World Neurosurg
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Intraosseous pneumatocyst refers to gas-filled cystic lesions inside bone. Whereas ilium and sacrum are the commonest locations for pneumatocysts, vertebral pneumatocysts are rare. Various theories have been proposed to explain the etiopathogenesis of vertebral pneumatocysts and the most widely accepted theory is the extension of air from intervertebral disc or joint spaces into the pneumatocyst cavity. The aim of this systematic review was to study all the cases of vertebral pneumatocyst reported in the literature to understand this rare disease and its clinical importance. ⋯ The prevalence of pneumatocyst increased with increasing age, with most of the reported patients belonging to the 50-70 years age-group. Most of these patients have large pneumatocysts with degenerative changes in spine. Another less common subset of young patients with small pneumatocysts without associated degenerative changes has also been described. Pneumatocysts were most common in the cervical spine, with C5 being the most commonly affected vertebra. Most of the pneumatocysts remain stable in size on follow-up, although 3 cases of enlarging pneumatocyst have also been reported. An enlarging pneumatocyst should be closely followed up, although its benign nature has been reported in the literature.
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Multicenter Study
Machine Learning-Based Multi-parametric MRI Radiomics for prediction of H3 K27M Mutation in Midline Gliomas.
H3K27M mutation in gliomas has prognostic implications. Previous magnetic resonance imaging (MRI) studies have reported variable rates of tumoral enhancement, necrotic changes, and peritumoral edema in H3K27M-mutant gliomas, with no distinguishing imaging features compared with wild-type gliomas. We aimed to construct an MRI machine learning (ML)-based radiomic model to predict H3K27M mutation in midline gliomas. ⋯ Our multi-institutional study suggests that ML-based radiomic analysis of multiparametric MRI can be a promising noninvasive technique to predict H3K27M mutation status in midline gliomas.
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Cone-beam computed tomography (CBCT) images for skull base tumors provide detailed vascular information and localization in regard to surrounding bony structures. We report use of the CBCT fusion technique for skull base meningiomas. ⋯ CBCT fusion images clearly visualized the feeders from each arterial system, the vascular compartments within the tumor, and possible peritumoral anastomoses. This technique provides a substantial contribution to both preoperative embolization and surgical resection of skull base meningiomas.
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Single-stage surgical treatment of cranial intraosseous meningiomas includes complete tumor resection followed by aesthetic reconstruction. Tailored tumor resection with a computer-aided design/computer-aided manufacturing custom-made implant for the defect has been advocated in recent years to achieve a satisfactory cosmetic result with reduced operative time and fewer complications. However, several technical nuances related to the area of osseous removal may compromise cranioplasty. ⋯ Custom templates based in cranial sutures may benefit single-step frame-guided resection and reconstruction of intraosseous tumors with compelling results.
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Skull base osteosarcoma is a rare and aggressive tumor that is most commonly treated with primary surgical resection and adjuvant chemoradiation. Using the National Cancer Database, we analyzed demographic and clinical prognosticators for overall survival (OS). ⋯ Tumor histologic subtype, advanced tumor grade, and greater tumor size are predictors of worse OS in skull base osteosarcoma. No significant differences in OS were identified based on treatment modality, which warrants further investigation.