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BACKGROUND: Hemangiopericytoma (HPC) is a rare malignancy accounting for 0.4% of intracranial tumors. HPCs are characterized by local aggressiveness, high rates of recurrence, and a tendency to metastasize to extracranial sites. These features make management of HPCs challenging, often requiring a combination of radical resection and radiation. Given their rarity, optimal treatment algorithms remain undefined. OBSERVATIONS: The authors report a series of four patients who underwent resection of intracranial HPC. Mean age at presentation was 49.3 years. Three patients had reoperation for progression of residual tumor, and one patient was surgically retreated for recurrence. One patient received adjuvant radiotherapy following initial resection, and three patients received adjuvant radiotherapy following resection of recurrent or residual disease. There was one death in the series. Average progression-free survival and overall survival following the index procedure were 32.8 and 82 months, respectively. Progression occurred locally in all patients, with metastatic recurrence in one patient. LESSONS: The current gold-standard treatment for intracranial HPC consists of gross-total resection followed by radiation therapy. This approach allows satisfactory local control; however, given the tendency for these tumors to recur either locally or distally within or outside of the central nervous system, there is a need for salvage therapies to improve long-term outcomes for patients.

Objective The aims of the study are (1) to evaluate the extended middle fossa approach (eMCF) for resection of tumors in the petroclivus and anterior cerebellopontine angle (CPA) and (2) to compare surgical outcomes between elderly (≥65 years) and nonelderly patients. Design Retrospective cohort. Setting Tertiary referral center. Participants Adults with petroclival, anterior CPA, or posterior fossa lesions who underwent an eMCF approach from 2012 to 2021 were included in the study. Main Outcome Measure Demographics, symptoms, cranial nerve (CN) function, and postoperative outcomes. Results Twenty-nine patients (mean age of 55 years, 59% females) were identified. Eleven (38%) were ≥65 years (65–79 years). The most common pathology was meningioma (n = 13, 45%), followed by vestibular schwannoma (n = 4, 14%) and squamous cell carcinoma (n = 3, 10%). Nineteen tumors (65.5%) were located in the petroclivus, 7 (24%) involved the cavernous sinus, and 10 (34%) were located in the posterior fossa. The mean tumor maximal diameter was 3.4 cm (range: 1.3–7.9 cm). Gross total tumor resection was accomplished in 15 (52%) patients. Most patients (n = 23, 79%) did not develop new CN deficits postoperatively. Of the 13 patients who had complete pre- and postoperative audiometric data, 69% (n = 9) maintained their hearing. Comparing the elderly versus nonelderly patients, there were no significant differences in the development of new CN palsies (p = 0.14), length of stay (p = 0.91), or incidence of postoperative complications (p = 0.30). Conclusions The eMCF approach provides exposure to the petroclival region, anterior CPA cistern, and posterior fossa for a variety of pathologies. It has a favorable safety profile in the elderly (≥65 years) population with low morbidity. [ABSTRACT FROM AUTHOR]

This article, titled "The Infundibulochiasmatic Angle Indicates Favorability of Endoscopic Endonasal Approach in Type IV Craniopharyngioma: Case Study and Technical Note," discusses the use of the midline transsphenoidal route as an alternative approach for tumors of the third ventricle. The authors introduce the concept of the "infundibulochiasmatic angle," which is a measurement that supports the feasibility of the trans-lamina terminalis endoscopic endonasal approach (EEA) for resection of type IV craniopharyngiomas. The article is authored by Guilherme Finger, Maria Jose C. Ruiz, Eman H. Salem, Matthew D. Marquardt, Kyle C. Wu, Lucas P. Carlstrom, Ricardo L. Carrau, Luciano M. Prevedello, and Daniel M. Prevedello. [Extracted from the article]

This article, published in the Journal of Neurological Surgery, discusses the management of giant arachnoid cysts (GACs), which are rare intracranial pathologies. The article presents a case study of a 33-year-old male patient with memory issues, bitemporal hemianopsia, and bilateral optic atrophy, who underwent an endoscopic transcortical transventricular fenestration procedure to treat the interpeduncular GAC. The patient experienced a complete resolution of their visual symptoms and made a smooth recovery after the procedure. The article highlights the importance of fenestration in decompressing the cyst and promoting cerebrospinal fluid flow to prevent symptomatic relapse. [Extracted from the article]

This article, published in the Journal of Neurological Surgery, discusses two cases of frontoethmoidal osteoma, a rare type of benign bone tumor. The patients presented with neurological deficits and cerebral spinal fluid (CSF) leaks. Both cases were successfully treated with different surgical approaches, resulting in complete tumor resection and no complications or signs of CSF leak. The authors emphasize the need for more cases to better understand the epidemiology, clinical presentation, treatment strategies, and outcomes of this condition. The article also includes a literature review of eight previously reported cases. [Extracted from the article]

This article discusses the successful treatment of recurrent lymphocytic hypophysitis (LH) using fractionated stereotactic radiotherapy (FSRT). LH is a rare autoimmune inflammation of the pituitary gland that can mimic pituitary adenomas. The authors conducted a systematic literature review and found that FSRT can be a viable alternative treatment for refractory cases of LH. The study included eight patients, and seven of them achieved a complete clinical response after one course of radiation. FSRT offers long-term disease control while minimizing radiation exposure to nearby critical structures. However, further studies are needed to determine the long-term effects, optimal dose planning, and patient selection criteria for FSRT. [Extracted from the article]

This article examines the morphological characteristics and surgical outcomes in patients with Type I Chiari malformation (CMI). The study compares individuals diagnosed with CMI to the general population to identify any discernible differences in parameters such as cerebellar width, 4th ventricle dimensions, cerebellar-to-Pons distance, cerebellar height, tentorial angle, and McRae line. The results show significant morphological differences between CMI patients and the normal population in various aspects. Postoperatively, some improvements in measurements were observed, but not in all parameters. These findings can help inform surgical decisions for patients with CMI experiencing ambiguous symptoms. [Extracted from the article]

This article discusses the occurrence of hypothyroidism following endoscopic endonasal resection of thyrotropin-secreting pituitary adenomas (TSHomas). The study conducted a retrospective review of patients who underwent this surgical procedure and found that postoperative hypothyroidism was a common outcome. The article emphasizes the importance of recognizing this potential outcome for appropriate postoperative management and patient counseling. The authors suggest that further research and larger case series are needed to gain more insights into the mechanism and peri-operative management of these patients. [Extracted from the article]