Intraoperative discovery of a radiographically occult subependymoma obstructing the obex in a patient with a Chiari malformation - A rare case.

Autor:	Peeters SF; Department of Neurosurgery, University of California Los Angeles (UCLA), Los Angeles, California, United States., Uhr L; Department of Neurosurgery, University of California Los Angeles (UCLA), Los Angeles, California, United States., Chivukula S; Department of Neurosurgery, University of Texas Southwestern, Dallas, Texas, United States., Everson R; Department of Neurosurgery, University of California Los Angeles (UCLA), Los Angeles, California, United States., Duong D; Department of Neurosurgery, Harbor (UCLA) Medical Center, Torrance, California, United States., McBride D; Department of Neurosurgery, University of California Los Angeles (UCLA), Los Angeles, California, United States., Kim W; Department of Neurosurgery, University of California Los Angeles (UCLA), Los Angeles, California, United States., Cornford M; Department of Pathology, Harbor (UCLA) Medical Center, Torrance, California, United States., Mlikotic A; Department of Radiology, Harbor (UCLA) Medical Center, Torrance, California, United States., Yang I; Department of Neurosurgery, University of California Los Angeles (UCLA), Los Angeles, California, United States.
Jazyk:	angličtina
Zdroj:	Surgical neurology international [Surg Neurol Int] 2024 Jan 05; Vol. 15, pp. 4. Date of Electronic Publication: 2024 Jan 05 (Print Publication: 2024).
DOI:	10.25259/SNI_683_2023
Abstrakt:	Background: Chiari (type I) malformations are typically congenital. Occasionally, however, tonsillar herniation can arise secondary to cerebrospinal fluid leakage, posterior fossa or intraventricular mass lesions, or other etiologies. We present the first-ever case of an intramedullary subependymoma at the cervicomedullary junction associated with vertebral bone abnormalities and an acquired secondary Chiari malformation. Case Description: A 60-year-old woman presented with a 3-year history of occipital, tussive headaches. Preoperative imaging was negative for mass lesions but demonstrated a Chiari malformation. She was recommended posterior fossa decompression with tonsillar shrinkage. During surgery, an intramedullary mass was incidentally observed, obstructing the obex at the cervicomedullary junction. Histopathological analysis of the resected lesion revealed a diagnosis of subependymoma. Conclusion: Subependymomas can sometimes present a diagnostic challenge due to their subtle appearance in neuroimaging. Only rarely are such masses associated with an acquired Chiari malformation. No such case has previously been reported. We present a literature review on acquired Chiari malformations and discuss their management. Competing Interests: There are no conflicts of interest. (Copyright: © 2024 Surgical Neurology International.)
Databáze:	MEDLINE
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