Tag Archives: tumor

PUBLISHED: Intraventricular Tumor Resection

September 23, 2024 Chris Boisvert

Intraventricular Tumor Resection
Tyler N. Adams¹; Marcus Czabanka, MD²
¹Louisiana State University School of Medicine
²Charite Hospital Berlin

This is a case of a 49-year-old patient who presented with persistent headaches with no focal neurologic deficit. An MRI was performed which revealed an intraventricular tumor. The lesion was seen entering the third ventricle and potentially compressing both foramina of Monro. This was further confirmed through coronal reconstruction. The proposed method for tumor removal is an interhemispheric, transcallosal approach.

Central nervous system (CNS) tumors, such as this, are uncommon neoplasms that often present with symptoms like headache, nausea, vomiting, ataxia, vertigo, and papilledema. There is also the possibility of hydrocephalus, as the tumor can obstruct cerebrospinal fluid (CSF) outflow, and the development of seizures. These tumors often grow slowly and can be managed with surgical resection, chemotherapy, and/or stereotactic radiosurgery. For intraventricular tumor resection, the surgical approach can vary based on the tumor location, experience, and preference of the surgeon.

OMFS, Print Release

PUBLISHED: Treatment of Squamous Cell Carcinoma from the Posterior Maxilla with Wide Local Excision of the Tumor and Total Alveolectomy, Reconstruction with a Buccal Fat Pad Advancement, Placement of a Surgical Obturator, and an Ipsilateral Supraomohyoid Neck Dissection

August 28, 2024 Chris Boisvert

Treatment of Squamous Cell Carcinoma from the Posterior Maxilla with Wide Local Excision of the Tumor and Total Alveolectomy, Reconstruction with a Buccal Fat Pad Advancement, Placement of a Surgical Obturator, and an Ipsilateral Supraomohyoid Neck Dissection
Daniel Oreadi, DMD
Tufts University

Surgery has been the first line of treatment for oral cavity cancer. After appropriate workup, the decision to include an ipsilateral or bilateral neck dissection is made. The patient presented here was diagnosed with a posterior maxillary alveolar tumor. The treatment plan included wide local excision of the tumor with total alveolectomy, reconstruction with a buccal fat pad advancement, and placement of surgical obturator. Additionally, an ipsilateral supraomohyoid neck dissection was performed due to the relative risk of regional metastases.

General Surgery, Print Release, Vascular Surgery

PUBLISHED: Leiomyosarcoma of Inferior Vena Cava: Resection and Reconstruction

July 25, 2024 Chris Boisvert

Leiomyosarcoma of Inferior Vena Cava: Resection and Reconstruction
Madhukar S. Patel, MD, MBA, ScM; Jahan Mohebali, MD, MPH; Parsia A. Vagefi, MD, FACS; Alex B. Haynes, MD, MPH, FACS
Massachusetts General Hospital

Primary leiomyosarcomas of the inferior vena cava (IVC) are rare tumors with complex anatomical relationships. Surgical resection remains the primary approach for management, with selective use of preoperative radiation and chemotherapy. Given the propensity for local invasion of these tumors, radical resection of surrounding structures is often required.

This article describes the presentation, work-up, operative management, and outcomes of these lesions through the case of a patient with a tumor involving the middle segment of the IVC. Given the extent of involvement, IVC resection with en bloc right nephrectomy, right adrenalectomy, and partial left renal vein resection was performed with vascular reconstruction using a prosthetic graft. With appropriate preoperative planning and a well-coordinated multidisciplinary approach, aggressive surgical resection can be safely performed and patients can benefit from favorable long-term survival.

General Surgery, Print Release

PUBLISHED: Laparoscopic Resection of Gastric GIST Tumor

March 28, 2024 Chris Boisvert

Laparoscopic Resection of Gastric GIST Tumor
Daniel Rice¹; David Rattner, MD²
¹Lake Erie College of Osteopathic Medicine
²Massachusetts General Hospital

This case illustrates a laparoscopic resection of a gastrointestinal stromal tumor (GIST): the most common mesenchymal tumor found in the gastrointestinal tract. GISTs can be found anywhere along the gastrointestinal tract; however, they are most commonly found in the stomach and small intestine. These tumors are often associated with mutations in the KIT (receptor tyrosine kinase) and PDGFRA (platelet-derived growth factor receptor alpha) genes. Because it is difficult to achieve a permanent cure using protein tyrosine kinase inhibitors, such as imatinib, surgical resection is the recommended therapy in most cases. While the surgical approach may vary on tumor characteristics, the laparoscopic approach is associated with low perioperative morbidity and mortality.

Neurosurgery, Otolaryngology, Print Release

PUBLISHED: Anterior Skull Base Resection of Esthesioneuroblastoma (Endoscopic)

June 8, 2023 Chris Boisvert

Anterior Skull Base Resection of Esthesioneuroblastoma (Endoscopic)
David W. Jang, MD¹; Ali R. Zomorodi, MD¹; Feras Ackall, MD¹; Josef Madrigal, BS²; C. Scott Brown, MD¹
¹Duke University Medical Center
²David Geffen School of Medicine at the University of California, Los Angeles

First described by Berger in 1924, esthesioneuroblastoma (ENB) remains a rare sinonasal tumor believed to originate from specialized sensory olfactory cells. To date, the literature includes 1,000 recorded cases of ENB. Patients with ENB often present with non-specific symptoms, most often chronic nasal obstruction or epistaxis. Careful examination may reveal a pink or brown polyploid mass in the nasal cavity. Overall, ENB may demonstrate various growth patterns ranging from slow, indolent progression to aggressive invasion with widespread metastasis.

Current literature indicates that ENB should be treated with a combination of surgical resection and postoperative radiation therapy with or without chemotherapy. However, significant controversy remains regarding the appropriate surgical approach. This video demonstrates a transnasal endoscopic approach, which has gained significant popularity over the previous two decades compared to classic “open” approaches. Although this approach demonstrates improved perioperative outcomes while still achieving oncologic margins, further work is required to evaluate long-term survival.

General Surgery, Otolaryngology, Print Release

PUBLISHED: Minimally Invasive Parathyroidectomy Under Local Cervical Block Anesthesia for Primary Hyperparathyroidism and Parathyroid Adenoma

April 26, 2022 JOMI Editors

Minimally Invasive Parathyroidectomy Under Local Cervical Block Anesthesia for Primary Hyperparathyroidism and Parathyroid Adenoma

Tobias Carling, MD, PhD, FACS
Yale School of Medicine

With improvement in both preoperative parathyroid tumor identification and the use of intraoperative parathyroid hormone assay, minimally invasive parathyroidectomy (MIP) is now performed more frequently in patients with primary hyperparathyroidism (pHPT). Still, many institutions are not familiar with performing MIP under regional or local anesthesia. Here, Dr. Tobias Carling presents an MIP performed under local cervical block anesthesia on a patient with pHPT and parathryoid adenoma.

Announcement, General Surgery, Preprint Release

PREPRINT RELEASE: Right Posterior Retroperitoneoscopic Adrenalectomy

June 27, 2018 JOMI Editors Leave a comment

Right Posterior Retroperitoneoscopic Adrenalectomy
Smilow Cancer Hospital at Yale New Haven

Tobias Carling, MD, PhD, FACS
Associate Professor of Surgery
Yale School of Medicine

One of the early adaptors of the approach, Tobias Carling, MD, PhD, FACS, performs a right posterior retroperitoneoscopic adrenalectomy on a patient that presented with subclinical Cushing's syndrome. Specifically, she had elevated urinary cortisol, failed a dexamethasone suppression test, and had a growing adrenal tumor as revealed by serial imaging. Due to the patient’s anatomy, Dr. Carling used a lateral approach to ligating the right adrenal vein; this video includes his usual medial approach as an additional module.

Neurosurgery, Preprint Release

PREPRINT RELEASE: Intraventricular Tumor Resection

April 4, 2017 JOMI Editors Leave a comment

Intraventricular Tumor Resection
Charite Hospital Berlin
PD Dr. med. Marcus Czabanka

Neurosurgeon Marcus Czabanka treats an intraventricular tumor found in a patient with persistent headaches by resecting the tumor via an interhemispheric transcallosal approach.

Fundamentals, Otolaryngology, Preprint Release

PREPRINT RELEASE: Parotid Dissection (Cadaver)

March 3, 2017 JOMI Editors Leave a comment

Parotid Dissection (Cadaver)
Duke University Medical Center
Ramon M Esclamado MD, MS
Professor, Department of Surgery
Chief, Division of Head and Neck Surgery & Communication Sciences

Dr. Esclamado instructs a cadaver lab at Duke University Hospital to assist resident training on a standard parotid dissection. The approach should be adjusted depending on tumor malignancy, as Dr. Esclamado explains.