Cases reported "Skull Neoplasms"

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1/81. Interesting radiologic findings in suprasellar mass lesions. Report of three cases.

    The authors report three quite rare lesions of the sellar/parasellar region. They are namely; pituitary abscess, cystic macroadenoma and osteochondroma. In none of the cases, the preoperative diagnostic priority was not same as the final histopathologic diagnosis. The radiologic findings of these pathologies are discussed with emphasis on differential diagnosis.
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ranking = 1
keywords = sella
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2/81. Sellar chondroma--case report.

    A 12-year-old boy presented with right visual disturbance. skull radiography and computed tomography (CT) showed an irregular deformity of the sella turcica, hypertrophic change of the dorsum sellae, and an inhomogeneously calcified mass in the sella turcica. Magnetic resonance (MR) imaging demonstrated the mass lesion filled the hypophyseal fossa, and extended to the dorsum sellae, right cavernous sinus, and right suprasellar region. The Dolenc pterional combined epidural and subdural approach was carried out. The histological diagnosis was chondroma. Sellar chondroma requires relief of the compression to the chiasm or optic nerve as soon as possible, so partial resection can still be beneficial. However, follow-up MR imaging or CT, visual examination, and control of pituitary dysfunction are required after the operation.
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ranking = 8.8962609732667
keywords = sella turcica, turcica, sella
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3/81. Giant cystic craniopharyngiomas with extension into the posterior fossa.

    Between 1991 and 1998, 24 patients underwent surgery for a craniopharyngioma in our department. This group included two patients who had tumors with extensive growth along the midline, and along the posterior fossa in particular. In both cases suprasellar calcifications were typical features on magnetic resonance imaging (MRI) and computed tomography (CT). A 7-year-old boy presented with a 6-month history of headache, nausea, and progressive unilateral hearing loss. With a suboccipital approach it was possible to remove the main part of the tumor. In a 13-year-old boy headache and visual deterioration led to the diagnosis of a craniopharyngioma, which was removed with a pterional approach. For the neuroimaging work-up in such cases of atypically growing craniopharyngiomas MRI is the method of choice. Additional CT scanning is recommended, which provides valuable information about bony changes at the skull base due to space-occupying growth. CT substantiates the differential diagnosis if typical calcifications are seen.
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ranking = 0.16666666666667
keywords = sella
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4/81. empty sella syndrome in nevoid basal cell carcinoma syndrome.

    We reported the magnetic resonance imaging of four young patients (13 to 19 years) with nevoid basal cell carcinoma syndrome (NBCCS), which showed empty sella, agenesis of the corpus callosum and empty sella, an interhemispheric lipoma with callosal dysgenesis, and an arachnoid cyst in the posterior fossa, respectively. Calcification of the diaphragma sellae, which is a protective barrier against the pulsating action of the cerebrospinal fluid, may cause the empty sella in NBCCS.
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ranking = 1.3333333333333
keywords = sella
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5/81. Intrasellar chordomas mimicking pituitary adenoma.

    OBJECT: Whereas chordomas involving the sellar region are uncommon, largely or entirely intrasellar examples are rare. The goal in this study was to present examples of these rare tumors as a guide to their proper diagnosis and treatment. methods: The authors report three cases in which the chordomas filled the pituitary fossa and presented as nonfunctioning pituitary adenomas. All lesions exhibited the typical histological patterns and immunophenotype of chordoma. One tumor, studied ultrastructurally and subjected to dna analysis, was shown to have a diploid histogram. The authors present a clinicopathological study of these three cases and review the literature on intrasellar chordomas. CONCLUSIONS: Although these tumors are easily misdiagnosed and therefore may not receive optimal treatment, aggressive surgical resection can yield a favorable prognosis in lesions with a limited extent.
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ranking = 1.1666666666667
keywords = sella
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6/81. Resection of suprasellar tumors by using a modified transsphenoidal approach. Report of four cases.

    Generally accepted contraindications to using a transsphenoidal approach for resection of tumors that arise in or extend into the suprasellar region include a normal-sized sella turcica, normal pituitary function, and adherence of tumor to vital intracranial structures. Thus, the transsphenoidal approach has traditionally been restricted to the removal of tumors involving the pituitary fossa and, occasionally, to suprasellar extensions of such tumors if the sella is enlarged. However, conventional transcranial approaches to the suprasellar region require significant brain retraction and offer limited visualization of contralateral tumor extension and the interface between the tumor and adjacent structures, such as the hypothalamus, third ventricle, optic apparatus, and major arteries. In this paper the authors describe successful removal of suprasellar tumors by using a modified transsphenoidal approach that circumvents some of the traditional contraindications to transsphenoidal surgery, while avoiding some of the disadvantages of transcranial surgery. Four patients harbored tumors (two craniopharyngiomas and two hemangioblastomas) that arose in the suprasellar region and were located either entirely (three patients) or primarily (one patient) within the suprasellar space. All patients had a normal-sized sella turcica. Preoperatively, three of the four patients had significant endocrinological deficits signifying involvement of the hypothalamus, pituitary stalk, or pituitary gland. Two patients exhibited preoperative visual field defects. For tumor excision, a recently described modification of the traditional transsphenoidal approach was used. Using this modification, one removes the posterior portion of the planum sphenoidale, allowing access to the suprasellar region. Total resection of tumor was achieved (including absence of residual tumor on follow-up imaging) in three of the four patients. In the remaining patient, total removal was not possible because of adherence of tumor to the hypothalamus and midbrain. One postoperative cerebrospinal fluid leak occurred. Postoperative endocrinological function was worse than preoperative function in one patient. No other new postoperative endocrinological or neurological deficits were encountered. This study demonstrates the feasibility of using a modified transsphenoidal approach for resection of certain suprasellar, nonpituitary tumors.
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ranking = 10.562927639933
keywords = sella turcica, turcica, sella
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7/81. 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 = 0.16666666666667
keywords = sella
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8/81. A heterotopic cerebellum presenting as a suprasellar mass with associated nasopharyngeal teratoma.

    We present a case of nasopharyngeal teratoma that was discovered in association with a suprasellar heterotopic cerebellum in a newborn. Well-differentiated, heterotopic, cerebellar masses have been reported in the orbits, spine, and frontal encephalocele but not, to our knowledge, in the suprasellar region. In this report, we describe the imaging findings and discuss the possible origins of the two masses discovered in this case.
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keywords = sella
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9/81. Cavernous haemangioma of cavernous sinus associated with an internal carotid artery aneurysm.

    A 50-year-old woman developed a sudden onset of ophthalmoplegia. CT and MRI showed a massive middle cranial fossa tumour encasing the intracavernous sinus carotid artery. The tumour extended into Meckel's cave and sella, and had eroded the lateral wall of the orbit. angiography showed a faint tumour blush and an aneurysm of the distal part of cavernous segment of internal carotid artery. On exploration, an extremely vascular, entirely intracavernous sinus cavernous haemangioma was completely excised and the aneurysm was clipped. The literature on this relatively rare and surgically formidable condition is reviewed.
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ranking = 0.16666666666667
keywords = sella
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10/81. Metastatic tumors in the sellar and parasellar regions: clinical review of four cases.

    Metastatic tumors in the sellar and parasellar regions are uncommon and rarely detected in clinical practice. We present four cases of sellar and parasellar metastatic tumors, which metastasized from distant organ in one case and extended directly from adjacent structures in three. Common presenting symptoms were cranial neuropathies, headache and facial pain. Invasion into the cavernous sinus was noted in all cases. We report rare cases of sellar and parasellar metastases. Also, we should consider the possibility of metastasis in these regions for patients who showed the above clinical presentations in systemic cancer patients. In extensive diseases, transient symptomatic relief could be obtained by direct surgical management, even in restricted degree.
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ranking = 2.3333333333333
keywords = sella
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