
keywords = sella
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7/30. 3-D-conformal radiation therapy for pediatric giant cell tumors of the skull base.

    BACKGROUND: giant cell tumors (GCT) of the base of skull are rare neoplasms. This report reviews the treatment of four pediatric patients presenting with aggressive giant cell tumor, using fractionated and combined, conformal proton and photon radiation therapy at massachusetts General Hospital and Harvard Cyclotron Laboratory. patients AND methods: Three female patients and one adolescent male, ages 10-15 years, had undergone prior, extensive surgical resection(s) and were treated for either primary (two patients) or recurrent (two patients) disease. Gross residual tumor was evident in three patients and microscopic disease suspected in one patient. Combined proton and photon radiation therapy was based on three-dimensional (3-D) planning, consisting of fractionated treatment, one fraction per day at 1.8 CGE (cobalt-gray equivalent) to total target doses of 57.6, 57.6, 59.4, and 61.2 Gy/CGE. RESULTS: With observation times of 3.1 years, 3.3, 5.3, and 5.8 years, all four patients were alive and well and remained locally controlled without evidence of recurrent disease. Except for one patient with partial pituitary insufficiency following radiotherapy for sellar recurrent disease, thus far no late effects attributable to radiation therapy have been observed. CONCLUSIONS: 3-D-conformal radiation therapy offers a realistic chance of tumor control for aggressive giant cell tumor in the skull base, either postoperatively or at time of recurrence. Conformal treatment techniques allow the safe delivery of relatively high radiation doses in the pediatric patient without apparent increase of side effects.
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ranking = 1
keywords = sella
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8/30. Infrasellar craniopharyngioma mimicking a clival chordoma: a case report.

    An unusual case of entirely infrasellar craniopharyngioma mimicking a clival chordoma is described. Only 22 cases of craniopharyngioma with nasopharyngeal extension have been reported in the literature. Of the reported cases, most were primarily intracranial with secondary downward extension; only two were thought to originate from an infrasellar location. The present case is another example of an entirely infrasellar craniopharyngioma, with extensive clival destruction, mimicking a clival chordoma. Relevant literature on the subject is reviewed.
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ranking = 7
keywords = sella
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9/30. chordoma in the sella turcica.

    A 75-year-old man presented with a rare case of chordoma in the sella turcica of the skull base. He had been treated for hypertension and chronic renal failure since 1990. Computed tomography detected a tumor in the sella turcica in 1994, but the patient had no clinical complaints and the serum pituitary hormone levels were normal. He died of disseminated intravascular coagulation, myocardial infarction, pulmonary infection, and multiple cerebral infarctions in 2000. At autopsy, the tumor in the sella turcica was 3.1 cm in greatest diameter and had compressed the pituitary gland posteriorly. Histological examination found oval cells and vacuolated short spindle-shaped cells which showed morphological changes similar to myxoma cells. The tumor was lobulated by narrow connective tissues. The tumor did not contain any cartilaginous tissue components, and was stained positively for epithelial membrane antigen but negatively for S-100 protein. The final diagnosis was chordoma. There was no association between the tumor and the cause of death.
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ranking = 81.834489656491
keywords = sella turcica, sella
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10/30. Aggressive intracranial fibromatosis: case report.

    Fibromatosis is a locally aggressive, proliferative fibroblastic lesion affecting musculoaponeurotic structures, most often in the limbs and trunk. Intracranial fibromatosis is extremely rare and requires aggressive treatment to prevent recurrence. We present the case of a 48 year old woman with aggressive skull base fibromatosis. The lesion extended through the sphenoid sinus, into both pterygoid recesses, destroying the right lateral wall of the sphenoid sinus and invading the cavernous sinus. There was also involvement of the floor of the sella, the clivus, the right petrous temporal bone and the right mastoid. The patient underwent partial resection of the lesion via an extended trans-sphenoidal approach. Postoperative MRI showed residual tissue. A review of the literature shows that intracranial fibromatosis usually appears in the first or second decade. Complete resection is often impossible because of its widely infiltrative nature. radiotherapy and chemotherapy are often required to improve local control of the lesion.
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ranking = 1
keywords = sella
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