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Diagnostic and surgical challenges in resection of cerebellar angle tumors and acoustic neuromas.

Patel N, Wilkinson J, Gianaris N, Cohen-Gadol AA - Surg Neurol Int (2012)

Bottom Line: The presence of any suspicious clinical and radiographic finding uncharacteristic of VS makes it necessary to maintain a broad differential diagnosis list.Differentiation of CPA lesions, although challenging, may be best achieved by incorporating the clinical history, physical exam findings, audiometry results, and multi-modality imaging studies to construct a comprehensive preoperative knowledge of the lesion.This knowledge will allow improved operative execution and outcomes.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurological Surgery, Goodman Campbell Brain and Spine, Indiana University, Indianapolis, Indiana, USA.

ABSTRACT

Background: Cerebellopontine angle (CPA) lesions can mimic more common tumors through nonspecific symptoms and radiologic findings.

Methods: To increase the preoperative diagnostic accuracy for CPA pathologies, the authors review the full spectrum of reported CPA lesions.

Results: A wide spectrum of lesions mimics vestibular schwannoma (VS) in the space of the CPA.

Conclusion: The presence of any suspicious clinical and radiographic finding uncharacteristic of VS makes it necessary to maintain a broad differential diagnosis list. Differentiation of CPA lesions, although challenging, may be best achieved by incorporating the clinical history, physical exam findings, audiometry results, and multi-modality imaging studies to construct a comprehensive preoperative knowledge of the lesion. This knowledge will allow improved operative execution and outcomes.

No MeSH data available.


Related in: MedlinePlus

Ependymomas usually arise from the fourth ventricle and its lateral recess and extend into the cerebellopontine angle (CPA) by means of exophytic growth. However, ependymomas of an extra-axial origin also exist and may grow directly into the CPA. They appear irregular and may invade the cerebellar parenchyma. Ependymomas appear as hypointense lesions on T1-weighted imaging and as hyperintense lesions on T2-weighted imaging (a and b:axial and coronal contrast-enhanced images and c: axial T2-weighted sequence)
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Figure 8: Ependymomas usually arise from the fourth ventricle and its lateral recess and extend into the cerebellopontine angle (CPA) by means of exophytic growth. However, ependymomas of an extra-axial origin also exist and may grow directly into the CPA. They appear irregular and may invade the cerebellar parenchyma. Ependymomas appear as hypointense lesions on T1-weighted imaging and as hyperintense lesions on T2-weighted imaging (a and b:axial and coronal contrast-enhanced images and c: axial T2-weighted sequence)

Mentions: Ependymomas usually arise from the fourth ventricle and its lateral recess and extend into the CPA by means of exophytic growth.[3] However, ependymomas of an extra-axial origin also exist and may grow directly into the CPA. They appear irregular and may invade the cerebellar parenchyma. Radiographically, ependymomas appear as hypointense lesions on T1-weighted imaging and as hyperintense lesions on T2-weighted imaging [Figure 8]. Ependymomas are markedly heterogeneous due to calcification, hemorrhage, cystic components, or necrosis.[3]


Diagnostic and surgical challenges in resection of cerebellar angle tumors and acoustic neuromas.

Patel N, Wilkinson J, Gianaris N, Cohen-Gadol AA - Surg Neurol Int (2012)

Ependymomas usually arise from the fourth ventricle and its lateral recess and extend into the cerebellopontine angle (CPA) by means of exophytic growth. However, ependymomas of an extra-axial origin also exist and may grow directly into the CPA. They appear irregular and may invade the cerebellar parenchyma. Ependymomas appear as hypointense lesions on T1-weighted imaging and as hyperintense lesions on T2-weighted imaging (a and b:axial and coronal contrast-enhanced images and c: axial T2-weighted sequence)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3307234&req=5

Figure 8: Ependymomas usually arise from the fourth ventricle and its lateral recess and extend into the cerebellopontine angle (CPA) by means of exophytic growth. However, ependymomas of an extra-axial origin also exist and may grow directly into the CPA. They appear irregular and may invade the cerebellar parenchyma. Ependymomas appear as hypointense lesions on T1-weighted imaging and as hyperintense lesions on T2-weighted imaging (a and b:axial and coronal contrast-enhanced images and c: axial T2-weighted sequence)
Mentions: Ependymomas usually arise from the fourth ventricle and its lateral recess and extend into the CPA by means of exophytic growth.[3] However, ependymomas of an extra-axial origin also exist and may grow directly into the CPA. They appear irregular and may invade the cerebellar parenchyma. Radiographically, ependymomas appear as hypointense lesions on T1-weighted imaging and as hyperintense lesions on T2-weighted imaging [Figure 8]. Ependymomas are markedly heterogeneous due to calcification, hemorrhage, cystic components, or necrosis.[3]

Bottom Line: The presence of any suspicious clinical and radiographic finding uncharacteristic of VS makes it necessary to maintain a broad differential diagnosis list.Differentiation of CPA lesions, although challenging, may be best achieved by incorporating the clinical history, physical exam findings, audiometry results, and multi-modality imaging studies to construct a comprehensive preoperative knowledge of the lesion.This knowledge will allow improved operative execution and outcomes.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurological Surgery, Goodman Campbell Brain and Spine, Indiana University, Indianapolis, Indiana, USA.

ABSTRACT

Background: Cerebellopontine angle (CPA) lesions can mimic more common tumors through nonspecific symptoms and radiologic findings.

Methods: To increase the preoperative diagnostic accuracy for CPA pathologies, the authors review the full spectrum of reported CPA lesions.

Results: A wide spectrum of lesions mimics vestibular schwannoma (VS) in the space of the CPA.

Conclusion: The presence of any suspicious clinical and radiographic finding uncharacteristic of VS makes it necessary to maintain a broad differential diagnosis list. Differentiation of CPA lesions, although challenging, may be best achieved by incorporating the clinical history, physical exam findings, audiometry results, and multi-modality imaging studies to construct a comprehensive preoperative knowledge of the lesion. This knowledge will allow improved operative execution and outcomes.

No MeSH data available.


Related in: MedlinePlus