• Title/Summary/Keyword: Posterior fossa tumor

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Meningioma in the Lateral Cerebellomedullary Cistern without Dural Attachment

  • Kim, Seong-Min;Jung, Sung-Sam;Park, Moon-Sun;Park, Ki-Seok
    • Journal of Korean Neurosurgical Society
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    • v.47 no.6
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    • pp.464-466
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    • 2010
  • A 59-year-old female presented with headache and dizziness for one year. Magnetic resonance imaging revealed a $52{\times}28$ mm, wellcircumscribed, homogenously enhancing mass lesion without dural attachment located in the left lateral cerebellomedullary cistern. The tumor was excised, and a histological diagnosis was a mixed pattern meningioma of meningothelial and fibroblastic type. A meningioma in the posterior fossa without dural attachment is quite rare. We report a rare case of lateral cerebellomedullary cistern meningioma without dural attachment with literature review.

Surgery for a Case of Three-Compartment Trigeminal Schwannoma : Technical Aspects

  • Chung, Jong-Chul;Chung, Seung-Young;Kim, Seong-Min;Park, Moon-Sun
    • Journal of Korean Neurosurgical Society
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    • v.48 no.4
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    • pp.383-387
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    • 2010
  • Complete removal of three-compartment trigeminal schwannomas is a challenge to neurosurgeons. To expand exposure of each compartment, the combination and modification of skull base approaches are necessary. The 61-year-old woman was admitted with chronic headache. Preoperative magnetic resonance imaging showed $47{\times}50{\times}40\;mm$-sized tumor originating primarily in the middle cranial fossa extended to the posterior and the infratemporal fossa. We performed operation in five stage; 1. Zygomatic osteotomy, 2. Inferior temporal fossa plate removal and foramen ovale opening, 3. Cavernous sinus opening, 4. Tailored anterior petrosectomy, 5. Meckel's cave opening. Combination of skull base surgery should be concerned according to the patient. In this study, extradural basal extension with zygomatic osteotomy, interdural posterior extension with tailored anterior petrosectomy, and intracavemous exploration are reasonable options for remodeling three-compartment lesion into a single compartment. Tailoring of bone resection and exploring through natural pathway between meningeal layers accomplish single-stage operation for complete removal of tumors.

Facial Nerve Schwannoma Located in Middle Cranial Fossa

  • Kim, Kyoung-Tae;Kwon, Jeong-Taik;Hong, Hyun-Jong;Kim, Young-Baeg
    • Journal of Korean Neurosurgical Society
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    • v.40 no.2
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    • pp.125-127
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    • 2006
  • Facial nerve schwannomas are uncommon tumors. A 40-year-old female presented with left-side facial weakness. Computed tomography[CT] imaging showed a $3\;{\times}\;2cm$ lesion on the posterior portion of the left middle cranial fossa. The mass abutted the anterior aspect of the left petrous bone with a wide erosive change involving the area of the left facial nerve ganglion [geniculate ganglion]. A well-circumscribed extra-axial mass was seen on magnetic resonance imaging[MRI]. The tumor was completely removed through subtemporal approach and the patient was discharged without additional neurological deficit. This rare case is discussed and a review of the relevant literature is presented.

Analysis of Empty Sella Secondary to the Brain Tumors

  • Kim, Ji-Hun;Ko, Jung-Ho;Kim, Hyun-Woo;Ha, Ho-Gyun;Jung, Chul-Ku
    • Journal of Korean Neurosurgical Society
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    • v.46 no.4
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    • pp.355-359
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    • 2009
  • Objective : The definition of empty sella syndrome is 'an anatomical entity in which the pituitary fossa is partially or completely filled with cerebrospinal fluid, while the pituitary gland is compressed against the posterior rim of the fossa'. Reports of this entities relating to the brain tumors not situated in the pituitary fossa, have rarely been reported. Methods : In order to analyze the incidence and relationship of empty sella in patients having brain tumors, the authors reviewed preoperative magnetic resonance imaging (MRI) of 72 patients with brain tumor regardless of pathology except the pituitary tumors. The patients were operated in single institute by one surgeon. There were 25 males and 47 females and mean patient age was 53 years old (range from 5 years to 84 years). Tumor volume was ranged from 2 cc to 238 cc. Results : The overall incidence of empty sella was positive in 57/72 cases (79.2%). Sorted by the pathology, empty sella was highest in meningioma (88.9%, p=0.042). The empty sella was correlated with patient's increasing age (p=0.003) and increasing tumor volume (p=0.016). Conclusion : Careful review of brain MRI with periodic follow up is necessary for the detection of secondary empty sella in patients with brain tumors. In patients with confirmed empty sella, follow up is mandatory for the management of hypopituitarism, cerebrospinal fluid (CSF) rhinorrhea, visual disturbance and increased intracranial pressure.

Technical Review of Target Volume Delineation on the Posterior Fossa Tumor : An Optimal Head and Neck Position (후두와 종양의 방사선치료 시 표적용적의 결정을 위한 적절한 치료자세 연구)

  • Yoon Sang Min;Lee Sang-wook;Ahn Seung Do;Kim Jong Hoon;YE Byong Yong;Ra Young Shin;Kim Tae Hyung;Choi Eun Kyung
    • Radiation Oncology Journal
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    • v.21 no.1
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    • pp.94-99
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    • 2003
  • Purpose : To explore a 3D conformal radiotherapy technique for a posterior fossa boost, and the potential advantages of a prone position for such radiotherapy. Materials and Methods :A CT simulator and 3D conformal radiotherapy Planning system was used for the posterior fossa boost treatment on a 13-year-old medulloblastoma patient. He was placed In the prone position and Immobilized with an aquaplast mask and immobilization mold. CT scans were obtained of the brain from the top of the skull to the lower neck, with IV contrast enhancement. The target volume and normal structures were delineated on each slice, with treatment planning peformed using non-coplanar conformal beams. Results : The CT scans, and treatment In the prone position, were peformed successfully. In the prone position, the definition of the target volume was made easier due to the well enhanced tentorium, In audition, the posterior fossa was located anteriorly, and with the greater choice of beam arrangements, more accurate treatment planning was possible as the primary beams were not obstructed by the treatment table. Conclusion : .A posterior fossa boost, in the prone position, Is feasible in cooperating patients, but further evaluation is needed to define the optimal and most comfortable treatment positions.

Atypical Teratoid Rhabdoid Tumors in Adult Patient with Multiple Lesions

  • Oh, Young-Min;Koh, Eun-Jeong;Choi, Ha-Young
    • Journal of Korean Neurosurgical Society
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    • v.38 no.5
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    • pp.387-389
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    • 2005
  • Primary atypical teratoid/rhabdoid tumor[AT/RT] of the central nervous system is a recently described, highly malignant neoplasm that usually occur in the posterior fossa of children. Although AT/RT usually occurs in young children, AT/RT is being recognized in adults with increasing frequency. The authors report 49-year-old man with multiple AT/RT lesions [right lateral ventricle, right temporal lobe and right cerebellum]. Histopathologic findings showed typical rhabdoid cells with eccentric nuclei and prominent nucleoli. Eventhough the tumor was removed, a patient was dead in one month after surgery due to recurrence and rapid regrowth of the tumor.

RADIOGRAPHIC ANALYSIS OF THE TEMPOROMANDIBULAR JOINT BY THE STANDARDIZED PROJECTION TECHNIQUE (악관절규격촬영법에 의한 과두위의 분석 연구)

  • Choe Han Up
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.13 no.1
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    • pp.7-15
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    • 1983
  • The purpose of this study was to investigate the radiographic images of the condylar head in clinically normal subjects and the TMJ patients using standardized projection technique. 45 subjects who have not clinical evidence of TMJ problems and 96 patients who have the clinical evidence of TMJ problems were evaluated, but the patients who had fracture, trauma and tumor on TMJ area were discluded in this study. For the evaluation of radiographic images, the author has observed the condylar head positions in closed mouth and 2.54㎝ open mouth position taken by the standardized transcranial oblique lateral projection technique. The results were as follows: 1. In closed mouth position, the crest of condylar head took relatively posterior position to the deepest point of the glenoid fossa in 8.9 % of the normals and in 26.6% of TMJ patients. 2. In 2.54㎝ open mouth position, condylar head took relatively posterior position to the articular eminence in 2.2% of TMJ patients and 39.6% of the normals. 3. In open mouth position, the horizontal distance from the deepest point of the glenoid fossa to the condyla head was 13.96㎜ in the normals and 10.68㎜ in TMJ patients. 4. The distance of true movement of condyalr head was 13.49㎜ in the normals and l0.27㎜ in TMJ patients. 5. The deviation of mandible in TMJ patients was slightly greater than that of the normals.

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Ganglioglioma in Brainstem : Case Report and a Review of Literatures

  • Kim, Sung-Duk;Kim, Jong Hyun;Lee, Cheol-Young;Kim, Hyun-Woo
    • Journal of Korean Neurosurgical Society
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    • v.55 no.3
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    • pp.164-166
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    • 2014
  • Ganglioglioma is an infrequent tumor of the central nervous system (CNS); mostly supratentorial region. But, they can occur anywhere in the central nervous system such as brainstem, cerebellopontine angle (CPA), thalamus, optic nerve and spinal cord. Although it occurs rarely, ganglioglioma should be included in the differential diagnosis of a posterior fossa mass because early recognition is important for treatment and patient counseling.

Hemifacial Spasm Caused by a Huge Tentorial Meningioma

  • Park, Hun;Hwang, Sun-Chul;Kim, Bum-Tae;Shin, Won-Han
    • Journal of Korean Neurosurgical Society
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    • v.46 no.3
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    • pp.269-272
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    • 2009
  • A rare case of hemifacial spasm caused by an ipsilateral tentorial meningioma is described. Magnetic resonance imaging showed a huge tumor in the right cerebellar hemisphere, distant to the cerebello-pontine cistern. The facial-vestibulocochlear nerve complex was stretched by the shift of the brainstem and the right cerebello-pontine cistern was effaced. After removing the tumor, the hemifacial spasm resolved completely. We review our case with the pertinent literature regarding the etiological mechanism.

Mandibular condyle and infratemporal fossa reconstruction using vascularized costochondral and calvarial bone grafts

  • Jang, Hyo Won;Kim, Nam-Kyoo;Lee, Won-Sang;Kim, Hyung Jun;Cha, In-Ho;Nam, Woong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.40 no.2
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    • pp.83-86
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    • 2014
  • There are some difficulties in approaching and removing the lesion in infratemporal fossa because of its anatomical location. After wide excision of tumor lesion, it is also difficult for reconstruction of mandibular condyle and cranium base on infratemporal fossa. Besides, there are some possibilities of cerebrospinal fluid leakage, intracranial infection and bone resorption. It is also challenging for functional reconstruction that allows normal mandibular movement, preventing mandibular condyle from invaginating into the skull. In this report, we present 14-month follow-up results of a patient who had undergone posterior segmental mandibulectomy including condyle and infratemporal calvarial bone and mandible reconstruction with free vascularized costochondral rib and calvarial bone graft to restoration of the temporomandibular joint area.