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Query: UMLS:C0027651 (tumor)
 685,946 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Non-traumatic C.S.F. rhinorrhea resulting from hypertensive obstructive hydrocephalus due to an intracranial tumor may constitute the presenting symptom of these affections. The authors report one case of intermittent and positional spontaneous rhinorrhea which was the only sign of a tumor in the pineal region. According to the literature and on the basis of Ommaya's classification of spontaneous rhinorrhea, we emphasize the need to distinguish between ventricular and arachnoid C.S.F leak. This different origins will determine the appropriate (ventricular or lumbar) C.S.F. shunt.
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PMID:[Non-traumatic hypertensive rhinorrhea. Apropos of a case]. 323 Dec 94

During the past 10 years, 125 operations for acoustic nerve tumors were performed on 114 patients at the authors' institution using a modified extended middle cranial fossa approach. This approach is based on a combination of King and Morrison's translabyrinthine-transtentorial approach and on the extended approach through the middle cranial fossa described by Bochenek and Kukwa. There were two hospital deaths (operative mortality 1.6%). In 102 operations on the initial tumor, total removal was performed in 89 cases (87%), and in 71 (80%) of these the facial nerve was anatomically preserved. Intracranial end-to-end anastomosis was performed on five of the 18 sacrificed facial nerves; a facial-hypoglossal anastomosis was carried out in the remaining 13 patients and in five (7%) of the 71 patients whose anatomically preserved facial nerve functioned poorly. In seven (39%) of the 18 patients in whom an attempt to preserve hearing was made, postoperative hearing was saved. In 23 operations on 17 patients for recurrent tumors, most of which had previously been removed subtotally via the suboccipital approach, total removal was accomplished in 13 (57% of the 23 reoperations and 76% of the 17 patients). At reoperation, the facial nerve was preserved in six (55%) of the 11 patients in whom the facial nerve had not been sacrificed. Postoperative leakage of cerebrospinal fluid occurred in 11 cases (8.8%), with rhinorrhea in 10 cases and otorrhea in one. Five of the fistulas were corrected by surgery and the rest healed spontaneously. Other complications were not significant.
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PMID:A modified extended middle cranial fossa approach for acoustic nerve tumors. Results of 125 operations. 334 7

Fifteen cases of adenocarcinoma of the ethmoid sinus treated by a combined subfrontal and transfacial approach after induction chemotherapy are reported. The surgical technique is described precisely including a paralateronasal approach combined with a bifrontocoronal incision, a bilateral ethmoidectomy and reconstruction of the anterior base of the skull by one sheets taken-out from the inner surface of the frontal flap or more recently madreporic coralline grafts; the dura is hermetically sealed and it is lined with a large galea flap. Results were as following: one post-operative death, no clinical rhinorrhea, no recurrence from the anterior cerebral fossa, one orbital and one sphenoidal recurrences. Surgical indications are discussed according to the different extensions of the tumor and a frontal lobe extension is not a contraindication. This surgical procedure should be employed for the adenocarcinomas of the ethmoid invading the superior cells even in the absence of lysis of the cribriform plate in order to avoid the endocranial recurrences.
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PMID:[Combined ORL and neurosurgical approach in adenocarcinoma of the ethmoid. Preliminary results apropos of 15 cases]. 368 40

Esthesioneuroblastoma, a tumor of neural crest origin arising in the nasal cavity, is uncommon, may be difficult to diagnose, and frequently is not cured. We report a case that was originally diagnosed as an inflammatory polyp and recurred with extension into the anterior cranial fossa. Surgery and radiotherapy were followed by local recurrence and cerebrospinal fluid rhinorrhea. Despite initial negative results of investigation for metastases, recurrence appeared in cervical nodes and was followed by widespread bone, soft tissue, and cerebral metastasis. There was no response to multiple-agent chemotherapy. The results of surgery, radiation, and chemotherapy in this rare and lethal tumor are reviewed.
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PMID:Esthesioneuroblastoma: cerebrospinal fluid rhinorrhea and widespread metastasis. 371 49

A case of mediastinal liposarcoma in a 45-year-old man is reported. The patient was admitted to the hospital complaining of rhinorrhea. A large mass was found in the right thorax by chest X-ray. At thoracotomy, a tumor measuring 11.5 X 9 X 8.5 cm located in the anterior mediastinum with an extension to the pleural cavity formed in right middle and lower lobes was found and removed from the adjacent visceral pleura. The tumor had a fibrous capsule and was multinodular in external appearance. The cut surface was yellowish and gelatinous. The histological diagnosis of myxoid liposarcoma was made according to the subclassification of liposarcoma proposed by Enzinger et al.
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PMID:[Liposarcoma of the mediastinum--a case report]. 373 78

Olfactory neuroblastoma is a rare tumor arising from the olfactory mucosal epithelium. 5 patients with this tumor were treated in our hospital from 1978 to 1982. The youngest patient was 3 years old and the eldest was 66. The clinical symptoms were nasal stuffiness, rhinorrhea, epistaxis and vascular polypoid mass in the nasal cavity. According to the staging system proposed by Kadish et al, the five patients in this series were 3 stage A and 2 stage C patients. Treatment consisted of radiotherapy, surgery or combination of radiotherapy and surgery. Our data indicate that the olfactory neuroblastoma is a radiosensitive tumor with the prognosis favorable in the stages A and B patients as treated by these three modalities. Two stage A patients are alive for more than 5 years. One of them was treated by radiotherapy alone, the other by combination of surgery and radiation. The third stage A patient as treated by radiotherapy alone has survived more than 3 years. One stage C patient, treated by combination of radiation and surgery, is still alive for more than 3 years. The other stage C patient, treated by radiotherapy alone, had survived for only 7 months after the treatment. The radiation dose varies with the extent of invasion. In stages A and B lesions, a dose of 4,500-5,500 rad in 5 weeks may be reasonable but in stage C, a dose of 6,000-6,500 rad in 7 weeks should be given. The authors agree to the prognostic equation proposed by Homzie et al. It may be possible to predict the tumor control or recurrence after a period of 3 years which gives an accuracy rate of 87%.
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PMID:[Radiotherapy of olfactory neuroblastoma--report of 5 patients]. 374 53

Three cases of tension pneumocephalus are reported and pathogenesis, clinical features and management of this complication is discussed. Case 1: A 12-year-old female underwent a craniotomy for a suprasellar tumor following V-P shunting. At that time, Mayfield's pin fixing head holder was used and a CSF leak from a puncture wound caused by the head holder was noted postoperatively. Although she showed uneventful recovery from the anesthesia, several hours after surgery, she developed general convulsions and deteriorated. CT scan revealed a huge bifrontal accumulation of air compressing the entire brain postero-caudally. No active measures were taken to treat the intracranial air and a follow-up CT scan revealed a hemorrhagic infarction in the right occipital lobe possibly caused by transtentorial herniation. The patient remained in a vegetative state until her death three years later. Case 2: A 55-year-old man had a pansinectomy for sinusitis. Seven days later he developed CSF rhinorrhea and a severe headache. A CT scan revealed air in the subarachnoid space as well as in the ventricles. After repeated spinal taps, he became stuporous. An emergency repair of the CSF leak was performed. Intraoperatively, the accumulation of air was noted in the subarachnoid space under extreme tension. He made a full recovery. Case 3: A 69-year-old woman underwent a neck clipping for a ruptured anterior communicating aneurysm 2 days after the onset. Shortly before the craniotomy, a continuous spinal drainage system was installed. Postoperatively she did not recover from the anesthesia and a CT scan showed an accumulation of air in the bifrontal subdural space compressing the brain posteriorly.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Postoperative tension pneumocephalus--report of 3 cases]. 374 94

Spontaneous cerebrospinal fluid (CSF) rhinorrhea, occurring in the absence of recent trauma, is a distinct clinical entity that can be difficult to diagnose and treat. The case records of 28 patients with this entity were reviewed retrospectively. Pertinent historical data and the results of radiographic evaluation are discussed. The patients were classified into one of three major etiological categories: congenital anomaly, delayed posttraumatic, and tumor groups. The fistulas causing the rhinorrhea were approached extracranially or intracranially, depending on the suspected cause and location. A cure was obtained in 22 of the 27 patients surgically treated (81%). Seventeen patients were cured by a single operation, 5 were cured after multiple operations, and 5 continued to leak despite surgical treatment. Three of the 5 patients who were surgical failures had intracranial tumors, and 2 of them died from complications of persistent fistulas. With the use of a multidisciplinary team approach, an extracranial operation (transethmoidal or transsphenoidal) to repair a spontaneous CSF leak offers a high success rate and is associated with minimal morbidity in appropriately selected patients.
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PMID:Spontaneous cerebrospinal fluid rhinorrhea: evolving concepts in diagnosis and surgical management based on the Mayo Clinic experience from 1970 through 1981. 398 9

A 47-year-old man exhibited loss of libido and impotence in association with plasma hyperprolactinemia and a pituitary mass with downward extension of the tumor to the sphenoid sinus and to the suprasellar cisterns. Bromocriptine, 15 mg daily, reduced the hyperprolactinemia as well as tumor size. After 8 months on this therapy, the patient developed overt CSF liquorrhea. Five days after discontinuation of bromocriptine, the CSF rhinorrhea stopped, and when bromocriptine was given again 2 weeks later, CSF rhinorrhea returned within 3 days. We believe this phenomenon to be due to retraction of tumor by bromocriptine exposing a defect in the sella floor. Transient occurrence of CSF rhinorrhea can be considered as a consequence of tumor regression in patients on bromocriptine. The possibility of this complication, especially in patients with downward extension of tumor, should be noted.
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PMID:Cerebrospinal fluid rhinorrhea during treatment with bromocriptine for prolactinoma. 402 53

We reviewed the records of 100 consecutive patients with histologically verified pituitary adenomas who underwent transsphenoidal decompression of the optic nerves and chiasm. The patients' ages ranged from 18 to 80 years, with a median of 52 years. Preoperatively, all patients had objective signs of visual acuity or field defects. Postoperatively, visual acuity was normal or improved in 79% of the eyes and the visual fields were normal or improved in 74%. The visual outcome (for both acuity and fields) was better in younger patients and those with a shorter duration of symptoms. Patients with lesser degrees of preoperative visual acuity compromise had better postoperative visual acuity outcome. However, the severity of preoperative visual field defects did not seem to predict postoperative field outcome, and even patients with severe preoperative field defects often had striking postoperative improvement. Patients who had undergone prior operation were less likely to have either visual acuity or visual field improvement after reoperation. Postoperative deterioration in visual acuity was noted in only 5 patients (6 eyes). Complications were few. There were 4 instances of cerebrospinal fluid rhinorrhea, but only 2 patients needed operative repair. There was no instance of permanent diabetes insipidus, although 17 patients developed transient diabetes insipidus. In most cases, visual improvement was sustained. The average duration of follow-up was 26 months. Three patients required a subsequent operation to correct visual loss in the immediate postoperative period, but only 1 patient has undergone late operation for recurrence of tumor. There was no operative mortality.
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PMID:Visual recovery after transsphenoidal removal of pituitary adenomas. 404 55


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