World Neurosurg
-
Case Reports
Primary extraosseous Ewing's sarcoma of the thoracic spine presenting as chest pain mimicking spinal schwannoma.
Extraosseous Ewing sarcoma (EES) usually has a pseudocapsule and high vascularity, making it well circumscribed and focally dense with contrast enhancement on magnetic resonance imaging (MRI). Consequently, it is difficult to diagnose and distinguish from other spinal tumors, based on pretreatment radiologic findings alone. Here, we present a case of EES involving the thoracic spinal column, which was suspected to be spinal schwannoma through pretreatment radiologic findings. ⋯ Clinicians should consider EES in the differential diagnosis of other neural foraminal spinal tumors, such as schwannoma. If clinicians are confident that EES has been removed completely and there are no other lesions, radiotherapy is sufficient and additional chemotherapy may not be necessary.
-
Surgery for idiopathic tarsal tunnel syndrome (TTS) is of limited effectiveness or ineffective. Using indocyanine green video angiography (ICG-VA), we treated idiopathic TTS by posterior tibial artery (PTA) decompression from the posterior tibial nerve (PTN) and evaluated postoperative patency of the PTA. ⋯ Our surgical method of treating idiopathic TTS under ICG-VA monitoring is simple, safe, and effective.
-
Trigeminal schwannomas are benign slow-growing tumors originating from the peripheral nerve sheath. They account for 0.1%-0.4% of all intracranial tumors and 1%-8% of all intracranial schwannomas.1-3 While most of these tumors develop in the trigeminal ganglion within the middle fossa, trigeminal schwannomas can develop anywhere along the course of the trigeminal nerve. As a result, they can be intradural, interdural, and extradural.4,5 Trigeminal schwannomas from the pterygopalatine fossa (PPF) are extremely rare and very difficult to remove because of limited access to this region and the rich neurovascular contents. ⋯ Given the size and location of the mass, an endoscopic endonasal approach was performed, and the tumor was successfully resected (Video 1). The postoperative course was uneventful, and the patient had significant improvement of her symptoms and was discharged with no new neurologic deficits. However, she continued to have hypoesthesia of the V2 segment of the trigeminal nerve.
-
Case Reports
Central Nervous System Solitary Fibrous Tumor/Hemangiopericytoma Penetrating the Skull Bone: An Unusual Presentation.
Central nervous system (CNS) solitary fibrous tumor/hemangiopericytoma (SFT/HPC) is a soft tissue neoplasm that accounts for <1% of all intracranial tumors. Its growth will be mostly intracranial, usually along the sinuses. We have reported a rare case of direct extracranial extension of CNS SFT/HPC penetrating the frontal bone. ⋯ The present case has shown that CNS SFT/HPC can infiltrate the full thickness of the skull bone and grow extracranially, even if low grade. However, the unusual presentation of the present made early exploration and total resection possible.
-
The most common complication of oblique lumbar interbody fusion (OLIF) is endplate fracture/subsidence. The mechanics of endplate fracture in OLIF surgery are still unclear. The aim of the present study was to evaluate the biomechanical stability in patients undergoing OLIF surgery with stand-alone (SA) and bilateral pedicle screw fixation (BPSF) methods. ⋯ OLIF surgery with BPSF could reduce the maximum stresses on the endplate, which might reduce the incidence of cage subsidence. OLIF surgery with the SA method produced more stress compared with BPSF, especially in extension and flexion, which might be a potential risk factor for cage subsidence.