Journal of neurosurgery. Case lessons最新文献

To patch or not to patch: is that the real question? The role of hemodynamics in carotid endarterectomy. Illustrative cases. 打补丁还是不打补丁：这是真正的问题吗？血流动力学在颈动脉内膜切除术中的作用。说明情况。

Journal of neurosurgery. Case lessons Pub Date : 2025-04-07 DOI: 10.3171/CASE24840

Tatiana Abou-Mrad, Laura Stone McGuire, Laurel Morgan Miller Marsh, Juan Cebral, Fady T Charbel

{"title":"To patch or not to patch: is that the real question? The role of hemodynamics in carotid endarterectomy. Illustrative cases.","authors":"Tatiana Abou-Mrad, Laura Stone McGuire, Laurel Morgan Miller Marsh, Juan Cebral, Fady T Charbel","doi":"10.3171/CASE24840","DOIUrl":"10.3171/CASE24840","url":null,"abstract":"Background: The utilizationof patches in carotid endarterectomy (CEA) for carotid artery stenosis remains controversial, with conflicting evidence regarding postoperative outcomes. This report accentuates this discourse with two selected representative cases with divergent outcomes.Observations: Computational fluid dynamics analyses of pre- and post-CEA hemodynamics revealed distinct hemodynamic profiles between the two patients. In the nonpatched internal carotid artery (ICA), the vessel retained a cylindrical shape, exhibiting swirling blood flow and higher wall shear stress (WSS)-patterns typical of healthy vasculature. The patched ICA adopted a bulbous shape, akin to the anatomical carotid bulb, and displayed lower WSS and noncoherent disturbed blood flow, which are features associated with atherosclerosis, endothelial dysfunction, and cellular damage.Lessons: This study suggests that the question may not be \"To patch or not to patch?\" but rather \"Is the restoration of the anatomical bulb shape beneficial or deleterious?\" It sheds light on the hemodynamic implications of this procedure and provides insight into the ongoing debate surrounding CEA. Using a patch might not necessarily result in improved flow or more favorable outcomes; thus, restoration of the carotid bulb configuration postendarterectomy might not optimize the hemodynamic profile for patients, but rather, a simple tubular shape, without a patch, might offer the best solution. https://thejns.org/doi/10.3171/CASE24840.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"9 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143805045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Applications of the SpineJack device in the surgical management of type A4 lumbar burst fractures without neurological deficit: illustrative cases. SpineJack装置在无神经功能缺损的A4型腰椎爆裂性骨折手术治疗中的应用：说明性病例

Journal of neurosurgery. Case lessons Pub Date : 2025-04-07 DOI: 10.3171/CASE24821

Giorgio Cracchiolo, Stefano Ticca, Nicholas Giulio Raccagni, Emanuele Costi, Angela Dele Rampini, Luigi Alberto Andrea Lanterna, Andrea Fanti

{"title":"Applications of the SpineJack device in the surgical management of type A4 lumbar burst fractures without neurological deficit: illustrative cases.","authors":"Giorgio Cracchiolo, Stefano Ticca, Nicholas Giulio Raccagni, Emanuele Costi, Angela Dele Rampini, Luigi Alberto Andrea Lanterna, Andrea Fanti","doi":"10.3171/CASE24821","DOIUrl":"10.3171/CASE24821","url":null,"abstract":"Background: Type A4 lumbar burst fractures are severe spinal injuries typically treated with posterior pedicle screw constructs, with or without corpectomy. However, traditional approaches can be highly invasive and are often limited in their ability to reconstruct the anterior column. The SpineJack device offers a minimally invasive alternative or complement to posterior fixation.Observations: Four neurologically intact patients with lumbar type A4 fractures were treated using the SpineJack device, either alone or in combination with different posterior fixation techniques. Clinical and radiological outcomes were evaluated preoperatively, postoperatively, and at the 1-year follow-up. The procedure led to significant pain relief and rapid mobilization for all patients. Radiologically, it restored vertebral body height (VBH), increased spinal canal patency, and corrected preoperative deformities, with minimal loss of correction at follow-up.Lessons: The SpineJack device is a viable, less invasive alternative to traditional pedicle screw constructs and serves as an effective adjunct for stabilization, potentially replacing corpectomy in some cases. It restores VBH and alignment, maintains load-bearing capacity, and reduces the need for additional hardware. Further research is needed to evaluate long-term outcomes, especially in younger patients. https://thejns.org/doi/10.3171/CASE24821.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"9 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143805026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Screw loosening and subsequent expectoration without anatomical defect following anterior cervical discectomy and fusion for cervical myelopathy: illustrative case. 颈椎前路椎间盘切除术融合治疗颈椎病后螺钉松动和随后无解剖缺陷的排痰：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-04-07 DOI: 10.3171/CASE24340

Nisha L Busch, Peter G Zaki, John Bolger, Nathan Esplin, Cody Woodhouse, Seung W Jeong, Shahed Elhamdani, Chen Xu, Alexander Yu

{"title":"Screw loosening and subsequent expectoration without anatomical defect following anterior cervical discectomy and fusion for cervical myelopathy: illustrative case.","authors":"Nisha L Busch, Peter G Zaki, John Bolger, Nathan Esplin, Cody Woodhouse, Seung W Jeong, Shahed Elhamdani, Chen Xu, Alexander Yu","doi":"10.3171/CASE24340","DOIUrl":"10.3171/CASE24340","url":null,"abstract":"Background: Anterior cervical discectomy and/or corpectomy with fusion is a standard treatment approach for cervical myelopathy and radiculopathy caused by anterior degenerative and compressive pathology. Serious complications are rare, but esophageal and pharyngeal injuries relating to anterior cervical operations can cause significant morbidity and mortality. The authors present the case of delayed anterior plate screw loosening with eventual expectoration of a screw without anatomical defect.Observations: A 52-year-old male presented to the neurosurgery clinic with cervical myeloradiculopathy. He had severe cervical stenosis with associated myelomalacia. Conservative management failed, and the patient underwent C4 corpectomy and C5-6 and C6-7 anterior cervical discectomy and fusion (ACDF) with anterior plating. He experienced backing out of some of his screws, refused revision, and eventually expectorated his right C3 screw 14 months after surgery with minimal symptoms. He showed no anatomical defects on evaluation and experienced no major morbidity.Lessons: Hardware expectoration is a rare complication of ACDF. The lack of an esophageal or laryngeal defect could possibly be explained by gradual healing of the injury given the chronicity of his problem. A patient with screw loosening after ACDF should be carefully monitored and evaluated postoperatively due to the potential for significant morbidity and mortality from screw migration and expectoration. https://thejns.org/doi/10.3171/CASE24340.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"9 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143805106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Repair of a ventral cervical cerebrospinal fluid leak via a single-level anterior cervical discectomy and fusion without corpectomy: illustrative case. 单节段前颈椎间盘切除术和融合术修复颈腹侧脑脊液漏而不切除椎体：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-04-07 DOI: 10.3171/CASE24770

Anthony J Maxin, Tyler S Pistone, Mithun G Sattur, Nicholas Borg

{"title":"Repair of a ventral cervical cerebrospinal fluid leak via a single-level anterior cervical discectomy and fusion without corpectomy: illustrative case.","authors":"Anthony J Maxin, Tyler S Pistone, Mithun G Sattur, Nicholas Borg","doi":"10.3171/CASE24770","DOIUrl":"10.3171/CASE24770","url":null,"abstract":"Background: Spontaneous intracranial hypotension (SIH) is caused by CSF leakage through the skull base or, more commonly, the spine. In the spine, the CSF might leak into either the epidural space or a paraspinal vein in patients with a CSF-venous fistula. Nonoperative management, including caffeine, abdominal binders, oral fluids, and bed rest, is typically appropriate, although it yields unsatisfactory results for some patients.Observations: The authors illustrate the surgical repair of a ventral, cervical CSF leak through a single-level anterior cervical discectomy and fusion (ACDF) without corpectomy in a 25-year-old patient with SIH. MRI and CT revealed a longitudinally extensive ventral epidural CSF collection and a calcified disc bulge at C5-6. Myelography showed no alternative source of leak. While a prior report describes repair via corpectomy, this article describes the technique for repair via ACDF only, with the use of a device designed for dural repair in minimally invasive spine surgery (DuraStat). This approach was particularly appealing in a young patient, and the dural defect was successfully repaired.Lessons: The ability to perform repair of a ventral cervical CSF leak through a single-level ACDF might allow for the resolution of this challenging-to-treat condition while minimizing surgical morbidity. https://thejns.org/doi/10.3171/CASE24770.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"9 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143805103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Concurrent glial tumors in the setting of a nonsyndromic adjacent/colliding meningioma: illustrative cases. 无综合征性相邻/碰撞性脑膜瘤并发神经胶质肿瘤：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-04-07 DOI: 10.3171/CASE24805

Ahmad Pour-Rashidi, Fada Hossein Nahang, Peyman Gookizadeh, Kourosh Karimi Yarandi, Abbas Amirjamshidi, Yalda Nilipour, Mohammad Shirani

{"title":"Concurrent glial tumors in the setting of a nonsyndromic adjacent/colliding meningioma: illustrative cases.","authors":"Ahmad Pour-Rashidi, Fada Hossein Nahang, Peyman Gookizadeh, Kourosh Karimi Yarandi, Abbas Amirjamshidi, Yalda Nilipour, Mohammad Shirani","doi":"10.3171/CASE24805","DOIUrl":"10.3171/CASE24805","url":null,"abstract":"Background: Meningioma, a common and mostly benign intracranial and spinal tumor, can coexist with other malignant tumors. Such a scenario is very rare in patients with no history of radiation therapy or phakomatosis. In this study, the authors present three cases of concurrent/adjacent CNS tumors, review the literature on this topic, and highlight some genomic alterations in that regard.Observations: The authors present three cases of patients who had coexistence of meningioma with other glial tumors in this study.Lessons: Coexistence/collision of intracranial and spinal meningiomas with another CNS pathology occurs anecdotally. This phenomenon does not necessarily preclude resection of both tumors in a single session, provided that a careful preoperative assessment of the surgical anatomy is undertaken. Conducting studies to evaluate the genomic structures of such cases and to explain why they occur in adjacency could be valuable in explaining this phenomenon. https://thejns.org/doi/10.3171/CASE24805.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"9 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143805066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Extensive spinal epidural abscess treated utilizing a single limited incision: illustrative case. 利用单一有限切口治疗大面积脊髓硬膜外脓肿：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-04-07 DOI: 10.3171/CASE24654

Ali M AlQahtani, Faisal Konbaz, Khaled Almusrea, Ziyad Alyousef, Fawaz Alshaalan, Monerah Annaim, Khalid Beidas, Abdullah Zain Aldeen, Anouar Bourghli

{"title":"Extensive spinal epidural abscess treated utilizing a single limited incision: illustrative case.","authors":"Ali M AlQahtani, Faisal Konbaz, Khaled Almusrea, Ziyad Alyousef, Fawaz Alshaalan, Monerah Annaim, Khalid Beidas, Abdullah Zain Aldeen, Anouar Bourghli","doi":"10.3171/CASE24654","DOIUrl":"10.3171/CASE24654","url":null,"abstract":"Background: Extensive spinal epidural abscess is an uncommon and potentially life-threatening condition that mandates appropriate early diagnosis and treatment to avoid potentially disastrous complications. Limited literature is available guiding the management of such an entity.Observations: The authors report the case of a 59-year-old female patient with a history of 5 days of severe back pain, fever, and associated lower limb neurological deficit. MRI revealed an epidural abscess extending from C2 to the sacrum. One-level segmental decompression was performed at the level of L2-3 in combination with the use of an epidurally introduced silicone catheter. Cultures came back positive for methicillin-resistant Staphylococcus aureus. The patient received 6 weeks of antibiotics. The infection was successfully treated after surgery and systemic antibiotic therapy, and full neurological recovery was observed.Lessons: This is the first report in the literature to describe successful surgical management of an extensive C2-S1 epidural abscess through a single incision and one-level decompression. This less invasive technique could treat the holospinal abscess without the need for other procedures. https://thejns.org/doi/10.3171/CASE24654.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"9 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143805080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A neurosurgical approach to skull metastasis from uterine leiomyosarcoma: illustrative case. 子宫平滑肌肉瘤颅骨转移的神经外科入路：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-03-31 DOI: 10.3171/CASE24769

Arturo Alejandro Carrillo-Uzeta, Eliany Varela-Avalos, Eduardo Agustin-Godinez, José Antonio Uehara-Gonzalez, José Raymundo Medina-Romero, Ana I Velazquez-Zamarripa, Alba M Quiñones-González, Patricia Anaid Romero-García

{"title":"A neurosurgical approach to skull metastasis from uterine leiomyosarcoma: illustrative case.","authors":"Arturo Alejandro Carrillo-Uzeta, Eliany Varela-Avalos, Eduardo Agustin-Godinez, José Antonio Uehara-Gonzalez, José Raymundo Medina-Romero, Ana I Velazquez-Zamarripa, Alba M Quiñones-González, Patricia Anaid Romero-García","doi":"10.3171/CASE24769","DOIUrl":"10.3171/CASE24769","url":null,"abstract":"Background: Leiomyosarcoma (LMS), a smooth muscle-derived tumor, is associated with a poor prognosis and a high potential for metastasis to local and distal sites. Skull metastases are exceptionally rare, with few cases documented in the literature. Diagnosing and treating these lesions is challenging due to their nonspecific clinical presentation and imaging similarities to other tumors.Observations: The authors report the case of a 46-year-old female with a 4-month history of a right parietal tumor, accompanied by headaches and left hemiparesis. MRI revealed a heterogeneous, intra- and extra-axial lesion with irregular margins in the right parietal region. Resection of the tumor was performed, and histopathological findings confirmed a diagnosis of metastatic LMS involving the bone and dura. Postoperative radiotherapy was administered, and the patient showed no evidence of recurrence 1 year after initial treatment. A review of the past 30 years of existing case reports of uterine LMS (uLMS) with cranial and intracranial metastases is also provided.Lessons: This report highlights the diagnostic and therapeutic complexity of metastatic LMS to the skull. Adjuvant radiotherapy might prove advantageous in improving the prognosis of patients with uLMS, underscoring the significance of integrating clinical, radiological, histopathological, and immunohistochemical findings for accurate diagnosis and management. https://thejns.org/doi/10.3171/CASE24769.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"9 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Spontaneous carotid-cavernous sinus fistula with fibromuscular dysplasia: illustrative case. 自发性颈动脉-海绵窦瘘伴纤维肌肉发育不良：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-03-31 DOI: 10.3171/CASE24622

Wen Tan, Lu Jiang, Kuangyang Yu, Yuyang Pan, Yubin Yang, Jinwei Pang, Kunyang Bao, Changren Huang, Jianhua Peng, Yong Jiang

{"title":"Spontaneous carotid-cavernous sinus fistula with fibromuscular dysplasia: illustrative case.","authors":"Wen Tan, Lu Jiang, Kuangyang Yu, Yuyang Pan, Yubin Yang, Jinwei Pang, Kunyang Bao, Changren Huang, Jianhua Peng, Yong Jiang","doi":"10.3171/CASE24622","DOIUrl":"10.3171/CASE24622","url":null,"abstract":"Background: A carotid artery cavernous sinus fistula (CCF) is an abnormal shunt of blood vessels, allowing blood to flow directly or indirectly from the carotid artery into the cavernous sinus. The most common cause of spontaneous CCF (s-CCF) is ruptured internal carotid-cavernous sinus aneurysms, while fibromuscular dysplasia (FMD) is rare. FMD is a rare, idiopathic, segmental, noninflammatory, and nonatherosclerotic disease of medium-sized arteries, characterized by abnormal cell proliferation and distortion of arterial wall architecture. The authors report the case of a patient with CCF with FMD.Observations: The authors report the case of a young woman with s-CCF who was effectively treated with coiling and balloon compression. Subsequently, she was shown to have FMD susceptibility genes using single nucleotide polymorphism (SNP) testing in the follow-up phase.Lessons: The authors report the case of s-CCF caused by FMD in a young patient. SNP testing validated the existence of FMD susceptibility genes. The patient successfully recuperated following endovascular embolization therapy. For patients with s-CCF, the possibility of FMD should be considered, especially in young women with a family history. https://thejns.org/doi/10.3171/CASE24622.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"9 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The use of radiofrequency ablation for the management of refractory lower extremity pain associated with lumbar spondylosis: illustrative case. 射频消融术治疗腰椎病伴下肢难治性疼痛：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-03-31 DOI: 10.3171/CASE24837

Vincent Codispoti, Matthew J Solomito

{"title":"The use of radiofrequency ablation for the management of refractory lower extremity pain associated with lumbar spondylosis: illustrative case.","authors":"Vincent Codispoti, Matthew J Solomito","doi":"10.3171/CASE24837","DOIUrl":"10.3171/CASE24837","url":null,"abstract":"Background: The lumbar spine is a common cause of referred pain to the lower extremities. Standard conservative treatments (i.e., physical therapy and pharmacotherapy) can provide only partial or temporary relief, in which case injections might be used. This often consists of epidural steroid injections to treat possible radicular pain. When symptoms still persist, radiofrequency ablation (RFA) to treat facet-mediated pain can offer a viable option before surgical intervention.Observations: In this illustrative case, a patient presenting with a complex array of worsening symptoms in the lower extremities, secondary to lumbar spondylosis, was treated using RFA. Conservative treatments resulted in partial, temporary relief. A facet-mediated source of pain was suspected, and diagnostic blocks indicated that the patient would be a candidate for bilateral RFA of the medial branches at L3, L4, and L5. Following the RFA procedure, the patient had full resolution of her lower extremity pain and paresthesias.Lessons: RFA procedures are typically performed to address low back pain rather than concomitant lower extremity pain and paresthesias. This case provides evidence indicating that, in the face of appropriate conservative management and diagnostic testing, RFA of the medial lumbar branches can address lower extremity pain secondary to lumbar spine pathology. https://thejns.org/doi/10.3171/CASE24837.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"9 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Parameningeal embryonal rhabdomyosarcoma with leptomeningeal metastasis in a young adult female: illustrative case. 一例年轻成年女性脑膜旁胚胎性横纹肌肉瘤伴小脑膜转移：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-03-31 DOI: 10.3171/CASE24755

Justin Maldonado, Youssef Zohdy, Stewart Neill, Travis Atchley, Edoardo Porto, Uday Thakar, Hithardhi Duggireddy, Karen Salmeron Moreno, Sarah G Mitchell, Bree R Eaton, Tomas Garzon-Muvdi

{"title":"Parameningeal embryonal rhabdomyosarcoma with leptomeningeal metastasis in a young adult female: illustrative case.","authors":"Justin Maldonado, Youssef Zohdy, Stewart Neill, Travis Atchley, Edoardo Porto, Uday Thakar, Hithardhi Duggireddy, Karen Salmeron Moreno, Sarah G Mitchell, Bree R Eaton, Tomas Garzon-Muvdi","doi":"10.3171/CASE24755","DOIUrl":"10.3171/CASE24755","url":null,"abstract":"Background: Rhabdomyosarcoma (RMS) is a rare malignancy of undifferentiated skeletal muscle tissue and is the most common pediatric soft tissue sarcoma. Adolescent and young adult (AYA) patients (15-21 years of age) experience poorer outcomes compared with younger patients, primarily due to unfavorable histological subtypes, primary location, and tumor size. Tumors that arise from the skull base called parameningeal RMS have a poor prognosis due to anatomical complexity and the risk of leptomeningeal metastasis.Observations: The authors present the case of an 18-year-old female patient with a 4-month history of multiple progressive cranial neuropathies. MRI demonstrated a large left-sided mass centered at the foramen ovale with significant intracranial and infratemporal extension. Following near-total resection, pathology revealed embryonal RMS with anaplastic features. She subsequently began six cycles of high-dose vincristine, actinomycin, and cyclophosphamide therapy and proton radiation therapy. Two weeks after completing radiation therapy, follow-up imaging revealed a recurrence with leptomeningeal metastasis. Despite treatment with vincristine, irinotecan, and temozolomide chemotherapy, and craniospinal irradiation, the patient died of disease 5 months after spinal metastasis diagnosis.Lessons: Genomic profiling might be considered for early integration as a standard practice in this population in cases of such aggressive and rare malignancies. https://thejns.org/doi/10.3171/CASE24755.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"9 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0