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Infundibular hemangioblastoma resection: Video case report

BACKGROUND: Hemangioblastomas are benign (World Health Organization Grade I), highly vascular neoplasms commonly associated with Von Hippel-Lindau (VHL) disease.[2] The VHL tumor-suppressor gene, located on chromosome 3, is implicated in sporadic cases and cases associated with VHL disease. Hemangio...

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Autores principales: Housley, Steven B., Recker, Matthew J., O’Connor, Timothy E., Siddiqui, Adnan H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Scientific Scholar 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9112985/
https://www.ncbi.nlm.nih.gov/pubmed/35592353
http://dx.doi.org/10.25259/SNI_288_2021
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author Housley, Steven B.
Recker, Matthew J.
O’Connor, Timothy E.
Siddiqui, Adnan H.
author_facet Housley, Steven B.
Recker, Matthew J.
O’Connor, Timothy E.
Siddiqui, Adnan H.
author_sort Housley, Steven B.
collection PubMed
description BACKGROUND: Hemangioblastomas are benign (World Health Organization Grade I), highly vascular neoplasms commonly associated with Von Hippel-Lindau (VHL) disease.[2] The VHL tumor-suppressor gene, located on chromosome 3, is implicated in sporadic cases and cases associated with VHL disease. Hemangioblastomas most commonly arise in the posterior fossa; however, they may also be found supratentorially or within the spinal cord.[3] Surgical intervention is indicated for symptomatic lesions with a goal of complete resection of the enhancing nodule.[1] CASE DESCRIPTION: We demonstrate the case of a 69-year-old man with a history of multiple hemangioblastomas who had undergone two previous craniotomies and Gamma-Knife radiosurgery (Video https://drive.google.com/file/d/1lUwsb80NLmIW2Enp-DVdtM9_Oqbid3Ih/view?usp=sharing). He presented with progressive imbalance and diplopia and was found to have a new lesion within the suprasellar cistern. Digital subtraction angiography (DSA) and magnetic resonance imaging (MRI) characteristics were typical of hemangioblastoma. Surgery was determined to be indicated, with a goal of vision preservation. Preoperative embolization was not possible because preoperative DSA demonstrated vascular supply by only small perforators directly from the internal carotid artery. Hypopituitarism was identified preoperatively, although diabetes insipidus was not present. The patient underwent a right orbitozygomatic craniotomy and extradural anterior clinoidectomy for access. The tumor was noted to encapsulate the infundibulum, which necessitated its sacrifice. Postoperatively, the patient remained at his neurologic baseline. He had a positive triphasic diabetes insipidus response and was discharged home on maintenance desmopressin. Postoperative MRI demonstrated complete lesion resection. The patient gave informed consent for treatment and video recording. Institutional review board approval was deemed unnecessary. CONCLUSION: This video highlights a safe and effective surgical technique for suprasellar lesions as well as the complex anatomy observed through an orbitozygomatic approach.
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spelling pubmed-91129852022-05-18 Infundibular hemangioblastoma resection: Video case report Housley, Steven B. Recker, Matthew J. O’Connor, Timothy E. Siddiqui, Adnan H. Surg Neurol Int Video Abstract BACKGROUND: Hemangioblastomas are benign (World Health Organization Grade I), highly vascular neoplasms commonly associated with Von Hippel-Lindau (VHL) disease.[2] The VHL tumor-suppressor gene, located on chromosome 3, is implicated in sporadic cases and cases associated with VHL disease. Hemangioblastomas most commonly arise in the posterior fossa; however, they may also be found supratentorially or within the spinal cord.[3] Surgical intervention is indicated for symptomatic lesions with a goal of complete resection of the enhancing nodule.[1] CASE DESCRIPTION: We demonstrate the case of a 69-year-old man with a history of multiple hemangioblastomas who had undergone two previous craniotomies and Gamma-Knife radiosurgery (Video https://drive.google.com/file/d/1lUwsb80NLmIW2Enp-DVdtM9_Oqbid3Ih/view?usp=sharing). He presented with progressive imbalance and diplopia and was found to have a new lesion within the suprasellar cistern. Digital subtraction angiography (DSA) and magnetic resonance imaging (MRI) characteristics were typical of hemangioblastoma. Surgery was determined to be indicated, with a goal of vision preservation. Preoperative embolization was not possible because preoperative DSA demonstrated vascular supply by only small perforators directly from the internal carotid artery. Hypopituitarism was identified preoperatively, although diabetes insipidus was not present. The patient underwent a right orbitozygomatic craniotomy and extradural anterior clinoidectomy for access. The tumor was noted to encapsulate the infundibulum, which necessitated its sacrifice. Postoperatively, the patient remained at his neurologic baseline. He had a positive triphasic diabetes insipidus response and was discharged home on maintenance desmopressin. Postoperative MRI demonstrated complete lesion resection. The patient gave informed consent for treatment and video recording. Institutional review board approval was deemed unnecessary. CONCLUSION: This video highlights a safe and effective surgical technique for suprasellar lesions as well as the complex anatomy observed through an orbitozygomatic approach. Scientific Scholar 2021-06-21 /pmc/articles/PMC9112985/ /pubmed/35592353 http://dx.doi.org/10.25259/SNI_288_2021 Text en Copyright: © 2021 Surgical Neurology International https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Video Abstract
Housley, Steven B.
Recker, Matthew J.
O’Connor, Timothy E.
Siddiqui, Adnan H.
Infundibular hemangioblastoma resection: Video case report
title Infundibular hemangioblastoma resection: Video case report
title_full Infundibular hemangioblastoma resection: Video case report
title_fullStr Infundibular hemangioblastoma resection: Video case report
title_full_unstemmed Infundibular hemangioblastoma resection: Video case report
title_short Infundibular hemangioblastoma resection: Video case report
title_sort infundibular hemangioblastoma resection: video case report
topic Video Abstract
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9112985/
https://www.ncbi.nlm.nih.gov/pubmed/35592353
http://dx.doi.org/10.25259/SNI_288_2021
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