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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 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 |
This item is licensed under a Creative Commons License