Cases reported "Skull Neoplasms"

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1/120. Melanotic neuroectodermal tumour of infancy at the anterior fontanelle.

    We describe a 4-month-old girl presenting with a melanotic neuroectodermal tumour of infancy at the anterior fontanelle. According to the neuroimaging findings, this tumour was found to lie epidurally, adherent to the dura mater, with thickening of the adjacent frontal bone. The tumour was dense on CT, while MRI showed a major part of the tumour to be isointense with cerebral cortex on both T1- and T2-weighted images. The neuroimaging and clinical features are briefly discussed.
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keywords = cerebral
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2/120. giant cell tumors of the jugular foramen.

    PURPOSE: To review the diagnosis and treatment of giant cell tumors of the jugular foramen. MATERIALS AND methods: A typical case is reported. Symptoms, signs, and diagnostic studies are reviewed. Photomicrographs and angiographic studies showing the differences between these and glomus jugulare tumors are provided. A coherent approach to their management is presented. RESULTS: These hypervascular, traditionally radioresistant tumors may cause pulsatile tinnitus, conductive hearing loss, and lower cranial nerve paresis. Angiographic studies showed a hypervascular lesion supplied by numerous small branches of the external carotid artery, making embolization difficult. Complete resection was achieved by an infratemporal fossa approach with preoperative embolization. CONCLUSION: giant cell tumors of the temporal bone may mimic glomus jugulare tumors with respect to anatomic location, cranial nerve deficits, and vascularity.
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ranking = 285.61717071937
keywords = foramen
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3/120. Giant-cell tumor of the skull base.

    giant cell tumors are uncommon primary bone tumors. They primarily occur in the long bones. giant cell tumors are extremely rare in the skull and head and neck. When it does occur, the maxilla and mandible are the common sites to be involved. We described two cases of giant cell tumor in the temporal bone. In the noncontrast enhanced CT, the lesion presents as a soft tissue density mass with expansion of the bone. The bony cortex is usually intact. The adjacent soft tissues and cerebral parenchyma show no infiltration or edema. The post contrast scan reveals homogenous enhancement of the mass.
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keywords = cerebral
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4/120. Cochleo-vestibular manifestations of jugular foramen pathologies.

    patients presenting pathologies of the jugular foramen are presented, for whom the main symptoms are of cochleo-vestibular nature. A classification of the various pathologies is attempted, the anatomy reviewed and hypotheses capable of producing the symptom elaborated.
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ranking = 285.61717071937
keywords = foramen
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5/120. Extradural meningioma in the left fronto-temporo-parietal region.

    A case of a 47-year-old male patient who presented with a history of complaints of headache, vertigo and an expanding painful swelling on the left side of the head over the last year is reported. The lump was 15 x 15 cm and protruded 1-3 centimeters. Neurological examination revealed the presence of a mild right hemiparesis with right central facial palsy. Plain skull x-ray film demonstrates a heterogeneous bone thickening in the left fronto-temporo-parietal region with a small osteolytic focus and spotted shadows. Computed tomography scan of the skull showed that a major part of the squamas of the frontal and temporal bones were transformed into spiculoform structures turned outwards and inwards. Thus the bone appeared thickened overall. There were no alterations in the cerebral structures. The tumour was completely removed. It was located extradurally and through the bones extended to the soft tissues under the skin. The histological findings showed a meningioma with hemorrhages and necroses and the presence of lipids containing xanthochromic cells. After a surgical extirpation of the tumour a reduction of the neurological symptomatology and subjective complaints was observed.
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ranking = 1
keywords = cerebral
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6/120. Enlargement of mandibular canal without hypesthesia caused by extranodal non-Hodgkin's lymphoma: a case report.

    A rare condition of enlargement of the mandibular canal caused by an extra-nodal non-Hodgkin's lymphoma in a 59-year-old Japanese woman was reported. The patient had a swelling of the hard palate and protrusion of both ocular bulbs, which had been present for 10 years. A panoramic radiograph revealed that the right mandibular canal was widely enlarged, extending from the mandibular foramen to the mental foramen, without bone destruction. The continuous dilation of the mandibular canal to an approximate 15-mm width was associated with peripheral bony sclerosis. Computed tomography and magnetic resonance imaging showed a soft tissue tumor inside the mandibular canal. The lesion demonstrated expansive growth in the orbits, extending to the skull base through the superior orbital fissures and cavernous sinus. The lymphoma was suspected to have grown so slowly that the adjacent mandibular canal and ocular bulbs enlarged without destroying the normal bone and nervous tissue.
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ranking = 114.24686828775
keywords = foramen
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7/120. Cystic schwannomas of the jugular foramen: clinical and surgical remarks.

    OBJECTIVE: The goals of this report were to outline the clinical presentation, radiological characteristics, surgical techniques, postoperative morbidity, and long-term follow-up results for cystic jugular foramen (JF) schwannomas and to describe their differences, compared with solid schwannomas involving the JF. methods: A retrospective analysis of radiological studies and surgical records identified five primarily cystic tumors among 21 cases of JF schwannomas that had been surgically treated at our institution. RESULTS: Two types of cystic JF schwannomas were observed, i.e., Type 1 lesions, which are single large cysts with thin ring-like enhancement of the tumor wall, and Type 2 lesions, which are multiple cysts with very irregular, thick enhancement of the cyst wall. The most common symptoms were hearing loss, ataxia, and headaches. Total surgical removal could be performed in all cases. The immediate postoperative findings indicated hearing improvement in three cases. No deterioration of lower cranial nerve function was observed. All patients were independent in the immediate postoperative period and in the long-term follow-up period (Karnofsky Performance Scale score, 90). CONCLUSION: Surgical treatment of cystic JF schwannomas can be very demanding because of generally stronger adhesion of the tumor capsule to the surrounding structures, fragile tumor capsules, and difficulty in identification of the arachnoidal planes in some cases. Early identification of the arachnoidal planes without opening of the cyst and sharp dissection may be useful. Careful intradural opening of the JF should be performed to achieve total removal of the last tumor portion within the JF. A comparison of these lesions with solid schwannomas involving the JF indicated that cystic tumors affected a younger population, with less preoperative swallowing impairment (P < 0.05). The immediate postoperative course in both types of cystic JF schwannomas was usually better than for solid lesions, because of minor postoperative cranial nerve morbidity, especially involving lower cranial nerve function, in the latter cases. Long-term follow-up data failed to demonstrate any significant differences in final patient outcomes, however.
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ranking = 285.61717071937
keywords = foramen
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8/120. Conservative facial nerve management in jugular foramen schwannomas.

    OBJECTIVE: Although transposition of the facial nerve is crucial in infiltrative vascular lesions involving the jugular foramen, the objective was to show that a conservative approach to management of the facial nerve is sufficient with jugular foramen neuromas because of their noninfiltrative, less vascular nature and medial location in the jugular foramen. STUDY DESIGN: Retrospective case review. SETTING: Tertiary, private, multiphysician, otologic practice. patients: Sixteen patients with jugular foramen schwannoma (18 procedures) treated between January 1975 and October 1995. The 8 male and 8 female patients ranged in age from 13 to 66 years (mean age 47.7 years). INTERVENTION: One-stage, total jugular foramen neuroma removal without transposition of the facial nerve, using a variety of surgical approaches. MAIN OUTCOME MEASURES: facial nerve transposition (yes or no), House-Brackmann facial nerve grade, lower cranial nerve status, complications. RESULTS: One-stage total tumor removal was accomplished in all the cases. In 13 (72%) of the neuromas, removal was accomplished without facial nerve transposition. Transposition was performed in 2 revision cases in which scar tissue from a previous operation prevented complete control of the carotid artery and safe removal, 2 cases with large tumor extension anteriorly to the petrous apex, and 1 case with extensive involvement of the middle ear. A House-Brackmann facial nerve Grade I or II was obtained in 16 of the 18 procedures, with 1 Grade III and 1 case that remained Grade V, as it was preoperatively. CONCLUSIONS: One-stage, total tumor removal can be achieved with excellent control of the important vascular structures and without transposition of the facial nerve in a majority of jugular foramen schwannomas.
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ranking = 571.23434143873
keywords = foramen
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9/120. The transcochlear approach to the skull base.

    A new approach to tumors of the skull base is described. This approach is accomplished by forward extension of the translabyrinthine opening into the cerebellopontine angle. The facial nerve is mobilized in the temporal bone from the stylomastoid foramen to its entrance into the internal auditory canal. Having removed the barrier of the facial nerve, additional bone removal can be carried forward to the internal carotid artery, which now becomes the forward limit for temporal bone resection. The access attained through this exposure allows removal of tumors arising from the petrous tip, as well as tumors arising directly from the clivus. We provide the case histories of four patients in whom this approach was successfully used in removal of skull base tumors.
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ranking = 57.123434143873
keywords = foramen
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10/120. Radiodiagnosis of intracranial pearly tumours with particular reference to the value of computer tomography.

    The radiological appearances of 22 histologically proven epidermoid and dermoid tumours occurring in four sites are presented - (1) the petrous apex and cerebellopontine angle, (2) the suprasellar region, (3) the cerebral hemispheres and (4) the cerebellum and 4th ventricle. Pathognomonic radiological changes are only uncommonly demonstrated by conventional neuroradiological techniques. Computer assisted tomography employing an EMI scanner has demonstrated diagnostic appearances. The availability of detailed density changes occurring within the tumours together with additional intracranial information makes computer tomography the investigation of choice.
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ranking = 1
keywords = cerebral
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