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Adenoid cystic carcinoma (ACC) is an uncommon malignant tumor that accounts for less than 5% of head and neck cancers. ACC is characteristic for its indolent nature and its propensity for late distant metastases. Late diagnosis, tendency to perineural invasion, periosteal infiltration and local recurrence are factors of poor prognosis. Although studies still discuss the ideal treatment, the initial therapy consists of surgical resection, followed by postoperative radiotherapy. [ABSTRACT FROM AUTHOR]

Decompressive craniectomy has been increasingly used in recent decades for the treatment of uncontrollable intracranial hypertension caused by trauma, malignant strokes, cerebral venous thrombosis, among others. Sinking flap syndrome (SFS) is a rare complication characterized by neurological deterioration after craniectomy. Here, we report the case of a 73-year-old female patient who presented with disorientation, lip rhyme deviation to the right and left hemiparesis after cardiac catheterization. In view of the presence of a malignant stroke, as well as the willingness of the family members to make a total investment to save the patient's life, decompressive hemicraniectomy was indicated. Subsequently, due to occasional headache attacks, nausea and vomiting, in addition to progressive depression of the subcutaneous flap, the possibility of SFS was suggested and cranioplasty was indicated, which occurred without perioperative intercurrences. Although the patient maintained a stable neurological status, a post-surgical computed tomography (CT) scan of the head showed a right intraparenchymal hemorrhagic lesion, associated with parenchymal expansion and midline deviation. To the best of our knowledge, intraparenchymal hemorrhages are not common complications after performing cranioplasty, and additional studies are needed to understand the reasons why this occurs. The mechanisms responsible for this type of injury are not well understood, but involve reperfusion damage and loss of brain compliance. Despite representing an uncommon complication, postcranioplasty hemorrhage can cause severe morbidity to the patient, and early diagnosis and intervention are of great importance in these cases. [ABSTRACT FROM AUTHOR]

Plasma cell neoplasms are common, accounting for more than 1% of all malignancies. Its most common form is multiple myeloma, but others, such as extramedullary plasmacytoma (EMP), exist. Spinal cord compression secondary to these pathologies is not uncommon, however, adjacent bone involvement is usually present. Spinal cord compression caused by isolated epidural EMP is extremely rare, with only one case reported to date. We describe the case of a 75-year-old female patient that presented with paraparesis, due to an isolated epidural EMP associated with light chain amyloidosis. She was treated with surgical decompression and neoadjuvant chemotherapy, and is currently with a 15-month disease-free period. [ABSTRACT FROM AUTHOR]

Melanomas originating from the dura-mater are extremely rare tumors. The diagnosis is complex, and usually only made after excluding other entities. The prognosis is poor, with average free-disease survival of 20 months, after treatment with complete surgical excision and adjuvant therapy. We report the case of a 41-year-old asymptomatic patient, presenting with a subcutaneous mass in the left parieto-occipital region, later diagnosed as a primary dura mater melanoma. Treatment included complete microsurgical excision, radiotherapy and adjuvant immunotherapy. Therefore, due to the rare nature of the disease and its high lethality, correct diagnosis and treatment are medical challenges. [ABSTRACT FROM AUTHOR]

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Background/Study Aims Percutaneous radiofrequency trigeminal rhizotomy (RTR) is a standardized treatment for trigeminal neuralgia, yet it has been associated with serious complications related to the cannulation of the foramen ovale. Some of these complications, such as carotid injury, are potentially lethal. Neuronavigation was recently proposed as a method to increase the procedure's safety. All of the techniques described so far rely on pre- or intraoperative computed tomography scanning. Here we present a simple method based on magnetic resonance imaging (MRI) (radiation free) used to target the foramen ovale under navigation guidance. Patients/Material and Methods We retrospectively analyzed nine patients who had undergone navigated percutaneous RTR based solely on preoperative MRI and compared them with 35 patients who underwent conventional RTR guided by fluoroscopy. We analyzed immediate and late outcome and categorized the results into pain free, > 70% pain reduction, and persistent pain. We also compared groups in terms of the duration of the procedure and the complication rates. Here we describe the navigation method in detail and review the anatomical landmarks for target definition. Results The duration of the surgical procedure was similar in both groups (32.1 in the standard technique versus 34.5 minutes with navigation; p = 0.5157). There was no significant difference between groups regarding pain reduction at the immediate (p = 1.0) or late follow-up (p = 0.6284) time points. Furthermore, no serious complications were observed in the navigated group. Conclusions We present a simple radiation-free method for neuronavigation-assisted percutaneous RTR. This method proved to be safe and effective, and it is especially recommended for young, inexperienced neurosurgeons. [ABSTRACT FROM AUTHOR]