World Neurosurg
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Review Case Reports
Pure Intrasellar Meningioma Mimicking Pituitary Macroadenoma: MR Imaging and Review of the Literature.
Intrasellar meningioma originating from the sellar floor is extremely rare and is often indistinguishable from pituitary macroadenoma, both clinically and radiologically. Here, we report a case involving a 68-year-old patient with intrasellar meningioma possibly originating from the sellar floor and present a brief review of all previous cases reported in the English literature.
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Case Reports
Prolactin-Secreting Pituitary Carcinoma with Dural Metastasis: Diagnosis, Treatment, and Future Directions.
Pituitary carcinoma is extremely rare, representing approximately 0.2% of all surgically resected pituitary neoplasms. It is thought to arise from World Health Organization grade II (atypical) pituitary adenomas. Pituitary carcinoma is defined by metastasis; it is otherwise indistinguishable from atypical pituitary adenomas, which can be considered carcinoma in situ. Pituitary carcinoma is difficult to diagnose and treat and is associated with poor long-term outcomes. ⋯ Long-term surveillance using serum prolactin as a tumor biomarker and correlation to imaging studies were critical for the diagnosis and interval screening for recurrence. This technique can be applied to all secretory atypical pituitary adenomas to improve early detection of potential metastasis. Further research, especially of genetic and epigenetic characteristics, could readily improve the diagnosis and treatment of pituitary carcinomas.
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Review Case Reports
Role of denosumab in endoscopic endonasal treatment for juvenile clival giant cell tumor: a case report.
Giant cell tumors (GCTs) are histologically benign bone neoplasms with a locally aggressive nature that primarily occur in the epiphyses of the long bones. A small proportion of these tumors, however, occur in the pelvis, spine, or skull bones. Among these, GCTs of the skull base cannot be completely resected and require adjuvant therapy. We report a juvenile case of clival GCT that was successfully treated by endoscopic endonasal transsphenoidal surgery and subsequent adjuvant therapy with denosumab, a monoclonal antibody to receptor activator of nuclear factor-κB ligand. ⋯ This is the first report to describe beneficial effects of denosumab in the treatment of GCT of the skull base.
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Review Case Reports
Fulminant vasculitis associated with extracranial dissections and occlusion, ischemic strokes, and aneurysm rupture: Case report and review of the literature.
Central nervous system vasculitis has multiple presentations, including stroke, seizures, cranial nerve palsies, and encephalopathy. ⋯ Fulminant central nervous system vasculitis can occur with critical vascular anomalies that require emergent intervention and should be part of the differential diagnosis of patients presenting with these multiple vascular pathologies.
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Review Case Reports
Nerve transfer for facial paralysis under IV sedation and local analgesia for the high surgical risk elderly patient.
This case report describes an 86-year-old woman with complete peripheral right-sided facial paralysis resulting from resection of a cervical lipoma 14 months before surgery. ⋯ To our knowledge, nerve transfers under light sedation and local anesthesia have not been described in the literature and may be useful in elderly patients with significant comorbidities.