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Title: Acute peritumoral brainstem hemorrhage of a clival chondrosarcoma successfully treated via endoscopic endonasal surgery: illustrative case.
Authors: Mitani, Koki
Tanji, Masahiro
Kitada, Yuji
Kikuchi, Masahiro
Sugimoto, Akihiko
Fujimoto, Masakazu
Arakawa, Yoshiki  kyouindb  KAKEN_id  orcid https://orcid.org/0000-0003-4626-4645 (unconfirmed)
Author's alias: 三谷, 幸輝
丹治, 正大
北田, 有史
菊地, 正弘
杉本, 曉彦
藤本, 正数
荒川, 芳輝
Keywords: chondrosarcoma
chordoma
endoscopic endonasal approach
brainstem hemorrhage
skull base
Issue Date: Sep-2024
Publisher: American Association of Neurological Surgeons
Journal title: Journal of Neurosurgery. Case Lessons
Volume: 8
Issue: 12
Thesis number: CASE2460
Abstract: BACKGROUND: Chondrosarcoma is typically a slow-growing tumor, and intratumoral hemorrhage is rare. Acute brainstem hemorrhage due to chondrosarcoma has rarely been reported. OBSERVATIONS: A 77-year-old man presented with the sudden onset of headache and vomiting followed by a declining level of consciousness, progressive right hemiparesis, and left ophthalmoplegia. Magnetic resonance imaging showed pontine hemorrhage and a mass in the retroclival space compressing the brainstem. Emergency endoscopic endonasal surgery was performed. Intraoperative observation revealed that a hematoma was located in the pons and subdural space around the tumor mass, suggesting that the hematoma had likely been caused by the rupture of small vessels around the pons, not by intratumoral hemorrhage. The pathological diagnosis was chondrosarcoma. The patient recovered well and underwent radiotherapy. LESSONS: This report describes a case of sudden neurological deterioration due to hemorrhage in a patient with chondrosarcoma of the skull base. An emergency endoscopic endonasal approach for mass reduction and hematoma removal was effective in the acute setting. This approach revealed the suspected etiology of peritumoral hemorrhage, not intratumoral hemorrhage.
Rights: © 2024 The authors
CC BY-NC-ND 4.0
URI: http://hdl.handle.net/2433/290108
DOI(Published Version): 10.3171/CASE2460
PubMed ID: 39284230
Appears in Collections:Journal Articles

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