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
Cerberus Fossae(CF)is a large fracture system on Mars that extends for more than 1200 km.The structures,or fossae,are southeast of,and oriented approximately radially to,the large shield volcano Elysium Mons.An
BACKGROUND We described a case of a patient with a meningioma in the posterior fossa presenting atypically with an isolated unilateral vocal cord palsy causing severe respiratory distress.This is of interest as the pa...BACKGROUND We described a case of a patient with a meningioma in the posterior fossa presenting atypically with an isolated unilateral vocal cord palsy causing severe respiratory distress.This is of interest as the patient had no other symptomatology,especially given the size of the mass,which would typically cause a pressure effect leading to neurological and auditory symptoms.CASE SUMMARY This case report described a 48-year-old male who was married with two children and employed as a car guard.He had a medical history of asthma for the past 10 years controlled with an as-needed beta 2 agonist metered dose inhaler.He initially presented to our facility with severe respiratory distress.He reported a 1-wk history of shortness of breath and wheezing that was not relieved by his bronchodilator.He had no constitutional symptoms or impairment of hearing.On clinical examination,the patient’s chest was“silent.”Our initial assessment was status asthmaticus with type 2 respiratory failure,based on the history of asthma,a“silent chest,”and the arterial blood gas results.CONCLUSION A posterior fossa meningioma of such a large size and with extensive infiltration rarely presents with an isolated unilateral vocal cord palsy.The patient’s chief presenting feature was severe respiratory distress,which combined with his background medical history of asthma,was misleading.Clinicians should thus consider meningioma as a differential diagnosis for a unilateral vocal cord palsy even without audiology involvement.展开更多
Pseudotumoral cerebellitis in childhood is an uncommon presentation of cerebellitis mimicking a brain tumor. It often follows an inflammatory or infectious event, particularly due to varicella virus. Patients could ha...Pseudotumoral cerebellitis in childhood is an uncommon presentation of cerebellitis mimicking a brain tumor. It often follows an inflammatory or infectious event, particularly due to varicella virus. Patients could have a wide clinical spectrum on presentation. Some patients may be asymptomatic or present at most with mild cerebellar signs, whereas others may suffer severe forms with brainstem involvement and severe intracranial hypertension mimicking tumor warranting surgical intervention. Imaging techniques especially multimodal magnetic resonance imaging represent an interesting tool to differentiate between posterior fossa tumors and acute cerebellitis. We describe a case of pseudotumoral cerebellitis in a 6-year-old girl consequent to mumps infection and review the literature on this rare association.展开更多
Posterior fossa ependymoma comprises two distinct molecular entities,ependymoma_posterior fossa A(EPN_PFA)and ependymoma_posterior fossa B(EPN_PFB),with differentiable gene expression profiles.As yet,the response of t...Posterior fossa ependymoma comprises two distinct molecular entities,ependymoma_posterior fossa A(EPN_PFA)and ependymoma_posterior fossa B(EPN_PFB),with differentiable gene expression profiles.As yet,the response of the two entities to treatment is unclear.To determine the relationship between the two molecular subgroups of posterior fossa ependymoma and treatment,we studied a cohort of 820 patients with molecularly profiled,clinically annotated posterior fossa ependymomas.We found that the strongest predictor of poor outcome in patients with posterior fossa ependymoma across the entire age spectrum was molecular subgroup EPN_PFA,which was recently reported in the paper entitled "Therapeutic impact of cytoreductive surgery and irradiation of posterior fossa ependymoma in the molecular era:a retrospective multicohort analysis" in the Journal ofClinical Oncology.Patients with incompletely resected EPN_PFA tumors had a very poor outcome despite receiving adjuvant radiation therapy,whereas a substantial proportion of patients with EPN_PFB tumors can be cured with surgery alone.展开更多
Objective To clarify the clinical features,therapeutic method and outcomes of the primary endodermal sinus tumors(ESTs)in the posterior cranial fossa.Methods The English literatures on EST in the posterior cranial fos...Objective To clarify the clinical features,therapeutic method and outcomes of the primary endodermal sinus tumors(ESTs)in the posterior cranial fossa.Methods The English literatures on EST in the posterior cranial fossa were retrieved from PubMed and reviewed.And a 4-year-old boy diagnosed with EST in our hospital was reported.The clinical manifestations,therapy,pathologic features,and prognosis of these cases were analyzed.Results Only seven cases of the ESTs in the posterior cranial fossa were enrolled in this review,including six cases searched from the PubMed and one case from our hospital.Six patients were boy and one patient’s gender was not available from the report.Ages ranged from 1 to 5 years(mean 3.14 years).The mean tumor size in our cohort was 4.4 cm.Six cases came from East Asia.Schiller-Duval bodies were found in all seven neoplasms.All tumors were positive for alpha-fetoprotein.The alpha-fetoprotein level in serum was increased to a very high level before therapy and depressed quickly after the effective chemotherapy.The mean follow-up time was 24.4 months(range 5-52 months).Six tumors were totally removed,and four of them recurred.Three cases died including one whose tumor was partially removed.Conclusions The serum alpha-fetoprotein level is well correlated with the severity of the tumor.A combination of operation and chemotherapy might be the effective management for EST in the posterior cranial fossa.The prognosis of extragonadal intracranial EST is poor.展开更多
INFLAMMATORY myofibroblastic tumor（IMT）,alsoknown as inflammatory pseudotumor or plasma cellgranulomas,is an uncommon fibro-inflammatorylesion which is composed of inflammatory cells andmyofibroblastic spindle cells...INFLAMMATORY myofibroblastic tumor（IMT）,alsoknown as inflammatory pseudotumor or plasma cellgranulomas,is an uncommon fibro-inflammatorylesion which is composed of inflammatory cells andmyofibroblastic spindle cells.1Its pathogenesis is still un-known.The tumor commonly occurs in the lung,upperrespiratory tract,live,orbit,abdominal membrane,retro-peritoneum,and genitourinary tract.2-4It rarely involvesthe central nerve system,5,展开更多
Objective and Methods: A case of Ondine’s curse after posterior fossa decompression was reported. A 33-year-old woman was admitted complaining 2 years of dizziness and progressive worsening of gait disturbances, and ...Objective and Methods: A case of Ondine’s curse after posterior fossa decompression was reported. A 33-year-old woman was admitted complaining 2 years of dizziness and progressive worsening of gait disturbances, and 1 year of repetitively ictal nausea. The diagnosis of Arnold-Chiari malformations was established. Results: The patient underwent suboccipital craniectomy and C1-3 laminectomy. In addition to this decompression measure, a fascial graft was sutured between the edges of the dural incision. Postoperatively, the patient lost automatic control of her respiration doting sleep and became hypercapnic and hypoxemic. Assisted ventilation was initiated. Conclusion: Ondine’s curse is possibly due to insensitivity of central chemoreceptors to carbon dioxide resulting in defective control of minute ventilation. Propofol is not recommended in eases of Ondine’s curse, and assisted ventilation until the restoration of automatic control of respiration can be of value. Oxygen inspiration alone is rather harmful than beneficial.展开更多
Backgrounds: It is difficult to develop clear endoscopic field during transurethral resection (TUR) of urethral tumors, because irrigation water easily spills out from the meatus. We have devised a surgical technique ...Backgrounds: It is difficult to develop clear endoscopic field during transurethral resection (TUR) of urethral tumors, because irrigation water easily spills out from the meatus. We have devised a surgical technique to facilitate TUR of urothelial tumors. Methods: A 79-year old man developed urethral tumors in the anterior urethra and fossa navicularis 6 months after TUR of bladder tumor. We covered his penis and the resectoscope with a tip-cut condom. The tip-end of condom and the resectoscope sheath was tightly sealed and irrigation water was filled inside the condom. Results: The urethral tumors were successfully resected under a clear vision by filling irrigation water inside a tip-cut condom that covered over the resectoscope and the penis. Conclusion: This technique may be useful for TUR of anterior urethral tumors, especially tumors at fossa navicularis, which is often associated with difficulty in obtaining clear surgical vision.展开更多
PURPOSE:To review the efficacy and patterns of failure in average-risk medulloblastoma patients treated withconcurrent chemotherapy and reduced-dose cranial spinal irradiation and a conformal tumor bed boost.METH-ODS ...PURPOSE:To review the efficacy and patterns of failure in average-risk medulloblastoma patients treated withconcurrent chemotherapy and reduced-dose cranial spinal irradiation and a conformal tumor bed boost.METH-ODS AND MATERIALS:Thirty-three patients with average risk(defined as<==1.5 cm(2)of residual tumorafter resection,age>3 years,and no involvement of the cerebrospinal fluid or spine)medulloblastoma werediagnosed at our institution between January 1994 and December 2001.They were enrolled in an institutional展开更多
Objective: To evaluate the prognostic influence on local control and survival in vary patterns of nasal fossa involvement in nasopharyngeal carcinoma (NPC) after radiation therapy. Methods: Between November 1989 and J...Objective: To evaluate the prognostic influence on local control and survival in vary patterns of nasal fossa involvement in nasopharyngeal carcinoma (NPC) after radiation therapy. Methods: Between November 1989 and July 1991, 218 patients with histologically diagnosed local-regional NPC were treated with radiotherapy. Based upon the fiberscope finding, we separated nasal fossa involvement into two types: exophytic protruding (EP), which indicated exophytic bulky tumor arising from the nasopharynx and protruding into the nasal fossa, and mucosal infiltration (MI), which indicated that the nasal cavity mucosa was clinically infiltrated by tumor. Of the 218 patients, 87 had nasal involvement. Sixty of them had a pattern of MI and another 27 had an EP component. Results: The likelihood of residual disease after irradiation, the local relapse rate, 5-year free from progression rate (FFP) and death rate associated with nasopharynx relapse (DRANP) of MI and EP were 36.7% vs 3.7%, 30.0% vs 7.4%, 26.7% vs 51.8% and 25.0% vs 3.7% with P<0.004, P<0.005, P<0.02 and P<0.03, respectively. Multivariate analysis in this selected group demonstrated that infiltration of nasal fossa mucosa was an independent prognostic factor on primary control and FFP. Conclusion: Differentiation of nasal fossa involvement according to MI or EP is of value in predicting the outcome of treatment. A specific biological difference between the MI and EP group might contribute to the statistical differences in the treatment endpoints we have observed.展开更多
GANGLIONEUROMA is considered as the most mature and noninvasive form of neuroblastic tumors. It derives from neural crest cells, and can arise from wherever sympathetic tissue exists, including neck, posterior medias...GANGLIONEUROMA is considered as the most mature and noninvasive form of neuroblastic tumors. It derives from neural crest cells, and can arise from wherever sympathetic tissue exists, including neck, posterior mediastinum, adrenal gland, retroperitoneum and pelvis. The two most common locations for this tumor are retroperitoneum and posterior mediastinum; infrequently it occurs in the intracranial re-gion,2-8 with only three cases has been reported arising from trigeminal nerve.2-4 The current paper presents a 49-year-old male patient with a ganglioneuroma arising from right trigeminal ganglion and extending to the mid-dle-posterior cranial fossa. We summarized the clinical and diagnostic characteristics of this extremely rare tumor, in comparison with the three reported cases in literatures.展开更多
In this study, we explored the operation options for middle cranial fossa arachnoid cysts （MCFAC）. One hundred and forty-nine patients who were operated for a symptomatic MCFAC between 1993 and 2006 in our hosptial ...In this study, we explored the operation options for middle cranial fossa arachnoid cysts （MCFAC）. One hundred and forty-nine patients who were operated for a symptomatic MCFAC between 1993 and 2006 in our hosptial were analyzed. Follow-up time ranged from 1 y to 14 y （mean=5.4 y）. All these patients were divided into three subgroups according to Galassi classification. Long-term outcome and complications were studied respectively. Fenestration （F） resulted in a more favorable long-term outcome and less complication for cysts of types I and Ⅱ, whereas a favorable outcome was noted in type Ⅲ patients who underwent cysto-peritoneal shunting （S）. We are led to conclude that Fenestration is suitable for cysts of types Ⅰ and Ⅱ （Galassi classification）, cysto-peritoneal shunting is better for cysts of type Ⅲ.展开更多
BACKGROUND Mucoepidermoid carcinoma is the most common primary epithelial salivary gland malignancy.It mostly occurs in the major or intraoral minor salivary glands but rarely in the infratemporal fossa.Here,we presen...BACKGROUND Mucoepidermoid carcinoma is the most common primary epithelial salivary gland malignancy.It mostly occurs in the major or intraoral minor salivary glands but rarely in the infratemporal fossa.Here,we present a case of aggressive mucoepidermoid carcinoma in the infratemporal fossa with neck lymph node metastasis and also discuss diagnostic and treatment strategies.CASE SUMMARY A 39-year-old woman with a mass located in the right submandibular area presented to our department.Physical examination revealed lymphadenopathy on the right submandibular side measuring 2.5 cm×3 cm that was hard and had poor mobility.Results of nasal endoscopy were unremarkable.Ultrasound examination revealed an enlarged lymph node at level II of the right side.Fine needle aspiration cytology of the metastatic lymph node revealed malignant cells with infection.Contrast-enhanced computed tomography revealed an enhancing ill-defined soft tissue mass in the right infratemporal region.Positron emission tomography/computed tomography revealed hyperintensity in the right infratemporal fossa along with lymphadenopathy at level II of the right-side lymph node.The patient underwent extended resection of the primary tumor,and ipsilateral radical neck dissection was also completed.Hematoxylin-eosin staining and immunohistochemistry revealed a high-grade mucoepidermoid carcinoma.No signs and symptoms of recurrence of the neoplasm were present after 20 mo of follow-up.CONCLUSION Positron emission tomography/computed tomography play a key role in primary tumor localization.Furthermore,histopathology and immunohistochemistry play pivotal roles in disease diagnosis.展开更多
According to the progress of the antibiotic medicine, the severe infection case is decreasing recently. We recently experienced a case of temporal fossa abscess caused by periapical periodontitis the upper left side o...According to the progress of the antibiotic medicine, the severe infection case is decreasing recently. We recently experienced a case of temporal fossa abscess caused by periapical periodontitis the upper left side of the second molar. A 79-year-old woman visited to Showa University Dental Hospital complaining of the painful swelling at the left side of the temporal and trismus. The routine blood test exhibited a severe inflammation. We performed drainage treatment at temporal skin and normal oral bacterial flora was detected by the bacteriological examination. Under treatment included the administration of antibiotics, the inflammation healed without serious complication and she recovered completely.展开更多
BACKGROUND Pseudogout is a benign joint lesion caused by the deposition of calcium pyrophosphate dihydrate crystals,but it is invasive.Pseudogout of the temporomandibular joint(TMJ)is uncommon,and it rarely invades th...BACKGROUND Pseudogout is a benign joint lesion caused by the deposition of calcium pyrophosphate dihydrate crystals,but it is invasive.Pseudogout of the temporomandibular joint(TMJ)is uncommon,and it rarely invades the skull base or penetrates into the middle cranial fossa.The disease has no characteristic clinical manifestations and is easily misdiagnosed.CASE SUMMARY We present two cases of tophaceous pseudogout of the TMJ invading the middle cranial fossa.A 46-year-old woman with a history of diabetes for more than 10 years was admitted to the hospital due to swelling and pain in the right temporal region.Another patient,a 52-year-old man with a mass in the left TMJ for 6 years,was admitted to the hospital.Maxillofacial imaging showed a calcified mass and severe bone destruction of the skull base in the TMJ area.Both patients underwent excision of the lesion.The lesion was pathologically diagnosed as tophaceous pseudogout.The symptoms in these patients were relieved after surgery.CONCLUSION Tophaceous pseudogout should be considered when there is a calcified mass in the TMJ with or without bone destruction.A pathological examination is the gold standard for diagnosing this disease.Surgical treatment is currently the recommended treatment,and the prognosis is good after surgery.展开更多
Thirteen patients with infratemporal fossamalignancies treated in the Sichuan Cancer Hospitalfrom 1988 to 1993 are reported. All cases were treatedsurgically with combined therapy. The survival rate ofthe patients wit...Thirteen patients with infratemporal fossamalignancies treated in the Sichuan Cancer Hospitalfrom 1988 to 1993 are reported. All cases were treatedsurgically with combined therapy. The survival rate ofthe patients with survival period beyond 2 years was53.8o/o. The survival was associated with the extent ofdissection (P<0.01). The operation value, surgicalapproaches, resection range, stylohamular line and repairare analyzed and discussed. A new surgical approach, amodified stylohamular line and a new surgical conceptfor resection of the infratemporal fossa malignanciesbony boundary of surgery are introduced in detail.展开更多
Background: Posterior fossa anomalies (PFAs) are considered one of the commonest brain anomalies identified by the fetal imaging techniques. The current study aims to estimate the significance of cerebellar vermis ass...Background: Posterior fossa anomalies (PFAs) are considered one of the commonest brain anomalies identified by the fetal imaging techniques. The current study aims to estimate the significance of cerebellar vermis assessment by fetal MRI in fetal brain malformations. Patients and Methods: The study was conducted at a tertiary University hospital in Upper Egypt. Data were gathered prospectively from sixty pregnant women with sonographically diagnosed fetal brain malformations referred for Magnetic Resonance Imaging (MRI) between April 2015 and May 2019 followed by postpartum neonatal MRI brain examination for non-terminated and live birth cases. Results: Of the sixty fetuses with brain malformations, additional cerebellar vermis findings were seen on MRI in 10 cases (16.6%). Fetal MRI sensitivity, specificity, positive and negative predictive values were 100% that were in correlation with those of prenatal ultrasound turned out to be significantly higher. Conclusion: This study recommends fetal MRI for cerebellar vermis assessment in fetal brain malformations to guide the clinical management.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.
基金supported by the Alexander von Humboldt Stiftung/Foundation
文摘Cerberus Fossae(CF)is a large fracture system on Mars that extends for more than 1200 km.The structures,or fossae,are southeast of,and oriented approximately radially to,the large shield volcano Elysium Mons.An
文摘BACKGROUND We described a case of a patient with a meningioma in the posterior fossa presenting atypically with an isolated unilateral vocal cord palsy causing severe respiratory distress.This is of interest as the patient had no other symptomatology,especially given the size of the mass,which would typically cause a pressure effect leading to neurological and auditory symptoms.CASE SUMMARY This case report described a 48-year-old male who was married with two children and employed as a car guard.He had a medical history of asthma for the past 10 years controlled with an as-needed beta 2 agonist metered dose inhaler.He initially presented to our facility with severe respiratory distress.He reported a 1-wk history of shortness of breath and wheezing that was not relieved by his bronchodilator.He had no constitutional symptoms or impairment of hearing.On clinical examination,the patient’s chest was“silent.”Our initial assessment was status asthmaticus with type 2 respiratory failure,based on the history of asthma,a“silent chest,”and the arterial blood gas results.CONCLUSION A posterior fossa meningioma of such a large size and with extensive infiltration rarely presents with an isolated unilateral vocal cord palsy.The patient’s chief presenting feature was severe respiratory distress,which combined with his background medical history of asthma,was misleading.Clinicians should thus consider meningioma as a differential diagnosis for a unilateral vocal cord palsy even without audiology involvement.
文摘Pseudotumoral cerebellitis in childhood is an uncommon presentation of cerebellitis mimicking a brain tumor. It often follows an inflammatory or infectious event, particularly due to varicella virus. Patients could have a wide clinical spectrum on presentation. Some patients may be asymptomatic or present at most with mild cerebellar signs, whereas others may suffer severe forms with brainstem involvement and severe intracranial hypertension mimicking tumor warranting surgical intervention. Imaging techniques especially multimodal magnetic resonance imaging represent an interesting tool to differentiate between posterior fossa tumors and acute cerebellitis. We describe a case of pseudotumoral cerebellitis in a 6-year-old girl consequent to mumps infection and review the literature on this rare association.
文摘Posterior fossa ependymoma comprises two distinct molecular entities,ependymoma_posterior fossa A(EPN_PFA)and ependymoma_posterior fossa B(EPN_PFB),with differentiable gene expression profiles.As yet,the response of the two entities to treatment is unclear.To determine the relationship between the two molecular subgroups of posterior fossa ependymoma and treatment,we studied a cohort of 820 patients with molecularly profiled,clinically annotated posterior fossa ependymomas.We found that the strongest predictor of poor outcome in patients with posterior fossa ependymoma across the entire age spectrum was molecular subgroup EPN_PFA,which was recently reported in the paper entitled "Therapeutic impact of cytoreductive surgery and irradiation of posterior fossa ependymoma in the molecular era:a retrospective multicohort analysis" in the Journal ofClinical Oncology.Patients with incompletely resected EPN_PFA tumors had a very poor outcome despite receiving adjuvant radiation therapy,whereas a substantial proportion of patients with EPN_PFB tumors can be cured with surgery alone.
文摘Objective To clarify the clinical features,therapeutic method and outcomes of the primary endodermal sinus tumors(ESTs)in the posterior cranial fossa.Methods The English literatures on EST in the posterior cranial fossa were retrieved from PubMed and reviewed.And a 4-year-old boy diagnosed with EST in our hospital was reported.The clinical manifestations,therapy,pathologic features,and prognosis of these cases were analyzed.Results Only seven cases of the ESTs in the posterior cranial fossa were enrolled in this review,including six cases searched from the PubMed and one case from our hospital.Six patients were boy and one patient’s gender was not available from the report.Ages ranged from 1 to 5 years(mean 3.14 years).The mean tumor size in our cohort was 4.4 cm.Six cases came from East Asia.Schiller-Duval bodies were found in all seven neoplasms.All tumors were positive for alpha-fetoprotein.The alpha-fetoprotein level in serum was increased to a very high level before therapy and depressed quickly after the effective chemotherapy.The mean follow-up time was 24.4 months(range 5-52 months).Six tumors were totally removed,and four of them recurred.Three cases died including one whose tumor was partially removed.Conclusions The serum alpha-fetoprotein level is well correlated with the severity of the tumor.A combination of operation and chemotherapy might be the effective management for EST in the posterior cranial fossa.The prognosis of extragonadal intracranial EST is poor.
文摘INFLAMMATORY myofibroblastic tumor（IMT）,alsoknown as inflammatory pseudotumor or plasma cellgranulomas,is an uncommon fibro-inflammatorylesion which is composed of inflammatory cells andmyofibroblastic spindle cells.1Its pathogenesis is still un-known.The tumor commonly occurs in the lung,upperrespiratory tract,live,orbit,abdominal membrane,retro-peritoneum,and genitourinary tract.2-4It rarely involvesthe central nerve system,5,
文摘Objective and Methods: A case of Ondine’s curse after posterior fossa decompression was reported. A 33-year-old woman was admitted complaining 2 years of dizziness and progressive worsening of gait disturbances, and 1 year of repetitively ictal nausea. The diagnosis of Arnold-Chiari malformations was established. Results: The patient underwent suboccipital craniectomy and C1-3 laminectomy. In addition to this decompression measure, a fascial graft was sutured between the edges of the dural incision. Postoperatively, the patient lost automatic control of her respiration doting sleep and became hypercapnic and hypoxemic. Assisted ventilation was initiated. Conclusion: Ondine’s curse is possibly due to insensitivity of central chemoreceptors to carbon dioxide resulting in defective control of minute ventilation. Propofol is not recommended in eases of Ondine’s curse, and assisted ventilation until the restoration of automatic control of respiration can be of value. Oxygen inspiration alone is rather harmful than beneficial.
文摘Backgrounds: It is difficult to develop clear endoscopic field during transurethral resection (TUR) of urethral tumors, because irrigation water easily spills out from the meatus. We have devised a surgical technique to facilitate TUR of urothelial tumors. Methods: A 79-year old man developed urethral tumors in the anterior urethra and fossa navicularis 6 months after TUR of bladder tumor. We covered his penis and the resectoscope with a tip-cut condom. The tip-end of condom and the resectoscope sheath was tightly sealed and irrigation water was filled inside the condom. Results: The urethral tumors were successfully resected under a clear vision by filling irrigation water inside a tip-cut condom that covered over the resectoscope and the penis. Conclusion: This technique may be useful for TUR of anterior urethral tumors, especially tumors at fossa navicularis, which is often associated with difficulty in obtaining clear surgical vision.
文摘PURPOSE:To review the efficacy and patterns of failure in average-risk medulloblastoma patients treated withconcurrent chemotherapy and reduced-dose cranial spinal irradiation and a conformal tumor bed boost.METH-ODS AND MATERIALS:Thirty-three patients with average risk(defined as<==1.5 cm(2)of residual tumorafter resection,age>3 years,and no involvement of the cerebrospinal fluid or spine)medulloblastoma werediagnosed at our institution between January 1994 and December 2001.They were enrolled in an institutional
基金This work was supported by a grant from Medical Science Foundation of Guangdong Province, China (No. A2000479).
文摘Objective: To evaluate the prognostic influence on local control and survival in vary patterns of nasal fossa involvement in nasopharyngeal carcinoma (NPC) after radiation therapy. Methods: Between November 1989 and July 1991, 218 patients with histologically diagnosed local-regional NPC were treated with radiotherapy. Based upon the fiberscope finding, we separated nasal fossa involvement into two types: exophytic protruding (EP), which indicated exophytic bulky tumor arising from the nasopharynx and protruding into the nasal fossa, and mucosal infiltration (MI), which indicated that the nasal cavity mucosa was clinically infiltrated by tumor. Of the 218 patients, 87 had nasal involvement. Sixty of them had a pattern of MI and another 27 had an EP component. Results: The likelihood of residual disease after irradiation, the local relapse rate, 5-year free from progression rate (FFP) and death rate associated with nasopharynx relapse (DRANP) of MI and EP were 36.7% vs 3.7%, 30.0% vs 7.4%, 26.7% vs 51.8% and 25.0% vs 3.7% with P<0.004, P<0.005, P<0.02 and P<0.03, respectively. Multivariate analysis in this selected group demonstrated that infiltration of nasal fossa mucosa was an independent prognostic factor on primary control and FFP. Conclusion: Differentiation of nasal fossa involvement according to MI or EP is of value in predicting the outcome of treatment. A specific biological difference between the MI and EP group might contribute to the statistical differences in the treatment endpoints we have observed.
基金Supported by National Natural Science Foundation of China(81101034)
文摘GANGLIONEUROMA is considered as the most mature and noninvasive form of neuroblastic tumors. It derives from neural crest cells, and can arise from wherever sympathetic tissue exists, including neck, posterior mediastinum, adrenal gland, retroperitoneum and pelvis. The two most common locations for this tumor are retroperitoneum and posterior mediastinum; infrequently it occurs in the intracranial re-gion,2-8 with only three cases has been reported arising from trigeminal nerve.2-4 The current paper presents a 49-year-old male patient with a ganglioneuroma arising from right trigeminal ganglion and extending to the mid-dle-posterior cranial fossa. We summarized the clinical and diagnostic characteristics of this extremely rare tumor, in comparison with the three reported cases in literatures.
文摘In this study, we explored the operation options for middle cranial fossa arachnoid cysts （MCFAC）. One hundred and forty-nine patients who were operated for a symptomatic MCFAC between 1993 and 2006 in our hosptial were analyzed. Follow-up time ranged from 1 y to 14 y （mean=5.4 y）. All these patients were divided into three subgroups according to Galassi classification. Long-term outcome and complications were studied respectively. Fenestration （F） resulted in a more favorable long-term outcome and less complication for cysts of types I and Ⅱ, whereas a favorable outcome was noted in type Ⅲ patients who underwent cysto-peritoneal shunting （S）. We are led to conclude that Fenestration is suitable for cysts of types Ⅰ and Ⅱ （Galassi classification）, cysto-peritoneal shunting is better for cysts of type Ⅲ.
基金the Basic Research Program of Shenzhen Innovation Council of China,No.JCYJ 20180228175511141 and No.SZBC2017023Sanming Project of Medicine in Shenzhen,No.SZSM 201512036(Oral and Maxillofacial Surgery Team,Professor Yu Guangyan,Stomatology Hospital Peking University).
文摘BACKGROUND Mucoepidermoid carcinoma is the most common primary epithelial salivary gland malignancy.It mostly occurs in the major or intraoral minor salivary glands but rarely in the infratemporal fossa.Here,we present a case of aggressive mucoepidermoid carcinoma in the infratemporal fossa with neck lymph node metastasis and also discuss diagnostic and treatment strategies.CASE SUMMARY A 39-year-old woman with a mass located in the right submandibular area presented to our department.Physical examination revealed lymphadenopathy on the right submandibular side measuring 2.5 cm×3 cm that was hard and had poor mobility.Results of nasal endoscopy were unremarkable.Ultrasound examination revealed an enlarged lymph node at level II of the right side.Fine needle aspiration cytology of the metastatic lymph node revealed malignant cells with infection.Contrast-enhanced computed tomography revealed an enhancing ill-defined soft tissue mass in the right infratemporal region.Positron emission tomography/computed tomography revealed hyperintensity in the right infratemporal fossa along with lymphadenopathy at level II of the right-side lymph node.The patient underwent extended resection of the primary tumor,and ipsilateral radical neck dissection was also completed.Hematoxylin-eosin staining and immunohistochemistry revealed a high-grade mucoepidermoid carcinoma.No signs and symptoms of recurrence of the neoplasm were present after 20 mo of follow-up.CONCLUSION Positron emission tomography/computed tomography play a key role in primary tumor localization.Furthermore,histopathology and immunohistochemistry play pivotal roles in disease diagnosis.
文摘According to the progress of the antibiotic medicine, the severe infection case is decreasing recently. We recently experienced a case of temporal fossa abscess caused by periapical periodontitis the upper left side of the second molar. A 79-year-old woman visited to Showa University Dental Hospital complaining of the painful swelling at the left side of the temporal and trismus. The routine blood test exhibited a severe inflammation. We performed drainage treatment at temporal skin and normal oral bacterial flora was detected by the bacteriological examination. Under treatment included the administration of antibiotics, the inflammation healed without serious complication and she recovered completely.
文摘BACKGROUND Pseudogout is a benign joint lesion caused by the deposition of calcium pyrophosphate dihydrate crystals,but it is invasive.Pseudogout of the temporomandibular joint(TMJ)is uncommon,and it rarely invades the skull base or penetrates into the middle cranial fossa.The disease has no characteristic clinical manifestations and is easily misdiagnosed.CASE SUMMARY We present two cases of tophaceous pseudogout of the TMJ invading the middle cranial fossa.A 46-year-old woman with a history of diabetes for more than 10 years was admitted to the hospital due to swelling and pain in the right temporal region.Another patient,a 52-year-old man with a mass in the left TMJ for 6 years,was admitted to the hospital.Maxillofacial imaging showed a calcified mass and severe bone destruction of the skull base in the TMJ area.Both patients underwent excision of the lesion.The lesion was pathologically diagnosed as tophaceous pseudogout.The symptoms in these patients were relieved after surgery.CONCLUSION Tophaceous pseudogout should be considered when there is a calcified mass in the TMJ with or without bone destruction.A pathological examination is the gold standard for diagnosing this disease.Surgical treatment is currently the recommended treatment,and the prognosis is good after surgery.
文摘Thirteen patients with infratemporal fossamalignancies treated in the Sichuan Cancer Hospitalfrom 1988 to 1993 are reported. All cases were treatedsurgically with combined therapy. The survival rate ofthe patients with survival period beyond 2 years was53.8o/o. The survival was associated with the extent ofdissection (P<0.01). The operation value, surgicalapproaches, resection range, stylohamular line and repairare analyzed and discussed. A new surgical approach, amodified stylohamular line and a new surgical conceptfor resection of the infratemporal fossa malignanciesbony boundary of surgery are introduced in detail.
文摘Background: Posterior fossa anomalies (PFAs) are considered one of the commonest brain anomalies identified by the fetal imaging techniques. The current study aims to estimate the significance of cerebellar vermis assessment by fetal MRI in fetal brain malformations. Patients and Methods: The study was conducted at a tertiary University hospital in Upper Egypt. Data were gathered prospectively from sixty pregnant women with sonographically diagnosed fetal brain malformations referred for Magnetic Resonance Imaging (MRI) between April 2015 and May 2019 followed by postpartum neonatal MRI brain examination for non-terminated and live birth cases. Results: Of the sixty fetuses with brain malformations, additional cerebellar vermis findings were seen on MRI in 10 cases (16.6%). Fetal MRI sensitivity, specificity, positive and negative predictive values were 100% that were in correlation with those of prenatal ultrasound turned out to be significantly higher. Conclusion: This study recommends fetal MRI for cerebellar vermis assessment in fetal brain malformations to guide the clinical management.
