CC BY-NC-ND 4.0 · J Neurol Surg B 2018; 79(S 05): S426-S427
DOI: 10.1055/s-0038-1669969
Skull Base: Operative Videos
Georg Thieme Verlag KG Stuttgart · New York

Microsurgical Gross Total Resection of a WHO Grade II Cerebellopontine Angle Ependymoma in an Adult

Sima Sayyahmelli
1  Department of Neurological Surgery, University of Wisconsin Medical School, Madison, Wisconsin, United States
,
Melih Ucer
1  Department of Neurological Surgery, University of Wisconsin Medical School, Madison, Wisconsin, United States
,
Mustafa K. Baskaya
1  Department of Neurological Surgery, University of Wisconsin Medical School, Madison, Wisconsin, United States
› Author Affiliations
Disclosure of Funding None.
Further Information

Address for correspondence

Mustafa K. Baskaya, MD
Department of Neurological Surgery, University of Wisconsin Medical School
K4/834 CSC, 600 Highland Avenue, Madison, WI 53792-0001
United States   

Publication History

30 May 2018

12 August 2018

Publication Date:
25 September 2018 (eFirst)

 

    Abstract

    Infratentorial ependymomas that arise in the fourth ventricle and extend into the cerebellopontine angle (CPA) through the foramina of Luschka are well described. However, a primary CPA location of an ependymoma is distinctly uncommon. In this video, we present a 46-year-old man with episodes of dizziness, left-sided tinnitus, imbalance, double vision, and nausea. An magnetic resonance imaging (MRI) scan of the head showed a large mass lesion centered in the CPA with heterogenous enhancement. Differential diagnosis included ependymoma, meningioma, schwannoma of the vestibular nerve, or lower cranial nerves, and choroid plexus papilloma. He underwent microsurgical gross total resection of the tumor via a retrosigmoid approach. Direct stimulation of the cranial nerves was performed throughout the case and there was no attachment of the tumor to any cranial nerve to suggest that this might be a schwannoma. The tumor encased important vasculature, including the posterior-inferior cerebellar artery. The histopathology was a grade II ependymoma. The patient tolerated the surgery well and his postoperative course was uneventful. He remained neurologically intact. He received radiation therapy and there was no recurrent or residual disease on follow-up studies. This video demonstrates important steps of the surgical approach and microsurgical resection techniques for this type of challenging tumor.

    The link to the video can be found at: https://youtu.be/KK-y6EYh888.


    #
    Zoom Image
    Fig. 1 Pre and postoperative magnetic resonance imaging.
    Zoom Image
    Fig. 2 Intraoperative images.

    www.thieme.com/skullbasevideos

    www.thieme.com/jnlsbvideos


    Quality:

    #

    Conflict of Interest

    None.

    Address for correspondence

    Mustafa K. Baskaya, MD
    Department of Neurological Surgery, University of Wisconsin Medical School
    K4/834 CSC, 600 Highland Avenue, Madison, WI 53792-0001
    United States   

      
    Zoom Image
    Fig. 1 Pre and postoperative magnetic resonance imaging.
    Zoom Image
    Fig. 2 Intraoperative images.