Objective: To study the imaging features of extra-axial tumors and tumor-likelesions involving both middle and posterior cranial fossae and to make a classification. Methods:Sixty cases of pathologically confirmed ext...Objective: To study the imaging features of extra-axial tumors and tumor-likelesions involving both middle and posterior cranial fossae and to make a classification. Methods:Sixty cases of pathologically confirmed extra-axil tumors and tumor-like lesions involving bothmiddle and posterior cranial fossae were analyzed. They were divided into central and lateral types,the latter of which were subdivided into three types: middle cranial fossae type, posterior cranialfossae type and the over-riding type. The constitution and imaging features of each type wereanalyzed. Results: There were 12 cases of central type, including chordoma (n=5), pituitary adenoma(n=3), nasopharyngeal carcinoma (n=2), craniopharyn-gioma (n=1) and meningioma (n=l). 48 cases oflateral type including trigeminal nerve tumors (n=14), meningioma (n=12), epidermoid cyst (n=11),dural cavernous hemangioma (n=4), dermoid cyst (n=2), metastasis (n=2), hemangiopericytoma (n=1),paraganglioma of glonius jugular (n=1) and nasopharyngeal carcinoma (n=1). Each type of the lesionshad its own shape features, some of which were characteristic for some specific tumors. Most of thetumors and tumor-like lesions could be qualitatively diagnosed according to their imagingcharacteristics and the extent of the lesions could be defined definitely. Conclusion: It is helpfulto categorize extra-axial tumors and tumor-like lesions involving both middle and posterior cranialfossae according to their location for qualitative diagnosis and description of the extent of theselesions. It is of great clinical value in providing more precise and thorough imaging informationfor planning therapeutic methods and route of operation.展开更多
Due to the rare occurrence of chordomas extra-axially, these lesions have not earned a great deal of consideration in the clinical and radiographic differential diagnoses of extra-axial paraspinal lesions. We describe...Due to the rare occurrence of chordomas extra-axially, these lesions have not earned a great deal of consideration in the clinical and radiographic differential diagnoses of extra-axial paraspinal lesions. We describe a case of a patient with a surgically resected extra-axial chordoma and review the radiologic characteristics of chordomas as an entity in the spectrum of extra-axial lesions. A 47-year-old man presented to our institution with four months of intermittent parethesias, pain, and subjective weakness in the left leg. MR imaging of the lumbar spine demonstrated a large heterogeneously- enhancing paraspinal lesion extending from the left L3-4 neural foramen into the psoas muscle. The patient underwent a CT-guided needle biopsy demonstrating features consistent with a chordoma. He then underwent a left retroperitoneal approach and en bloc resection of the lesion from the vertebral column. Pathology confirmed chordoma as the diagnosis. EACs are a rare but important consideration in the diagnosis of extra-axial lesions of the central nervous system.展开更多
Background: A number of meningeal neoplastic lesions may radiologically and clinically simulate meningioma, include hemangiopericytomas, solitary fibrous tumors, schwannomas, hematolymphoid lesions, metastases, and ot...Background: A number of meningeal neoplastic lesions may radiologically and clinically simulate meningioma, include hemangiopericytomas, solitary fibrous tumors, schwannomas, hematolymphoid lesions, metastases, and others very rarely, also may clinically mimic meningiomas. Case Description: We present the case of A 28-year-old male patient, with no notable medical history, who presented with worsening headaches for 3 months, imbalance, and visual deficits, An initial MRI revealed extra-axial lesion involving the right Parieto-occipital, The tumor was hypointense on T1-weighted MR images, hyperintense signals on T2-weightedMR images, and heterogeneously enhanced suggestive of a meningioma, total resection was achieved, and the histopathological analysis confirmed the diagnosis of an angioblastic meningioma. However, 15 months later, the patient presented with the same initial visual complaints. A subsequent MRI showed lesion recurrence, leading to a second surgical intervention. The histopathological analysis confirmed the diagnosis of an anaplastic xanthoastrocytoma. Conclusion: This represents an unusual location for an anaplastic pleomorphic xanthoastrocytoma, which should broaden the differential diagnosis of extra-axial lesions.展开更多
Parasellar extra-axial cavemomas are rare lesions.The authors report a case of extra-axial cavemoma in a 50-year-old male patient,who presented with occipital headache and double vision.The magnetic resonance imaging ...Parasellar extra-axial cavemomas are rare lesions.The authors report a case of extra-axial cavemoma in a 50-year-old male patient,who presented with occipital headache and double vision.The magnetic resonance imaging showed an enhancing extra-axial dural-based mass in the left parasellar region invading cavernous sinus,hyper-intense on T2-weighted images,iso-intense on Tl-weighted images and high relative cerebral blood velocity on magnetic resonance perfusion.The patient underwent a left pterional craniotomy and parasellar space occupying lesion was excised.Histopathology was suggestive of cavernous hemangioma.展开更多
Background:Neuronavigation is a very beneficial tool in modern neurosurgical practice.However,the neuronavigation is not available in most of the hospitals in our country raising the question about its importance in l...Background:Neuronavigation is a very beneficial tool in modern neurosurgical practice.However,the neuronavigation is not available in most of the hospitals in our country raising the question about its importance in localizing the calvarial extra-axial lesions and to what extent it is safe to operate without it.Methods:We studied twenty patients with calvarial extra-axial lesions who underwent surgical interventions.All lesions were preoperatively located with both neuronavigation and the usual linear measurements.Both methods were compared regarding the time consumed to localize the tumor and the accuracy of each method to anticipate the actual center of the tumor.Results:The mean error of distance between the planned center of the tumor and the actual was 6.50±1.762 mm in conventional method,whereas the error was 3.85±1.309 mm in IGS method.Much more time was consumed during the neuronavigation method including booting,registration,and positioning.A statistically significant difference was found between the mean time passed in the conventional method and IGS method(2.05±0.826,24.90±1.334,respectively),P-value<0.001.Conclusion:In the setting of limited resources,the linear measurement localization method seems to have an accepted accuracy in the localization of calvarial extra-axial lesions and it saves more time than neuronavigation method.展开更多
Cerebellopontine angle (CPA) medulloblastomas (MB) are rare lesions with few cases previously described in the literature. We report one more case of CPA MB. The patient was a (36)-year-old female with a mass developi...Cerebellopontine angle (CPA) medulloblastomas (MB) are rare lesions with few cases previously described in the literature. We report one more case of CPA MB. The patient was a (36)-year-old female with a mass developing in the CPA. The preoperative radiological diagnosis was (hemangioblastoma) in the case. The patient was operated in Tripoli university hospital September 2020 neurosurgical department. Operated through a (retrosigmoid) approach. The intraoperative findings revealed an extra-axial tumor and the histological diagnosis was classic type of MB in the case. We review the literature and discuss pathological, radiological features and clinical follow up of CPA MB, underlining the necessity to consider MB in the differential diagnosis of CPA lesions.展开更多
文摘Objective: To study the imaging features of extra-axial tumors and tumor-likelesions involving both middle and posterior cranial fossae and to make a classification. Methods:Sixty cases of pathologically confirmed extra-axil tumors and tumor-like lesions involving bothmiddle and posterior cranial fossae were analyzed. They were divided into central and lateral types,the latter of which were subdivided into three types: middle cranial fossae type, posterior cranialfossae type and the over-riding type. The constitution and imaging features of each type wereanalyzed. Results: There were 12 cases of central type, including chordoma (n=5), pituitary adenoma(n=3), nasopharyngeal carcinoma (n=2), craniopharyn-gioma (n=1) and meningioma (n=l). 48 cases oflateral type including trigeminal nerve tumors (n=14), meningioma (n=12), epidermoid cyst (n=11),dural cavernous hemangioma (n=4), dermoid cyst (n=2), metastasis (n=2), hemangiopericytoma (n=1),paraganglioma of glonius jugular (n=1) and nasopharyngeal carcinoma (n=1). Each type of the lesionshad its own shape features, some of which were characteristic for some specific tumors. Most of thetumors and tumor-like lesions could be qualitatively diagnosed according to their imagingcharacteristics and the extent of the lesions could be defined definitely. Conclusion: It is helpfulto categorize extra-axial tumors and tumor-like lesions involving both middle and posterior cranialfossae according to their location for qualitative diagnosis and description of the extent of theselesions. It is of great clinical value in providing more precise and thorough imaging informationfor planning therapeutic methods and route of operation.
文摘Due to the rare occurrence of chordomas extra-axially, these lesions have not earned a great deal of consideration in the clinical and radiographic differential diagnoses of extra-axial paraspinal lesions. We describe a case of a patient with a surgically resected extra-axial chordoma and review the radiologic characteristics of chordomas as an entity in the spectrum of extra-axial lesions. A 47-year-old man presented to our institution with four months of intermittent parethesias, pain, and subjective weakness in the left leg. MR imaging of the lumbar spine demonstrated a large heterogeneously- enhancing paraspinal lesion extending from the left L3-4 neural foramen into the psoas muscle. The patient underwent a CT-guided needle biopsy demonstrating features consistent with a chordoma. He then underwent a left retroperitoneal approach and en bloc resection of the lesion from the vertebral column. Pathology confirmed chordoma as the diagnosis. EACs are a rare but important consideration in the diagnosis of extra-axial lesions of the central nervous system.
文摘Background: A number of meningeal neoplastic lesions may radiologically and clinically simulate meningioma, include hemangiopericytomas, solitary fibrous tumors, schwannomas, hematolymphoid lesions, metastases, and others very rarely, also may clinically mimic meningiomas. Case Description: We present the case of A 28-year-old male patient, with no notable medical history, who presented with worsening headaches for 3 months, imbalance, and visual deficits, An initial MRI revealed extra-axial lesion involving the right Parieto-occipital, The tumor was hypointense on T1-weighted MR images, hyperintense signals on T2-weightedMR images, and heterogeneously enhanced suggestive of a meningioma, total resection was achieved, and the histopathological analysis confirmed the diagnosis of an angioblastic meningioma. However, 15 months later, the patient presented with the same initial visual complaints. A subsequent MRI showed lesion recurrence, leading to a second surgical intervention. The histopathological analysis confirmed the diagnosis of an anaplastic xanthoastrocytoma. Conclusion: This represents an unusual location for an anaplastic pleomorphic xanthoastrocytoma, which should broaden the differential diagnosis of extra-axial lesions.
文摘Parasellar extra-axial cavemomas are rare lesions.The authors report a case of extra-axial cavemoma in a 50-year-old male patient,who presented with occipital headache and double vision.The magnetic resonance imaging showed an enhancing extra-axial dural-based mass in the left parasellar region invading cavernous sinus,hyper-intense on T2-weighted images,iso-intense on Tl-weighted images and high relative cerebral blood velocity on magnetic resonance perfusion.The patient underwent a left pterional craniotomy and parasellar space occupying lesion was excised.Histopathology was suggestive of cavernous hemangioma.
文摘Background:Neuronavigation is a very beneficial tool in modern neurosurgical practice.However,the neuronavigation is not available in most of the hospitals in our country raising the question about its importance in localizing the calvarial extra-axial lesions and to what extent it is safe to operate without it.Methods:We studied twenty patients with calvarial extra-axial lesions who underwent surgical interventions.All lesions were preoperatively located with both neuronavigation and the usual linear measurements.Both methods were compared regarding the time consumed to localize the tumor and the accuracy of each method to anticipate the actual center of the tumor.Results:The mean error of distance between the planned center of the tumor and the actual was 6.50±1.762 mm in conventional method,whereas the error was 3.85±1.309 mm in IGS method.Much more time was consumed during the neuronavigation method including booting,registration,and positioning.A statistically significant difference was found between the mean time passed in the conventional method and IGS method(2.05±0.826,24.90±1.334,respectively),P-value<0.001.Conclusion:In the setting of limited resources,the linear measurement localization method seems to have an accepted accuracy in the localization of calvarial extra-axial lesions and it saves more time than neuronavigation method.
文摘Cerebellopontine angle (CPA) medulloblastomas (MB) are rare lesions with few cases previously described in the literature. We report one more case of CPA MB. The patient was a (36)-year-old female with a mass developing in the CPA. The preoperative radiological diagnosis was (hemangioblastoma) in the case. The patient was operated in Tripoli university hospital September 2020 neurosurgical department. Operated through a (retrosigmoid) approach. The intraoperative findings revealed an extra-axial tumor and the histological diagnosis was classic type of MB in the case. We review the literature and discuss pathological, radiological features and clinical follow up of CPA MB, underlining the necessity to consider MB in the differential diagnosis of CPA lesions.
