PubMed · 594539
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M Rusu, G Costăchescu. [Diffuse cerebellar leptomeningeal sarcoma].. https://pubmed.ncbi.nlm.nih.gov/594539/
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OBJECTIVES: Cerebellopontine angle tumors are uncommon lesions that can potentially be cured by microsurgical removal. The primary objective of the surgical treatment differs between vestibular schwannoma and meningioma. This feature may be influenced by the site of tumor origin and displacement of neurovascular structures as well as by their different tumor biology. METHODS: A review of the current literature was conducted. RESULTS AND CONCLUSIONS: Relevant cranial nerves and vascular involvement as well as anatomical location with respect to the cerebellopontine angle are discussed for vestibular schwannoma and meningioma. The main factors influencing the surgical outcome are outlined with special reference to facial and cochlear nerve function and cerebrospinal fluid leakage. The retrosigmoid approach offers a comparable success rate for hearing conservation and probably a superior outcome in terms of facial nerve function when compared with the middle fossa approach. The intrameatal limitations of the retrosigmoid approach can be excluded by the intraoperative assistance of an endoscope. The advantages of endoscope-assisted surgery may include improved visualization of relevant structures, more complete tumor removal, and a lowered risk of cerebrospinal fluid leakage.
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CASE REPORT: The authors describe an unusual case of an intradural cerebellar chordoma, the first such case to be reported in a child. A 9-year-old girl presented with headaches and papilloedema, and a discrete cerebellar mass was resected, which was shown histologically to be chordoma. There was no bony or dural association, and after radiologically proven complete resection it was elected that the child be followed expectantly. DISCUSSION: The case is compared with the few previously reported intradural chordomas, and insights into the origins and management of such cases are discussed.