Iatrogenic seeding of tumor cells in thigh soft tissue upon surgical removal of intracranial meningioma

Introduction: Meningioma is a benign and slowly-growing tumor that is responsible for 20% of brain neoplasms. It can be accompanied by some genetic disorders such as neurofibromatosis type 2 and is more common among women. As a space occupying lesion, it produces a wide range of signs and symptoms by compressing the adjacent and underlying tissues in the brain. Trauma and viruses are possible etiologies for meningioma. The ideal treatment of benign meningioma is surgical resection

Case Presentation: In this case report, we present a middle-aged man with a seeding metastasis of the cranial meningioma [after its removal] in the left thigh. During the removal operation, fascia lata had been used to repair the dura mater and the skin defect was repaired primarily

Conclusion: We believe that the occurrence of meningioma at the site of incision in the thigh is related to using the same surgical instruments for the removal of the brain tumor

Anterior trans cervicothoracic approach for complete resection of cervicothoracic mediastinal neurogenic tumors

Introduction: Neurogenic mediastinal tumors comprise a wide range of benign and malignant diseases. A group of these tumors, located at thoracic apex, sometimes spread to cervical spaces causing numerous surgical difficulties. In thoracotomy approaches, due to proximity of the tumors to major blood vessels, complete removal of these tumors from cervical spaces is impossible or may cause intraoperative severe bleeding or other dangerous incidents Because of the adjacent major vessels that are not visible. The aim of this study is to report cases of surgical treatment of such tumors using Anterior Trans Cervicothoracic Approach [ATCA]

Materials and Methods: All patients with neurogenic tumors and cervicomediastinal [CM] spread who underwent surgey with ATCA technique during 2005-2011 were included in our study. Then they were evaluated in terms of age, sex, clinical symptoms, radiological and pathological findings, technical success rate of the surgery, surgical complications and first-year relapse rate after the surgery

Results: Our study included 10 patients from whom 9 were female and 1 was male [M/F= 1/9] and the mean age was 27 years. The most common symptoms were pain and feeling of a lump. All patients were operated by this technique successfully. The most common pathological finding was neurofibroma [in 5 patients] and surgical complications occurred in 2 patients [20%] [Wound infection in 1 patient and brachial plexus injury in another patient]. There was no mortality. Disease relapse was reported in 1 patient ganglioneuroblastoma who underwent surgical resection for the second time

Conclusion: Considering the successful removal of the tumors and favorable exposure of major vessels in cervicomediastinal spaces, this technique is recommended to resect mediastinal tumors with spread to cervical spaces. However, a more definite conclusion requires further studies