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首页> 外文期刊>Surgical neurology >Attenuation of vascularity by preoperative radiosurgery facilitates total removal of a hypervascular hemangioblastoma at the cerebello-pontine angle: case report.
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Attenuation of vascularity by preoperative radiosurgery facilitates total removal of a hypervascular hemangioblastoma at the cerebello-pontine angle: case report.

机译:术前放射外科手术可减轻血管的形成,有利于在小脑桥脑角完全切除高血管性成血管细胞瘤:病例报告。

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摘要

BACKGROUND: The surgical removal of solid, large, and deep-seated hemangioblastomas remains challenging because it is difficult to control bleeding during the procedure. We used preoperative radiosurgery in a solid, highly vascular hemangioblastoma at the left cerebello-pontine angle and present our angiographic, operative, and histologic findings. CASE DESCRIPTION: A 37-year-old paraplegic woman with multiple hemangioblastomas was re-admitted to our clinic with cerebellar ataxia 6 years after resection of a tumor at the fourth ventricle. A vertebral artery angiogram revealed that the 3.5 cm diameter hemangioblastoma at the left cerebello-pontine angle was highly vascular and fed by the left anterior inferior cerebellar artery and posterior inferior cerebellar artery. Nine months before surgical removal it was treated with stereotactic radiosurgery (gamma knife, margin dose 28 Gy) to inhibit tumor progression and to reduce its vascularity. The tumor was totally removed via the left lateral suboccipitalapproach; bleeding was well controlled and there were no complications. Pathologic examination of the content of the excised tumor revealed coagulation necrosis with hyaline degeneration of the tumor vessels, resulting in a marked decrease in its vascularity. CONCLUSION: Preoperative radiosurgery led to a marked reduction in the vascularity of this hypervascular hemangioblastoma and was useful for controlling bleeding from the tumor during resection. We succeeded to remove the vascular-rich hemangioblastma after the intentional preoperative radiosurgery. The pathologic changes induced by radiotherapy were confirmed by operative finding.
机译:背景:由于难以控制手术过程中的出血,因此手术切除实体,大和深层的血管母细胞瘤仍然具有挑战性。我们在左脑桥桥角的实体血管高度血管成血管细胞瘤中进行了术前放射外科手术,并介绍了我们的血管造影,手术和组织学检查结果。病例描述:一名37岁的患有多发血管母细胞瘤的截瘫患者在第四脑室切除肿瘤6年后因小脑共济失调再次进入我们的诊所。椎动脉血管造影显示,在小脑桥-左脑角处直径为3.5 cm的血管母细胞瘤高度血管化,并由左小脑前下动脉和小脑后下动脉供血。手术切除前9个月,采用立体定向放射外科手术(伽玛刀,边缘剂量28 Gy)进行治疗,以抑制肿瘤进展并减少其血管形成。通过左侧枕下外侧方法完全切除了肿瘤。出血得到了很好的控制,没有并发症。对切​​除的肿瘤的内容进行病理检查,发现凝结坏死伴有肿瘤血管的透明变性,导致其血管明显减少。结论:术前放射外科手术显着降低了这种血管性成血管母细胞瘤的血管,可用于控制切除过程中肿瘤的出血。我们在有意进行术前放射外科手术后成功去除了血管丰富的血管母细胞瘤。手术发现证实了放疗引起的病理改变。

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