These findings suggest a relationship between recurrence of craniopharyngiomas and angiogenesis. New treatment modalities with selective PDGFR-alpha blockers may represent a novel and effective therapeutic option for the treatment of craniopharyngiomas.
ABSTRACTof tumor growth leading to large tumor sizes at the time of diagnosis (8,33,41). The differentiation from meningiomas of the planum sphenoidale and tuberculum sellae is of clinical and surgical importance; tumors arising from these sites are usually diagnosed at an early stage due to visual impairment, which is a late finding in OGMs (7,11,22,28).Anatomically, OGMs arise from the weakest part of the skull base, i.e. the cribriform plate, making them prone to infiltrate the underlying bone and extend into the paranasal sinuses and nasal cavity. This feature is rarely observed in planum █ INTRODUCTION O lfactory groove meningiomas (OGMs) account for 4-13% of all intracranial meningiomas. They originate from the dura of the anterior cranial fossa over the cribriform plate and frontosphenoidal suture (7,10,11,25,36).OGMs usually present with hypo/anosmia, visual deterioration, mental changes and headache as a result of olfactory or optic nerve and frontal lobe compression. Seizures are also common in these patients (8,33). However, these tumors grow slowly and usually remain clinically quiescent during the early phases AIM: Olfactory groove meningiomas make up 4 to 13% of meningiomas. The first line treatment of meningiomas is surgery, but the extent and types of approaches advised for olfactory groove meningiomas are diverse, from aggressive skull base approaches to standard or minimally invasive craniotomies and endoscopic approaches. We retrospectively reviewed our series of olfactory groove meningiomas that were operated microsurgically by standard pterional or unifrontal approaches. MATERIAL and METHODS:Our series of 61 olfactory groove meningioma patients operated through pterional or unifrontal approaches between March 1987 and September 2015 was reviewed and the clinical data, radiological findings, surgical treatment and clinical outcomes of the patients were retrospectively analyzed. RESULTS:Sixty-three craniotomies were performed in total. Pterional and unifrontal approaches were used in 38 (60.3%) and 25 (39.7%) surgical procedures, respectively. Overall, gross total tumor resection was achieved in 59 (93.7%) cases. Complications were seen in 8 cases, and 2 of these patients underwent reoperation. Three of the 4 patients where only subtotal resection could be achieved underwent gamma knife radiosurgery.CONCLUSION: Pterional and unifrontal approaches, which are familiar and standard for neurosurgeons, can accomplish high rates of total resection with acceptable complication and recurrence rates for the treatment of olfactory groove meningiomas.
Colloid cysts appear most commonly in the third ventricle, their occurrence in the sellar region is uncommon. The authors report a female patient with a pituitary colloid cyst. She was diagnosed incidentally with a sellar lesion by a routine paranasal computed tomography examination performed for planning of a dental implant surgery. Radiologic examinations revealed a pituitary lesion that was removed by transnasal transsphenoidal route. Her pathologic examination revealed that the lesion was a colloid cyst. Although rare, colloid cysts should be considered in the differential diagnosis of pituitary lesions
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Şıvannomalar yılda 0.3-0.5/100.000 insidans ile en sık görülen primer omurga tümörleridir. Sendromik olmayan spinal şıvannomalar için güncel tedavi yöntemi tümörün nörovasküler yapılar korunarak total çıkarımıdır. Bu makale, kliniğimizdeki sendromik olmayan spinal şıvannoma vakalarının tedaviden sonraki nörolojik ve radyolojik sonuçlarını rapor etmeyi amaçlamaktadır. Hastalar ve Yöntemler:Bu retrospektif vaka serisi, sendromik olmayan spinal şıvannomu olan 82 hasta ile yapılmıştır. Hastaların verileri hastane kayıtlarından bulunmuştur. Tümör çıkarım ameliyatı sonrası nörolojik muayene ve kırk beşinci, yüz sekseninci ve üç yüz altmışıncı günlerde takibi yapılmıştır. Karnofsky performans durum değerlendirmesi ışığında; hastaların acı, duyu ve motor zayıflıkları nörolojik iyileşmeyi göstermek için puanlandırılmıştır. Bulgular: Ameliyat öncesinde ve sonrasındaki komplikasyon sadece iki hastada gerçekleşmiştir. Sonuç: Bulgularımız, sendromik olmayan spinal şıvannomaların total reseksiyonunun, etkin ve güvenilir bir cerrahi girişim olduğunu ortaya koymaktadır.
Pituitary tumors are the most common form of intracranial neoplasms. However, clinically relevant pituitary tumors presenting with disturbances of hormonal secretion or mass effect are rare and they only represent about 10 % of all surgically resected intracranial neoplasms. Prolactinomas are the most common types of pituitary adenomas. Generally, hormonal expression patterns provided by immunohistochemistry (IHC) studies are correlated with the clinical features and endocrine activity of the patients. Nonetheless, exceptions occur where the immunocytochemical staining is not concordant with the clinical picture. Pituitary adenomas presenting with apoplexy are well known. However, pituitary adenomas causing cerebral stroke and resulting in hemiplegia are unusual. Here, we report an unusual case of prolactinoma with cerebral stroke and sparse prolactin (PRL) expression. A 25-year-old woman complaining of amenorrhea, dysphasia, and left hemiplegia presented with serum PRL level in excess of 4,700 ng/ml. Pre-operational radiology images revealed a giant macroadenoma and a thalamic infarct due to carotid compression. Transcranial surgery was performed. IHC study of the adenoma revealed no hormonal expression other than sparse PRL immunoreactivity. Therefore, a sparsely granulated PRL cell adenoma was diagnosed. The patient is still under follow-up with continuing cabergoline treatment.
Objective Inflammatory response has been acknowledged to be an important factor in the process of disc degeneration and may play an important role in generation of pain, among patients with spinal herniation. The aim of this study is to investigate the total antioxidant status (TAS), total oxidant status (TOS), and their ratio, oxidative stress index (OSI) in patients with spinal herniations, and the relationship between these dependent variables and location of herniation, gender and age. Materials and Methods 19 female (48,72%) and 20 male (51,28%) patients are included in the study. TAS and TOS levels are measured by commercially available kits in laboratory (Rel Assay Diagnostics, Turkey). OSI levels are calculated by their ratio. Results Results show that mean TAS level is 1,518 ± 0,176, mean TOS level is 3,168 ± 0,956, and mean OSI level is 0,222 ± 0,078. No correlations are found between age with the TAS, TOS and OSI levels. Conclusion Post-operative patients with spinal herniation have normal oxidative statuses and the location of herniation and gender seems to have no statistically significant effect on the TAS, TOS and OSI levels. Keywords Spinal herniation; antioxidant; free radical; oxidative stress. Öz Amaç İnflamatuar yanıt disk bozulmalarında görülen önemli bir faktör olarak kabul görmüştür ve spinal herniasyon hastalarında acı hissinin ortaya çıkmasında önemli bir rolü olabilir. Bu çalışmanın amacı, cerrahi tedavi görmüş spinal herniasyon hastalarındaki toplam antioksidan statüsü (TAS), toplam oksidan statüsü (TOS) ve oranlanmalarından ortaya çıkan oksidatif stress endeksinin (OSE) ölçülmesi ve bu değerlerin toplanan yaş, cinsiyet ve herniasyon bölgesi arasında ilişki olup olmadığının araştırılmasıdır. Gereç ve Yöntemler 19 kadın (48,72%) ve 20 erkek (51,28%) hasta çalışmaya dahil edilmiştir. TAS ve TOS seviyeleri laboratuvarda bulunan kitlerle ölçülmüş ve OSE bu değerlerin oranlanmasıyla elde edilmiştir (Rel Assay Diagnostics, Türkiye).
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