Miscellaneous » Case of the Month - June 2012

5 years ago
by petra.ernestova@gmail.com

This discussion group relates to the Case of the Month section. You are very welcome to discuss the case with the authors and other individual members here.

5 years ago
by m.torrens@hygeia.gr

Since stereotactic radiosurgery will almost certainly be necessary sooner or later, why not do it as the primary treatment and spare the patient all the unpleasantness and danger of an operation? SRS would be an appropriate treatment for any lesion with these features. I do not believe the obsession with diagnosis should be allowed to put the patient at risk. Anyway there are other methods to obtain a diagnosis if it is thought essential.

5 years ago
by tiit.mathiesen@karolinska.se

This is a nice case. Some relevant info is lacking: what was the condition of lower cranial nerves? How was vestibular function and hegaring? How do you explain the symptoms - the images show a lesion with potential to affect Nn XII-IX. Which differential diagnoses were considered? Did you consider wait and scan? Was the surgical indication an intention to improve symptoms or to obtain a diagnosis (or to achieve a complete removal?). What was the outcome regarding preop symptoms and lower cranial nerves?

5 years ago
by adrian.merlo@gmx.ch

Nice case, challenging surgery avoiding hemibulbar paralysis! An additional new option for such skull base lesions represents beta-radiotherapy, using the successful protocol established for carcinoid tumors (i.v. somatostatin receptor targeting, the peptide contains a DOTA-chelator that entraps the therapeutic radionuclide Yttrium-90). The response rate is around 90% producing lasting effects, and all additional options are still available (surgery-gammaKnife-ext beam RT). Observation intervall meanwhile > 10 years in a series of 15 patients done at the U of Basel together with NuclearMedicine (Thesis).

5 years ago
by adrian.merlo@gmx.ch

Nice case, challenging surgery avoiding hemibulbar paralysis! An additional new option for such skull base lesions represents beta-radiotherapy, using the successful protocol established for carcinoid tumors (i.v. somatostatin receptor targeting, the peptide contains a DOTA-chelator that entraps the therapeutic radionuclide Yttrium-90). The response rate is around 90% producing lasting effects, and all additional options are still available (surgery-gammaKnife-ext beam RT). Observation intervall meanwhile > 10 years in a series of 15 patients done at the U of Basel together with NuclearMedicine (Thesis).

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