World Neurosurg
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Tumor recurrence or residual regrowth are poor prognoses for pituitary adenoma (PA). However, there is no validated and well-accepted prognostic classification of PAs to predict the clinical outcome and guide clinical practice. We analyzed the relevant data of a large cohort of patients with PA and thereafter proposed a new clinicopathologic classification for prognostic prediction. ⋯ The proposed clinicopathologic classification of PAs showed significant value in predicting prognosis and succeeded in identifying cases with more clinically aggressive lesions with recurrence or residual regrowth. This prognostic classification may be helpful when identifying aggressive PAs and deciding the appropriate therapeutic strategy for patients with PAs.
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Although intracranial and spinal ependymomas are histopathologically similar, the molecular landscape is heterogeneous. An urgent need exists to identify differences in the genomic profiles to tailor treatment strategies. In the present study, we delineated differential gene expression patterns between intracranial and spinal ependymomas. ⋯ The most substantial magnitude of DEGs in ependymoma might be HOX genes. However, whether the differential expression of these genes is the cause or consequence of the disease remains to be elucidated in a larger prospective study.
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To investigate how frameless navigational techniques can be implemented to support standard frame-based stereotactic procedures. ⋯ In a setting with intraoperative imaging, the combination of frameless and frame-based techniques offers new possibilities. Because of the high registration accuracy, the additional navigation provides improved safety and redundancy. Furthermore, the stereotactic procedure is supported by enhanced intuitive intraoperative visualization during the advancement of a biopsy needle or electrode. However, further technical refinements are necessary, such as possibilities to track microelectrodes during the advancement with a microdrive.
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This study aimed to investigate the effects of lumbar interbody fusion-induced biomechanical changes on the adjacent segments, especially disc height and segmental lordosis restoration, and to provide more information for proper surgical strategy selection. ⋯ Improved lumbar lordosis is correlated with a lower incidence of ASD, and adequate disc height and segmental lordosis restoration are essential for ASD prevention.
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Case Reports
Precocious Solitary Cervical Metastasis from Endometrial Cancer Presenting as Cervical Radicular Pain.
Bone metastases from endometrial cancer are rare. To our knowledge, only 2 cases of solitary vertebral metastases from endometrial cancer presenting with osseous and/or neurologic symptoms before the diagnosis of the primary endometrial cancer have been reported; however, in both cases, the metastases were thoracic. Thus, cervical vertebral metastases are extremely rare. ⋯ We describe an extremely rare case of a precocious solitary cervical metastasis from an endometrial cancer presenting as cervical radicular pain. In our review of published reports, we found that solitary spinal metastases are significantly associated with longer overall survival than are multiple lesions. Resection of the spinal lesion with rigid spinal reconstruction followed by radical hysterectomy may be beneficial in such patients.