Tumor Volume Decrease via Feeder Occlusion for Treating a Large, Firm Trigone Meningioma
Autor: | Takao Kojima, Takuma Nakashima, Norikazu Hatano, Yukio Seki, Teppei Kawabata, Fumiaki Kanamori, Shinsuke Muraoka, Tadashi Watanabe, Tetsuya Nagatani, Syuntaro Takasu |
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Rok vydání: | 2018 |
Předmět: |
medicine.medical_specialty
business.industry Brain tumor lateral ventricle Case Report feeder occlusion Surgical procedures medicine.disease meningioma Resection Meningioma 03 medical and health sciences 0302 clinical medicine tumor volume 030220 oncology & carcinogenesis Occlusion medicine Trigone of urinary bladder Surgical excision Radiology Surgical treatment business 030217 neurology & neurosurgery |
Zdroj: | NMC Case Report Journal |
ISSN: | 2188-4226 |
Popis: | Trigone meningiomas are considered a surgical challenge, as they tend to be considerably large and hypervascularized at the time of presentation. We experienced a case of a large and very hard trigone meningioma that was effectively treated using initial microsurgical feeder occlusion followed by surgery in stages. A 19-year-old woman who presented with loss of consciousness was referred to our hospital for surgical treatment of a brain tumor. Radiological findings were compatible with a left ventricular trigone meningioma extending laterally in proximity to the Sylvian fissure. At initial surgery using the transsylvian approach, main feeders originating from the anterior and lateral posterior choroidal arteries were occluded at the inferior horn; however, only a small section of the tumor could initially be removed because of its firmness. Over time, feeder occlusion resulted in tumor necrosis and a 20% decrease in its diameter; the mass effect was alleviated within 1 year. The residual meningioma was then totally excised in staged surgical procedures after resection became more feasible owing to ischemia-induced partial softening of the tumor. When a trigone meningioma is large and very hard, initial microsurgical feeder occlusion in the inferior horn can be a safe and effective option, and can lead to necrosis, volume decrease, and partial softening of the residual tumor to allow for its staged surgical excision. |
Databáze: | OpenAIRE |
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