Metástasis en clivus de hepatocarcinoma asociado a quimiembolización transarterial hepática

Escarda, Ana; Vaquer, P; Bonet, Lucía; Miralbes, S.; Gómez, Cristina; Obrador, Antoni

doi:10.1157/13091453

Cited by 10 publications

(3 citation statements)

References 23 publications

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“…Metastases in the nervous system, particularly in the clivus, are rare. The case of a patient with hepatocellular carcinoma treated with transarterial chemoembolization is presented, in which metastasis in the clivus was diagnosed ( 35 ).…”

Section: Discussionmentioning

confidence: 99%

Case report: Unilateral paralysis of the hypoglossal nerve as the only clinical sign of clivus meningioma - a case report and literature review

Stamenović,

Živadinović,

Đurić

2024

Front. Oncol.

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IntroductionClivus meningiomas are benign tumors that occur at the skull base in the posterior cranial fossa. Symptoms usually progress several months or years before diagnosis and may include: headache, vertigo, hearing impairment, ataxia with gait disturbances, sensory problems. In the neurological findings, paralysis of the lower cranial nerves is most often seen, which in the later course can be accompanied by cerebellar and pyramidal signs until the development of a consciousness impairment.Case presentationWe presented the case of a patient who at the time of diagnosis had only unilateral hypoglossal nerve paralysis with dysarthria and mild dysphagia. After the neurosurgical procedure, pathohistological analysis confirmed meningothelial meningioma.ConclusionEarly recognition of clivus tumors, which include meningiomas, is necessary in order to implement an adequate therapeutic procedure and prevent further deterioration of the patient’s condition.

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Section: Discussionmentioning

confidence: 99%

Case report: Unilateral paralysis of the hypoglossal nerve as the only clinical sign of clivus meningioma - a case report and literature review

Stamenović,

Živadinović,

Đurić

2024

Front. Oncol.

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“…Because of its aggressive nature, distant metastases to the central nervous system (CNS) and skull base (SB) are exceedingly uncommon. Reviewing the literature, only 15 cases of HCC with SB involvement had been reported [19][20][21][22][23][24][25][26][27][28][29][30]. Due to the aggressiveness and the multiple metastatic localizations, our patient died after a few months of our intervention.…”

Section: Discussionmentioning

confidence: 99%

Extremely Rare Pathologies of the Craniovertebral Junction Region: A Case Series and Review of the Literature

Maiorano,

Spena,

Sovardi

et al. 2023

Surgeries

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Background: The craniovertebral junction is a complex region, connecting the occiput, the atlas, the axis, and the containing vital neural and vascular structures. There is a great variability in diseases involving the craniovertebral junction, of different nature, each rare in frequency. Methods: We conducted a retrospective chart review of the patients diagnosed with extremely rare pathologies of the craniovertebral junction that we have operated in the last 5 years. Results: After excluding the relatively more frequent pathologies, we identified nine cases of rare craniovertebral junction pathologies. Six were operated using an endoscopic endonasal approach, two using a far lateral transcranial approach, and one underwent a C1 hemilaminectomy. Conclusions: Diagnosis and management of the rare pathologies of the craniovertebral junction are challenging. A multidisciplinary approach is recommended for the proper management of these patients.

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“…C ancer of the clivus is caused by primary osseous or chondral lesions, such as chordomas or chondrosarcomas, local spread of oropharyngeal masses, and metastasis of solid or hematopoietic tumors (1)(2)(3)(4). Because the sixth nerve traverses the tight space of the Dorello canal adjacent to the clivus, it is readily compromised by a tumor, such that sixth nerve palsy may be a presenting sign (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14).…”

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confidence: 99%

MRI Diagnosis of Clival Cancer and Sixth Nerve Palsy

Halawa¹,

Kim²,

Liao³

et al. 2022

Journal of Neuro-Ophthalmology

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Background:Imaging diagnosis of clival cancer may be difficult, in part because of normal variation in marrow signal with aging. Identifying whether clival cancer has damaged the sixth cranial nerve is a further challenge because minimal clival abnormalities could impinge on the nerve, which travels very close to the clivus.Methods:Two neuroradiologists, who were unaware of previous imaging and clinical diagnoses, reviewed MRI studies of 25 patients with cancer but no clival involvement and no sixth nerve palsy, 24 patients with clival cancer but without sixth nerve palsy, and 31 patients with clival cancer and sixth nerve palsy. The radiologists were tasked with determining whether there was clival cancer, whether there was a sixth nerve palsy and its laterality, and with indicating the pulse sequences used to make those determinations.Results:Both neuroradiologists correctly identified all 25 cases with a normal clivus. In about half of those cases, they depended on finding a homogeneously bright marrow signal; in the remaining cases, they excluded cancer by determining that the clivus was not expanded and that there were no focal signal abnormalities. Both neuroradiologists correctly identified clival cancer in 54 (98%) of the 55 cases with and without sixth nerve palsy. In doing so, they relied mostly on clival expansion but also on focal signal abnormalities. Both neuroradiologists were at least 80% correct in identifying a sixth nerve palsy, but they often incorrectly identified a palsy in patients who did not have one. When there was a one-sided signal abnormality or the clivus was expanded in one direction, both neuroradiologists were accurate in identifying the side of the sixth nerve palsy.Conclusion:Current MRI pulse sequences allow accurate differentiation of a normal from a cancerous clivus. When the marrow signal is not homogeneously bright in adults, cancer can be diagnosed on the basis of clival expansion or focal signal abnormalities. MRI is less accurate in predicting the presence of a sixth nerve palsy. However, the side of a unilateral palsy can be predicted when the clivus is clearly expanded in one direction or there is a focal signal abnormality on one side.

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Metástasis en clivus de hepatocarcinoma asociado a quimiembolización transarterial hepática

Cited by 10 publications

References 23 publications

Case report: Unilateral paralysis of the hypoglossal nerve as the only clinical sign of clivus meningioma - a case report and literature review

Case report: Unilateral paralysis of the hypoglossal nerve as the only clinical sign of clivus meningioma - a case report and literature review

Extremely Rare Pathologies of the Craniovertebral Junction Region: A Case Series and Review of the Literature

MRI Diagnosis of Clival Cancer and Sixth Nerve Palsy

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