World Neurosurg
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Adult sellar atypical teratoid/rhabdoid tumor (ATRT) is a rare diagnosis that has recently been shown to be a clinicopathologically and genetically distinct variant of ATRT occurring almost exclusively in middle-aged women. Although up to one third of pediatric ATRT is caused by a familial syndrome, no previous cases of a familial adult sellar ATRT have been reported. We present the first case report of a familial germline mutation causing adult sellar ATRT and a literature review of 29 previously reported cases of sporadic adult sellar ATRT. ⋯ This is the first case report of a familial germline mutation causing adult sellar ATRT. This article highlights the importance of a thorough family history and genetic testing in these individuals and reviews the current genetics, histopathology, and multidisciplinary treatment approach in this rare condition.
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Imaging to visualize nerves around tumors preoperatively could help the surgeon to plan the surgery and excise the tumor with preservation or improvement in patients' quality of life. In the present prospective study, we attempted to correlate the preoperative cranial nerves (i.e., trigeminal, abducens, facial, and vestibulocochlear diffusion tensor tractography and anatomic magnetic resonance imaging [MRI] findings) with intraoperative findings during cerebellopontine angle (CPA) tumor surgery. ⋯ The modified technical parameters proposed could lead to better preservation of cranial nerve function, especially for patients with large tumors. To the best of our knowledge, the present study is the first systematic study of relevant cranial nerves in 40 patients with demonstration of the vestibulocochlear bundle by preoperative MRI in the most common CPA tumors using advanced MRI sequences such as diffusion tensor tractography and capturing the data in a multiplanar format.
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Intramedullary schwannomas of the spinal cord are extremely rare. Most previous studies are case reports, which have found that intramedullary schwannomas could be homogeneous or asymmetrically enhanced with gadolinium. However, intramedullary schwannomas with minimal enhancement have not been reported. ⋯ We report a case of intramedullary schwannoma that presented inconspicuous enhancement with gadolinium. MRI is useful but cannot be used to differentiate schwannomas from other intramedullary spinal tumours. Surgical resection is the most vital factor for the treatment of intramedullary schwannoma.
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The vast majority of cerebellopontine angle tumors are benign with a favorable prognosis. Metastatic tumors occurring in the cerebellopontine angle are extremely rare. Herein, we report a case of colon carcinoma metastasis to the bilateral internal auditory canals. ⋯ Clinicians should be aware of metastatic tumors in the internal auditory canals. Comprehensive clinicoradiologic evaluation should be highlighted. A history of malignancy and rapidly progressive hearing loss and facial palsy may suggest the diagnosis of metastasis to the internal auditory canal. The definitive diagnosis still depends on histopathologic examination.
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There is limited information on the impact of smoking on postcraniotomy mortality. In this study we used the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) to examine this issue. ⋯ This study identified ≥30 pack-years as a risk factor for male patients undergoing craniotomy as treatment for neurovascular diseases.