Perineural spread ppf

2021 ◽  
Author(s):  
Karda Cavanagh
Keyword(s):  
Perineural Spread

Combined Approaches to the Skull Base for Intracranial Extension of Tumors via Perineural Spread can Improve Patient Outcomes

2016 ◽  
Vol 77 (S 01) ◽  
Author(s):  
Sheri Palejwala ◽  
Jonnae Barry ◽  
Crystal Rodriguez ◽  
Chandni Parikh ◽  
Stephen Goldstein ◽  
...  
Keyword(s):  
Skull Base ◽  
Patient Outcomes ◽  
Intracranial Extension ◽  
Perineural Spread ◽  
Improve Patient

scholarly journals IgG4-related intracranial disease

2018 ◽  
Vol 32 (1) ◽  
pp. 29-35 ◽  
Author(s):  
Shahine Goulam-Houssein ◽  
Jeffrey L Grenville ◽  
Katerina Mastrocostas ◽  
David G Munoz ◽  
Amy Lin ◽  
...  
Keyword(s):  
Plasma Cells ◽  
Surgical Intervention ◽  
Case Series ◽  
Hypertrophic Pachymeningitis ◽  
Diagnostic Challenge ◽  
Perineural Spread ◽  
Related Disease ◽  
The Third ◽  
Igg4 Related Disease ◽  
Intracranial Involvement

IgG4-related disease (IgG4-RD) is a multi-organ chronic inflammatory process caused by infiltration of IgG4-positive plasma cells in one or more organs. Intracranial involvement has only recently become better recognized. Our case series adds to the growing literature on the varying presentations of intracranial IgG4 by describing the clinical and imaging findings of three patients who presented to our institution with intracranial involvement. Our first patient presented with a mass-forming IgG4 pachymeningitis mimicking a sphenoid wing meningioma, which is to our knowledge the largest mass-forming pachymeningitis published in the literature. Our second case depicts another presentation of extensive IgG4 pachymeningitis involving both cavernous sinuses and surrounding Meckel’s caves. The third case describes a patient with presumed lymphocytic hypophysitis, which was later determined to be IgG4-related hypophysitis with concomitant pachymeningitis and perineural spread along the optic nerves. The delayed diagnoses in our cases illustrates the diagnostic challenge that clinicians face in differentiating intracranial IgG4-RD from other infiltrative diseases such as sarcoidosis, granulomatous disease, tuberculosis and lymphoma. Earlier consideration of IgG4-related hypophysitis and hypertrophic pachymeningitis in the differential diagnosis can prevent significant morbidity including unnecessary surgical intervention and organ failure secondary to extensive fibrosis.

scholarly journals Perineural spread of pelvic malignancies to the lumbosacral plexus and beyond: clinical and imaging patterns

2015 ◽  
Vol 39 (3) ◽  
pp. E14 ◽  
Author(s):  
Stepan Capek ◽  
Benjamin M. Howe ◽  
Kimberly K. Amrami ◽  
Robert J. Spinner
Keyword(s):  
Sciatic Nerve ◽  
Lumbosacral Plexus ◽  
Perineural Spread ◽  
Tumor Spread ◽  
Spinal Nerves ◽  
Lumbosacral Plexopathy ◽  
Pelvic Cancer ◽  
Group A ◽  
Group B

OBJECT Perineural spread along pelvic autonomie nerves has emerged as a logical, anatomical explanation for selected cases of neoplastic lumbosacral plexopathy (LSP) in patients with prostate, bladder, rectal, and cervical cancer. The authors wondered whether common radiological and clinical patterns shared by various types of pelvic cancer exist. METHODS The authors retrospectively reviewed their institutional series of 17 cases concluded as perineural tumor spread. All available history, physical examination, electrodiagnostic studies, biopsy data and imaging studies, evidence of other metastatic disease, and follow-up were recorded in detail. The series was divided into 2 groups: cases with neoplastic lumbosacral plexopathy confirmed by biopsy (Group A) and cases included based on imaging characteristics despite the lack of biopsy or negative biopsy results (Group B). RESULTS Group A comprised 10 patients (mean age 69 years); 9 patients were symptomatic and 1 was asymptomatic. The L5–S1 spinal nerves and sciatic nerve were most frequently involved. Three patients had intradural extension. Seven patients were alive at last follow-up. Group B consisted of 7 patients (mean age 64 years); 4 patients were symptomatic, 2 were asymptomatic, and 1 had only imaging available. The L5–S1 spinal nerves and the sciatic nerve were most frequently involved. No patients had intradural extension. Four patients were alive at last follow-up. CONCLUSIONS The authors provide a unifying theory to explain lumbosacral plexopathy in select cases of various pelvic neoplasms. The tumor cells can use splanchnic nerves as conduits and spread from the end organ to the lumbosacral plexus. Tumor can continue to spread along osseous and muscle nerve branches, resulting in muscle and bone “metastases.” Radiological studies show a reproducible, although nonspecific pattern, and the same applies to clinical presentation.

Perineural extension of cutaneous desmoplastic melanoma mimicking an intracranial malignant peripheral nerve sheath tumor

2011 ◽  
Vol 115 (2) ◽  
pp. 273-277 ◽  
Author(s):  
Samuel L. Barnett ◽  
Michael J. Wells ◽  
Bruce Mickey ◽  
Kimmo J. Hatanpaa
Keyword(s):  
Peripheral Nerve ◽  
Skin Lesions ◽  
Nerve Sheath Tumor ◽  
Facial Skin ◽  
Perineural Spread ◽  
Peripheral Nerve Sheath Tumor ◽  
Desmoplastic Melanoma ◽  
Nerve Sheath ◽  
Diagnostic Difficulties ◽  
The Brain

The authors present a case illustrating the importance of obtaining a biopsy of any facial skin lesions in a patient presenting with an intracranial tumor involving the facial or trigeminal nerve. Conventional malignant melanoma metastasizes to the brain frequently and does not usually pose diagnostic difficulties. Direct intracranial spread of cutaneous melanoma is rare. In our patient, desmoplastic melanoma with perineural spread to the Meckel cave mimicked a malignant peripheral nerve sheath tumor clinically, radiographically, and histologically.

Endoscopic Endonasal Interdural Middle Fossa Approach to the Maxillary Nerve: Anatomic Considerations and Surgical Relevance

2017 ◽  
Vol 13 (4) ◽  
pp. 522-528 ◽  
Author(s):  
Kumar Abhinav ◽  
David Panczykowski ◽  
Wei-Hsin Wang ◽  
Carl H. Synderman ◽  
Paul A. Gardner ◽  
...  
Keyword(s):  
Average Length ◽  
Tumor Resection ◽  
Human Head ◽  
Proximal Part ◽  
Gasserian Ganglion ◽  
Middle Fossa ◽  
Perineural Spread ◽  
Endoscopic Endonasal ◽  
Middle Fossa Approach ◽  
Maxillary Nerve

Abstract BACKGROUND: The maxillary nerve (V2) can be approached via the open middle fossa approach. OBJECTIVE: To delineate the anatomy of V2 and its specific segments with respect to the endonasal landmarks. We present the endoscopic endonasal interdural middle fossa approach to V2 and its potential application for the treatment of perineural spread in sinonasal/skull base tumors. METHODS: Five human head silicon-injected specimens underwent bilateral endoscopic endonasal transpterygoid approaches. V2 prominence and the maxillary strut were identified in the lateral recess along with paraclival carotid protruberance. The regions superior and inferior to V2 corresponding to the anteromedial and anterolateral triangles of the middle fossa were exposed. RESULTS: V2 can be classified into 3 segments: interdural (from the Gasserian ganglion to the proximal part of the maxillary strut), intracanalicular (corresponding to the anteroposterior length of the maxillary strut), and pterygopalatine (distal to the maxillary strut and the site of its divisions). Endonasally, the average length of the interdural and the intracanalicular segments were approximately 9 and 4.4 mm, respectively. V2, following its division distal to the maxillary strut, was successfully dissected off the middle fossa dura and transected just distal to the Gasserian ganglion. CONCLUSION: Endonasally, the interdural segment can be safely mobilized between the periosteal and meningeal dural layers while ensuring the integrity of the middle fossa dura. This allows transection of infiltrated V2 to facilitate tumor resection without entering the intradural/arachnoidal space. Posteriorly, this is limited by the Gasserian ganglion and superomedially by the dural envelope surrounding the cavernous sinus and the paraclival carotid artery.

scholarly journals Differentiation of Benign and Malignant Parotid Gland Tumors with MRI and Diffusion Weighted Imaging

2021 ◽  
Author(s):  
Umut Perçem Orhan Söylemez ◽  
Başak Atalay
Keyword(s):  
Parotid Gland ◽  
Signal Intensity ◽  
Perineural Spread ◽  
Adc Value ◽  
Parotid Gland Tumors ◽  
Superficial Lobe ◽  
Adjacent Structures ◽  
Significant Difference ◽  
Pleomorphic Adenomas ◽  
Adc Values

Objective: This study investigated the effectivity of Magnetic Resonance Imaging (MRI) findings and Apparent Diffusion Coefficient (ADC) value in evaluating parotid gland tumors (PGTs), and aimed to reduce the biopsy procedure before surgery. Methods: This retrospective study included 54 PGTs of 42 patients’ (24 female, 18 male, mean age; 51.4±15.9). All of the patients had an MRI, and histopathologic diagnosis. The signal intensity [T1 and T2 Weighted (W), T1W after intravenous contrast agent injection] and mean ADC values of the PGTs were measured. Also contrast enhancement pattern (homogenous, heterogeneous, peripheral or none), margin features (well or ill-defined), sizes, location (superficial lobe/deeplobe/both), perineural spread, presence of lymphadenopathy, and extension to adjacent structures were noted. Results: The distribution of PGTs was; 21 pleomorphic adenomas, 18 Warthin tumors, 2 lymph nodes, 2 mucoepidermoid carcinomas, 5 adenoid cystic carcinoma, 1 basal cell carcinoma,2 metastases and 2 lymphomas; (13 malignant and 41 benign lesions). Morphologic parameters; ill-defined margin, perineural spread, lymphadenopathy, and extension to adjacent structures were found to be significantly associated with malign lesions (p<0.01). There was a significant difference between ADC values of malignant and benign PGTs (p<0.05). Also ADC values and T2 signal intensity was significantly lower in Warthin tumors rather than pleomorphic adenomas (p<0.05). Conclusions: Mean ADC values when considered with morphological features may be accessible methods to distinguish benign and malignant PGTs, also ADC values and T2 signal intensity may be useful for differentiating pleomorphic adenomas from Warthin tumors, thereby reducing the number of biopsies and thus complications.

Sign in / Sign up

Export Citation Format

Share Document