Remarkable reduction or disappearance of retroodontoid pseudotumors after occipitocervical fusion

Abstract

<jats:p>✓ Retroodontoid or periodontoid pseudotumor unassociated with rheumatoid arthritis or hemodialysis is clinically rare. The authors report three cases of retroodontoid pseudotumor that they treated surgically. All patients exhibited myelopathy of the upper cervical spinal cord. Plain radiography depicted atlantoaxial instability in two of the three patients. Spinal cord compression caused by a mass lesion in all patients was clearly demonstrated on magnetic resonance images. In two patients, the mass lesion was not limited to the retroodontoid region and expanded continuously to the cranial base. Posterior laminectomy of the atlas and occipitocervical fusion were performed. After surgery, the pseudotumor disappeared in two cases and was clearly reduced in one case, and neurological symptoms also improved. Retroodontoid pseudotumor is a lesion for which symptomatic improvement can be expected with posterior decompression and fusion, even without direct tumor excision.</jats:p>

C1 laminectomy for retro-odontoid pseudotumor without atlantoaxial subluxation: review of seven consecutive cases

“…Neurological and symptomatic improvement can be expected following posterior fusion [8,11,12]. Furthermore, spontaneous regression of pseudotumors following posterior fusion has been reported [10,13]. On the other hand, Suetsuna et al [14] reported spontaneous regression of retro-odontoid pseudotumors following C1 laminoplasty.…”

Odontoid pseudotumor and serial postfusion radiographic evaluation in a patient with a C1–2 mass

“…Yamaguchi et al reported a series of 3 cases of idiopathic pseudotumor, in which the patients underwent laminectomy and posterior fusion with complete resolution of symptoms and reduction or disappearance of the mass. 24 Additionally, our literature review gives several descriptions of the histopathological appearance of a pseudotumor specimen. Crockard et al describes the mass associated with pseudotumor as degenerative fibrochondral tissue without evidence of inflammation, 1 similar to the histopathological description in the case we report.…”

“…5B). Although these ligaments are interconnected, our literature review revealed that the most common site of occurrence of the pseudotumor was from the band of the cruciate ligament 24 (Fig. 5C).…”

“…However, this approach has been traditionally fraught with many complications including complicated postoperative management, an increased risk of infection, need for external fixation and/or fusion due to instability, delayed extubation due to the risk of palatal dehiscence, pharyngeal hemorrhage, and airway edema. 12,24 However, with the current state of neuronavigation, obtaining a small tissue biopsy sample is easier and poses less risk to the patient. In our case we opted to obtain a minimally invasive transoral biopsy sample by using fluoroscopy to decrease the risk to the patient while obtaining a specimen to evaluate for malignancy.…”

A modified “far-lateral” approach for safe resection of retroodontoid dural cysts

“…Cystic mass lesions at the ventral craniocervical junction have been thought to be exceedingly rare [6], although more reports have been published within the past few years [2,4,18,19]. Owing to the rarity of these lesions, there is no generally accepted terminology up to date and such cysts have been categorized as dural cysts or as synovial cysts associated with degeneration of the transverse ligament or arising from the atlantoaxial joint, occasionally in patients with atlantoaxial instability or rheumatoid arthritis [6,9,14].…”