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clivus-involved immunoglobulin G4 related hypertrophic pachymeningitis mimicking meningioma:A case report

World Journal of Clinical Cases 2022年第18期10卷 6269-6276页

作者： Yang Yu Liang Lv Sen-Lin Yin Cheng Chen Shu Jiang Pei-Zhi Zhou Department of Neur-osurgery West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina

BACKGROUND Immunoglobulin G4 related disease(Ig G4-RD)is a fibroinflammatory disease with markedly elevated serum Ig G4 levels and fibrous tissue proliferation,accompanied by numerous plasma *** G4 related hypertrophic pachymeningitis(Ig G4-RHP)is relatively rare and indistinguishable from other phymatoid diseases before the *** risk of long-term immunosuppression needs to be balanced with disease *** SUMMARY A 40-year-old man presented with headache and bilateral abducent *** was also diagnosed with pulmonary tuberculosis 10 years ago and was on regular treatment for the *** the operation and steroid therapy,the patient was suspected of having tubercular meningitis at a local hospital.A clivus lesion was found via brain magnetic resonance imaging(MRI)at this *** was preliminarily diagnosed with meningioma and underwent Gamma Knife *** endoscopic resection was performed to treat deterioration of nerve *** pathologic examination suggested Ig ***,the serum Ig G4 was elevated at 1.90 g/L(reference range:0.035-1.500 g/L).After steroid therapy for 2 mo,the lesion size diminished on MRI,and the function of bilateral abducent nerves *** Ig G4-RHP is relatively rare and indistinguishable before the *** serum Ig G4 levels and imaging examination help in the diagnosis of Ig *** is necessary when lesions progress and patients start to develop cranial nerve function deficit.

关键词： Immunoglobulin G4 related disease Hypertrophic pachymeningitis Immu-noglobulin G4 related hypertrophic pachymeningitis clivus Case report

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Endoscopic endonasal transclival removal of tumors of the clivus and anterior region of the posterior cranial fossa (results of surgical treatment of 140 patients)

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Chinese Neurosurgical Journal 2018年第4期4卷 219-232页

作者： Alexey N. Shkarubo Konstantin V. Koval Ilia V. Chernov Dmitry N. Andreev Alexey B. Kurnosov Andrey A. Panteleyev Federal State Autonomous Institution N.N. Burdenko National Medical Research Center of Neurosurgery of the Ministry of Health of the Russian Federation (N.N. Burdenko NMRCN) 4-ya Tverskaya-YAmskaya street 16 Moscow Russian Federation

Background: Until recently, tumors of the clivus and the anterior region of the posterior cranial fossa were considered extremely difficult to access and often inoperable using standard transcranial approaches. With the introduction into the neurosurgical practice of minimally invasive methods utilizing endoscopic techniques, it became possible to effectively remove hard-to-reach tumors, including central tumors of the anterior region of the posterior cranial fossa. Methods: From 2008 to the present time, the inpatient institution has operated on 140 patients with various tumors of the base of the skull, localized to the clivus and anterior region of the posterior cranial fossa (65 men and 75 women). The age of patients ranged from 3 to 74 years. Tumor distribution according to the histopathological features was as follows: chordomas, 103 (73.57%);meningiomas, 12 (8.57%);pituitary adenomas, 9 (6.43%);fibrous dysplasia, 4 (2.86%);cholesteatoma, 3 (2.14%);craniopharyngiomas, 2 (1.43%);plasmacytomas, 2 (1.43%);and other tumors (giant cell tumor, neurohypophyseal glioma, osteoma, carcinoid, chondroma), 5 (3.57%). The tumors had the following size distribution: giant (more than 60 mm), 35 (25%);large (35–59 mm), 83 (59.3%);medium (21–35 mm), 21 (15%);and small (less than 20 mm), 1 (0.7%). In 11 cases, intraoperative monitoring of the cranial nerves was performed (21 cranial nerves were identified). Results: Upper, middle, and lower transclival approaches provide access to the anterior surface of the upper, middle, and lower neurovascular complexes of the posterior cranial fossa. The chordoma cases were distributed as follows according to extent of removal: total removal, 68 (66.02%);subtotal removal, 25 (24.27%);and partial removal, 10 (9.71%). The adenomas of the pituitary gland were removed totally in 6 cases, subtotally in 1 case and partially in 2 cases. The meningiomas were removed totally in 1 case, subtotally in 5 cases, and partially in 5 cases, with less than 50

关键词： clivus Clival chordoma Endoscopic endonasal transclival approach Monitoring of cranial nerves Posterior cranial fossa Skull base anatomy Skull base surgery

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Surgical Excision of clivus Chordoma with the Use of Coblator—A Case Report

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International Journal of Otolaryngology and Head & Neck Surgery 2015年第3期4卷 211-214页

作者： Saloni Shah Roma Gandh Hemang Brahmbahtt Rajesh Viswakarma B.J. Medical College Civil Hospital Ahmedabad India ENT Department Civil Hospital Ahmedabad India

Chordomas are dysembryogenic tumors originating from the notochordal process [1] [2]. They are aggressive tumours with unique diagnostic and management challenges. Primary therapy is complete surgical removal of the tumour as much as possible. The likelihood of recurrence is high in spite of complete surgical resection. A 52-year-old female patient presented with complaints of decreased vision in right eye, nasal bleeding, nasal blockage and difficulties in swallowing. CT scan and nasal biopsy were performed which confirmed the diagnosis of clivus chordoma. The CT scan showed extension into nasopharynx, nasal cavity and oropharynx pushing onto the soft palate. Surgical excision of the mass was performed with coblator by both intraoral and intra nasal approach [3]. On follow-up, nasal endoscopy and CT were done;the patient was relieved of the symptoms and was clinically better.

关键词： Chordoma clivus Nasopharynx Oropharynx Endoscopic Excision Coblator

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Clival Salivary Heterotopia (Salivary Choristoma): A Rare Radiopathogical Lesión

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Open Journal of Pathology 2022年第4期12卷 115-119页

作者： Javier Ortiz Juan Carlos Paniagua Luis Chinchilla Enrique Montero Elisa Muñoz María Dolores Ludeña Dpto. de Biología Celular y Patología (Universidad de Salamanca) Servicio de Anatomía Patológica (Hospital Universitario de Salamanca) Salamanca Spain Servicio de Radiodiagnóstico (Hospital Universitario de Salamanca) Salamanca Spain

Objective: To describe the radiological and pathological presentation of a salivary heterotopia in clivus. The lesion was detected incidentally in a 57-year-old woman. Material and Methods: Radiologic imaging (CT scan and MRI) and histological picture obtained from a clival lesion. Results: Radiologically the lesion presented as a well-limited lytic lesion with a diameter of 1.5 cm and accompanied by a cerebrospinal fluid secondary fistula. Histological examination revealed non-pathological salivary gland tissue. Conclusion: The differential diagnosis of this rare entity mandates a histological examination of the lesion.

关键词： Salivary Heterotopia clivus

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The anatomic study of clival screw fixation for the craniovertebral region

The anatomic study of clival screw fixation for the craniove...

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浙江省医学会骨科学分会30年庆典暨2011年浙江省骨科学学术年会

作者：季伟王向阳徐华梓池永龙温州医学院附属第二医院骨科医院脊柱外科

Study *** clival screw fixation is described,as is the surgical technique for reconstruction of the craniovertebral *** pertinent anatomy is described and a computed tomography scans based screw assessment of the feasibility,safety,and general applicability of this technique *** study the anatomic parameters related to clival screw and establish reference data concerning

关键词： clivus craniovertebral fusion screw placement anatomical study

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