ABSTRACT
Seeding on surgical pathway is a rare form of clival chordoma treatment failure. We report the case of a 42-year-old male with a clival chondroid chordoma removed by a sublabial transsphenoidal approach followed by proton beam radiotherapy, who developed a maxillary bone recurrence 3 years after surgery.
Subject(s)
Chordoma/secondary , Maxillary Neoplasms/secondary , Neoplasm Seeding , Skull Base Neoplasms , Adult , Cranial Fossa, Posterior , Fatal Outcome , Humans , Magnetic Resonance Imaging , Male , Treatment FailureABSTRACT
We present three cases of meningiomas developing at the site of an old head trauma. We then review the literature regarding the controversies on the development of post-traumatic brain tumors and, finally, we emphasize the medico-legal characteristics of post-traumatic meningiomas, particularly with respect to their cell type which is frequently atypical or anaplastic and which have a poor outcome.
Subject(s)
Craniocerebral Trauma/pathology , Meningeal Neoplasms/pathology , Meningioma/pathology , Skull Fractures/pathology , Adult , Aged , Arachnoid/diagnostic imaging , Arachnoid/injuries , Arachnoid/pathology , Craniocerebral Trauma/diagnostic imaging , Craniocerebral Trauma/etiology , Dura Mater/diagnostic imaging , Dura Mater/injuries , Dura Mater/pathology , Humans , Male , Meningeal Neoplasms/diagnostic imaging , Meningeal Neoplasms/etiology , Meningioma/diagnostic imaging , Meningioma/etiology , Radiography , Skull Fractures/diagnostic imaging , Skull Fractures/etiologyABSTRACT
OBJECTIVE: Pontine cavernomas are benign vascular lesions whose surgical treatment is challenging due to their localization. We report our experience in the surgical management of these lesions exclusively using a lateral, subtemporal transtentorial approach in high pontine lesions and an anterior petrosal approach in low pontine lesions. METHODS: We performed a retrospective study on a series of patients who were operated on for a pontine cavernoma in our neurosurgery department between 1987 and 2007. In the study, we detail the patients' clinical and preoperative radiological data and compare the two surgical techniques we used. Finally, we analyze the postoperative follow-up, the morbidity encountered according to the surgical approach used, and the long-term outcomes. RESULTS: We enrolled nine patients into the study. Six patients were operated on using an anterior petrosal approach. None of the patients died. Five patients were able to resume their former professional activity after surgery and were clearly improved following surgery. One patient was worse after surgery (hemiplegia and deafness). We used a subtemporal transtentorial approach in three of the patients. None of the patients died. Two of the patients were able to resume their prior professional activities without any sequels, and the third patient's condition worsened following surgery (temporal hematoma). CONCLUSION: The lateral surgical approach for pontine cavernomas constitutes a reasonable surgical alternative to the transventricular, suboccipital, retromastoid, or transclival approaches. Patient morbidity in both approaches is acceptable, and the long-term outcome is satisfactory with respect to sequels and the resumption of prior professional activity.
