Sphenoid wing

  • 文章类型: Case Reports
    En斑块状脑膜瘤是一种罕见的脑膜瘤,具有浸润性,片状生长,有时侵入骨头。我们在这里报告一例斑块状脑膜瘤。患者是一名66岁的女性,表现为头痛和双侧眼球突出疼痛。脑磁共振成像显示双侧斑块状脑膜瘤,表现为双侧大翼蝶骨骨增生,伴有双侧颞前区和斜坡后区域的硬脑膜增厚和增强,两侧侵入海绵窦,视神经的交叉前部分,和眼眶外侧直肌通过眶上裂引起双侧眼球突出症。由于海绵窦和眶尖的侵入,小量但广泛的切除结合上眶裂和视神经管的骨性减压,然后进行辅助放疗通常会产生良好的功能和美容效果。在三年的时间里,随访磁共振成像扫描显示无明显复发征象。
    En plaque meningioma is a rare type of meningioma characterized by an infiltrative nature, sheet-like growth, and at times invading the bone. We report here a case of en plaque meningioma. The patient was a 66-year-old woman presenting with headache and painful bilateral proptosis. Cerebral magnetic resonance imaging revealed a bilateral en plaque meningioma showed as a bilateral hyperostotic of greater wing sphenoid bone associated with bilateral thickening and enhancement of the dura in the anterior temporal area and the retroclival region invading bilaterally the cavernous sinus, the prechiasmatic portion of the optic nerve, and the lateral rectus muscle of the orbit through the superior orbital fissure causing bilateral exophthalmia. Due to invasion of the cavernous sinus and the orbital apex, a subtotal but extensive removal combined with bony decompression of the cranial nerves at the superior orbital fissure and optic canal followed by adjuvant radiotherapy frequently produces good functional and cosmetic results, and over a 3-year period, follow-up magnetic resonance imaging scans showed no obvious signs of recurrence.
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  • 文章类型: Case Reports
    该病例报告讨论了由位于蝶骨翼(SW)区域的罕见类型的颅内硬脑膜动静脉瘘(DAVF)引起的搏动性耳鸣(PT)的独特实例,PT是唯一的症状。患者最初接受了多次误诊,并在正确诊断之前在多家医院寻求医疗救助。影像学研究显示DAVF在SW地区的存在,导致患者转诊到介入放射学/神经学,尽管她选择了保守观察而没有手术干预。值得注意的是,患者的PT在30个月后自发停止,没有任何明显的原因,随访影像学证实没有DAVF相关异常。该案例强调了将DAVF视为PT的潜在原因的重要性,即使在听觉装置附近没有明显的异常。它还强调耳鼻喉科医生需要将检查范围扩大到颞骨以外的区域,如蝶骨和眼眶区域,当PT是唯一的症状。该案例强调了早期发现和干预DAVF的重要性,因为它们会导致使人衰弱的并发症,尽管在这种情况下很少发生自发症状解决。
    This case report discusses a unique instance of pulsatile tinnitus (PT) caused by a rare type of intracranial dural arteriovenous fistula (DAVF) located in the sphenoid wing (SW) region, with PT being the sole presenting symptom. The patient initially received multiple misdiagnoses and sought medical attention at various hospitals before being correctly diagnosed. Imaging studies revealed the DAVF\'s presence in the SW region, which led to the patient\'s referral to interventional radiology/neurology, although she chose conservative observation without surgical intervention. Remarkably, the patient\'s PT spontaneously ceased after 30 months without any apparent cause, and follow-up imaging confirmed the absence of DAVF-related abnormalities. The case highlights the importance of considering DAVF as a potential cause of PT, even when there are no evident abnormalities in proximity to the auditory apparatus. It also emphasizes the need for otolaryngologists to extend their examination to include regions beyond the temporal bone, such as the sphenoid bone and orbital areas, when PT is the exclusive symptom. The case underscores the significance of early detection and intervention for DAVFs, as they can lead to debilitating complications, despite the rare occurrence of spontaneous symptom resolution in this case.
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  • 文章类型: Case Reports
    一只9岁的雌性混血犬,用于治疗假定的蝶骨翼脑膜瘤。临床症状包括持续<1分钟的强直阵挛性癫痫发作,这是在3个月前开始的。体检结果无明显差异。在术前磁共振成像(MRI)中观察到右蝶骨区域中偏心的肿瘤性囊状结构,提示脑膜瘤和肿瘤周围脑水肿。手术前,使用计算机断层扫描(CT)图像和计算机辅助3D设计软件,设计了三维(3D)患者特异性指针(PSP).在3D-PSP的引导下,通过颅骨切除术对右颞叶的外侧部分进行了针对性的方法和暴露后,脑膜瘤的完全宏观零碎切除可以使用内窥镜辅助的脑部手术进行.术后MRI证实肿瘤完全切除。抗惊厥治疗90天后停止,手术后2周,抗惊厥药的剂量逐渐减少。在术后225天的随访检查中,没有观察到癫痫发作的复发,并且通过重复MRI检查证实没有肿瘤复发。据我们所知,这是兽医领域的第一份报告,描述了使用3D-PSP成功切除蝶骨翼脑膜瘤.3D-PSP辅助的颅骨切除术可能是一些犬类颅骨肿瘤的手术选择,如蝶骨翼脑膜瘤。
    A 9-year-old female mixed-breed dog presented for treatment of a presumed sphenoid-wing meningioma. Clinical signs included tonic-clonic seizures lasting <1 min, which had started 3 months previously. The physical examination results were unremarkable. An eccentrically located neoplastic cystic structure in the right sphenoid bone region suggestive of a meningioma and peritumoural brain oedema was observed in pre-operative magnetic resonance imaging (MRI). Prior to surgery, a three-dimensional (3D) patient-specific pointer (PSP) was designed using computed tomography (CT) images and computer-aided 3D design software. After a targeted approach and exposure of the lateral part of the right temporal lobe by a craniectomy guided by the 3D-PSP, complete macroscopic piecemeal resection of the meningioma could be performed using endoscopy-assisted brain surgery. Post-operative MRI confirmed complete excision of the tumor. Anticonvulsive therapy was discontinued after 90 days, and the dosage of anticonvulsants was tapered 2 weeks after surgery. At a follow-up examination 225 days post-operatively, recurrence of seizures was not observed, and the absence of tumor recurrence was confirmed by a repeat MRI examination. To the best of our knowledge, this is the first report in veterinary medicine describing a successful resection of a sphenoid-wing meningioma using a 3D-PSP. 3D-PSP-assisted craniectomy may be a surgical option for some canine skull-based tumors, such as sphenoid wing meningiomas.
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  • 文章类型: Case Reports
    UNASSIGNED:En-斑块-脑膜瘤(EPM)的特征是其沿骨轮廓的平坦生长。它占所有脑膜瘤的2-9%。报告的II或III级EPM病例很少。蝶骨翼EPM的手术切除尤其具有挑战性,因为肿瘤倾向于侵入海绵窦,和/或轨道,以及它们的神经血管结构.因此,这些部位的肿瘤具有较高的复发率。我们报告了II级EPM第二次复发的患者的临床过程和管理。II级EPM的临床过程,EPM多次复发的管理在文献中几乎没有报道。
    方法:一名53岁男性,有3次EPM手术史,右眼视力下降。脑磁共振成像(MRI)显示蝶骨翼脑膜瘤侵入左视神经,表明肿瘤的第二次复发。
    未经评估:我们回顾了讨论II级EPM临床过程的文献,和多次复发的病例。仅发现少数病例具有不同的临床病程和管理。在我们的案例中,手术干预是必要的,以挽救患者的视力。进行了改良的眶骨切开术。留下一个侵入海绵窦的小残留肿瘤,进行立体定向放射外科治疗。
    结论:蝶骨翼EPM是具有挑战性的病理学管理,尤其是很少见的II级肿瘤。手术和放疗的多模式治疗为EPM患者提供了最佳的治疗机会。
    UNASSIGNED: En-plaque-meningioma (EPM) is characterized by its flat growth along the bony contour. It accounts for 2-9% of all meningiomas. Very few grade II or III EPM cases were reported. Surgical resection of sphenoid wing EPM is especially challenging as the tumour tends to invade the cavernous sinus, and/or the orbit, and their neurovascular structures. Consequently, tumours in such locations have a higher rate of recurrence. We report the clinical course and management of a patient suffering a second recurrence of grade II EPM. The clinical course of grade II EPM, and the management of multiple recurrences of EPM are scarcely reported in the literature.
    METHODS: A 53-year-old male with a history of three previous surgeries for EPM presented with decreased vision in the right eye. Brain magnetic resonance imaging (MRI) showed progression of a sphenoid wing meningioma invading the left optic nerve, indicating a second recurrence of the tumour.
    UNASSIGNED: We reviewed the literature discussing the clinical course of grade II EPM, and cases suffering multiple recurrences. Only a few cases were found with varying clinical course and management. In our case, surgical intervention was necessary to save the patient\'s vision. A modified orbitozygomatic craniotomy was performed. A small residual tumour invading the cavernous sinus was left for treatment with stereotactic radiosurgery.
    CONCLUSIONS: Sphenoid wing EPM is challenging pathology to manage, especially grade II tumours which are rarely encountered. Multimodality treatment with surgery and radiotherapy offers EPM patients the best chance of treatment.
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  • 文章类型: Case Reports
    “骨化性纤维瘤”是成纤维细胞组织的良性肿瘤,含有大量牙骨质样钙化组织,通常发生在第三个和第四个十年之间。骨化性纤维瘤是罕见的非牙源性纤维瘤,由中胚层胚层引起的牙周膜纤维骨性肿瘤3。我们报告了一个12岁的男孩,在左眼角度附近的左颞区出现肿胀。这些非肿瘤,局部破坏性肿瘤表现为累及下颌骨的骨性病变,上颌骨,zygoma,鼻旁窦,轨道,很少有乳突区域。术前CT和MRI均未明确诊断,and,因此,所有纤维骨病变均被视为鉴别诊断.手术完全切除了病灶,组织学证实它是胶结性纤维瘤。根据世界卫生组织的分类,这是一种胶结纤维瘤的变种,代表牙骨质瘤的一个亚组,也就是说,含有牙骨质的纤维骨病变。组织学上,这些是具有类似骨和牙骨质的钙化结构的纤维组织。同时进行颅骨成形术,成功的临床结果。
    \"Cementifying fibroma\" is a benign tumor of the fibroblastic tissue containing masses of cementum-like calcified tissue, usually occurring between the third and fourth decades. Cementifying-ossifying fibromas are rare non-odontogenic, fibro-osseous tumors of the periodontal ligament that arise from the mesodermal germ layer3. We report a 12-year-old male child, who presented with a swelling in the left temporal region near the angle of the left eye. These non-neoplastic, locally destructive tumors present as an osseous lesion involving the mandible, maxilla, zygoma, paranasal sinuses, orbit, and rarely the petromastoid regions. The preoperative diagnosis was not clear even with CT and MRI, and, hence, all fibro-osseous lesions were considered as differential diagnosis. The lesion was surgically resected completely, and the histology confirmed it as a cementifying fibroma. According to the WHO classification, this is a variant of cementifying fibromas, which represent a subgroup of cementomas, that is, fibro-osseous lesions containing cementum. Histologically, these are fibrous tissues with calcified structures resembling bone and cementum. Cranioplasty was done simultaneously, with successful clinical results.
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  • 文章类型: Case Reports
    UNASSIGNED: We report an unusual case of a benign lateral sphenoid wing meningioma that presented with, and was masked by, an acute intracerebral hemorrhage.
    METHODS: A 68-year-old woman was admitted after sudden onset of coma. Computed tomography (CT) revealed an intracerebral hemorrhage, without any underlying vascular pathology on CT angiography. During the surgery, we found a lateral sphenoid wing meningioma with intratumoral bleeding that extended into the surrounding brain parenchyma.
    RESULTS: We removed the hematoma and resected the tumor completely in the same session. The histopathological classification of the tumor was a WHO grade I meningothelial meningioma. The patient recovered very well after surgery, without significant neurological sequelae.
    CONCLUSIONS: Having reviewed the relevant references from the medical literature, we consider this event as an extremely rare presentation of a benign sphenoid wing meningioma in a patient without any predisposing medical factors. The possible mechanisms of bleeding from this tumor type are discussed.
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