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[PMID]: 28452709
[Au] Autor:Al-Asousi F; Okpaleke C; Dadgostar A; Javer A
[Ad] Address:Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, St. Paul's Sinus Centre, University of British Columbia, Vancouver, British Columbia, Canada.
[Ti] Title:The use of polydioxanone plates for endoscopic skull base repair.
[So] Source:Am J Rhinol Allergy;31(2):122-126, 2017 Mar 01.
[Is] ISSN:1945-8932
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Many reconstructive techniques and materials have been reported for repair of skull base defects after sinonasal tumor excision, cerebrospinal fluid (CSF) leaks, and coverage of denuded bone. Synthetic materials have been developed for endoscopic skull base repair to avoid donor-site morbidity. Polydioxanone plate is a bioabsorbable implant designed for nasal septal reconstruction and has the ability to retain strength for at least 10 weeks and absorbs in 6 months. OBJECTIVES: This study aimed to describe the use of polydioxanone plates in endoscopic skull base defect and CSF leak repair, and to describe our experience with the surgical technique and postoperative management. METHODS: This was a retrospective case series of patients who, between May 2013 and December 2015, underwent endoscopic sinus surgery and skull base repair for CSF leak or after excision of a skull base tumor by using polydioxanone plates. Patients who presented with sinonasal inflammatory disease or skull base tumors underwent endoscopic skull base repair by using polydioxanone plates in an underlay fashion and mucosal membrane grafts with or without adjuvant materials in an overlay fashion. The patients were reviewed at 6 days, 6 weeks, and 3 months after surgery. Postoperative adverse events, including CSF leak, infection, bleeding, headache, and graft failure, were recorded. RESULTS: The cases of seven patients (five women, two men; mean age, 53.9 years) were reviewed. Five patients underwent sinonasal tumor resection and two underwent repair for CSF leak. The mean (standard deviation) defect size was 16.4 ± 11.4 mm. There was no evidence of postoperative CSF leak, and lumbar drains were not used. One patient reported transient headache and facial pressure at the 6-week follow-up visit. The surgeons' experience with polydioxanone plate placement, postoperative healing, and follow-up was satisfactory. CONCLUSION: Polydioxanone could be used to achieve rigid repair of endoscopic skull base defects. These early results, although promising, require validation in clinical trials.
[Mh] MeSH terms primary: Absorbable Implants/utilization
Cerebrospinal Fluid Leak/surgery
Endoscopy
Paranasal Sinuses/surgery
Reconstructive Surgical Procedures
Skull Base Neoplasms/surgery
Skull Base/surgery
[Mh] MeSH terms secundary: Biocompatible Materials/chemistry
Female
Follow-Up Studies
Humans
Male
Middle Aged
Paranasal Sinuses/pathology
Polydioxanone/chemistry
Postoperative Complications
Retrospective Studies
Skull Base/abnormalities
Skull Base/pathology
Skull Base Neoplasms/pathology
Treatment Outcome
[Pt] Publication type:JOURNAL ARTICLE
[Nm] Name of substance:0 (Biocompatible Materials); 31621-87-1 (Polydioxanone)
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[Js] Journal subset:IM
[Da] Date of entry for processing:170429
[St] Status:MEDLINE
[do] DOI:10.2500/ajra.2017.31.4411

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[PMID]: 29028221
[Au] Autor:Verma V; Simone CB; Mishra MV
[Ad] Address:Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE; Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD.
[Ti] Title:Quality of Life and Patient-Reported Outcomes Following Proton Radiation Therapy: A Systematic Review.
[So] Source:J Natl Cancer Inst;110(4), 2018 Apr 01.
[Is] ISSN:1460-2105
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Background: As costs of cancer care rise, the importance of documenting value in oncology increases. Proton beam radiotherapy (PBT) has the potential to reduce toxicities in cancer patients, but is relatively expensive and unproven. Evaluating quality of life (QOL) and patient-reported outcomes (PROs) is essential to establishing PBT's "value" in oncologic therapy. The goal of this systematic review was to assess QOL and PROs in patients treated with PBT. Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-guided systematic searches were conducted. The PubMed search engine was the primary data source, along with publications found from references of selected articles, and articles known to the authors published through 2017. Seventeen original investigations were found to have sufficient focus and relevance to be incorporated into the systematic review. Results: Studies of skull base (n = 1), brain (n = 1), head/neck (n = 1), lung (n = 1), breast (n = 2), prostate (n = 8), and pediatric (n = 3) malignancies treated with PBT that met eligibility criteria were included. QOL did not deteriorate during PBT for skull base and after PBT for brain tumors, respectively. PROs were higher for PBT than photon-based radiotherapy for both head/neck and lung cancer. Patient-reported breast cosmesis was appropriate after PBT and comparable to photon modalities. PBT in various settings of prostate cancer displayed an expected post-therapy decline; one study showed improved PROs (rectal urgency, bowel frequency) for PBT, and two others showed PROs/QOL comparable with other modalities. Pediatric studies demonstrated improvements in QOL during therapy, with additional increases thereafter. Conclusions: Based on limited data, PBT provides favorable QOL/PRO profiles for select brain, head/neck, lung, and pediatric cancers; measures for prostate and breast cancers were more modest. These results have implications for cost-effective cancer care and prudently designed QOL evaluation in ongoing trials, which are discussed. Future data could substantially change the conclusions of this review.
[Mh] MeSH terms primary: Neoplasms/radiotherapy
Patient Reported Outcome Measures
Proton Therapy
Quality of Life
[Mh] MeSH terms secundary: Brain Neoplasms/radiotherapy
Breast Neoplasms/radiotherapy
Female
Head and Neck Neoplasms/radiotherapy
Humans
Lung Neoplasms/radiotherapy
Male
Prostatic Neoplasms/radiotherapy
Proton Therapy/adverse effects
Skull Base Neoplasms/radiotherapy
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1710
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[Js] Journal subset:IM
[Da] Date of entry for processing:171014
[St] Status:MEDLINE
[do] DOI:10.1093/jnci/djx208

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[PMID]: 29406260
[Au] Autor:Chen MJ; Yang C; Zheng JS; Bai G; Han ZX; Wang YW
[Ad] Address:Professor, Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; and National Clinical Research Center of Stomatology, Shanghai, China.
[Ti] Title:Skull Base Erosion Resulting From Primary Tumors of the Temporomandibular Joint and Skull Base Region: Our Classification and Reconstruction Experience.
[So] Source:J Oral Maxillofac Surg;, 2018 Jan 03.
[Is] ISSN:1531-5053
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE: We sought to introduce our classification and reconstruction protocol for skull base erosions in the temporomandibular joint and skull base region. PATIENTS AND METHODS: Patients with neoplasms in the temporomandibular joint and skull base region treated from January 2006 to March 2017 were reviewed. Skull base erosion was classified into 3 types according to the size of the defect. RESULTS: We included 33 patients, of whom 5 (15.2%) had type I defects (including 3 in whom free fat grafts were placed and 2 in whom deep temporal fascial fat flaps were placed). There were 8 patients (24.2%) with type II defects, all of whom received deep temporal fascial fat flaps. A total of 20 patients (60.6%) had type III defects, including 17 in whom autogenous bone grafts were placed, 1 in whom titanium mesh was placed, and 2 who received total alloplastic joints. The mean follow-up period was 50 months. All of the patients exhibited stable occlusion and good facial symmetry. No recurrence was noted. CONCLUSIONS: Our classification and reconstruction principles allowed reliable morpho-functional skull base reconstruction.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180304
[Lr] Last revision date:180304
[St] Status:Publisher

  4 / 7056 MEDLINE  
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[PMID]: 29490552
[Au] Autor:Lucke-Wold B; Brown EC; Cetas JS; Dogan A; Gupta S; Hullar TE; Smith TL; Ciporen JN
[Ad] Address:School of Medicine, West Virginia University, Morgantown, West Virginia; and.
[Ti] Title:Minimally invasive endoscopic repair of refractory lateral skull base cerebrospinal fluid rhinorrhea: case report and review of the literature.
[So] Source:Neurosurg Focus;44(3):E8, 2018 Mar.
[Is] ISSN:1092-0684
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Cerebrospinal fluid (CSF) leaks occur in approximately 10% of patients undergoing a translabyrinthine, retrosigmoid, or middle fossa approach for vestibular schwannoma resection. Cerebrospinal fluid rhinorrhea also results from trauma, neoplasms, and congenital defects. A high degree of difficulty in repair sometimes requires repetitive microsurgical revisions-a rate of 10% of cases is often cited. This can not only lead to morbidity but is also costly and burdensome to the health care system. In this case-based theoretical analysis, the authors summarize the literature regarding endoscopic endonasal techniques to obliterate the eustachian tube (ET) as well as compare endoscopic endonasal versus open approaches for repair. Given the results of their analysis, they recommend endoscopic endonasal ET obliteration (EEETO) as a first- or second-line technique for the repair of CSF rhinorrhea from a lateral skull base source refractory to spontaneous healing and CSF diversion. They present a case in which EEETO resolved refractory CSF rhinorrhea over a 10-month follow-up after CSF diversions, wound reexploration, revised packing of the ET via a lateral microscopic translabyrinthine approach, and the use of a vascularized flap had failed. They further summarize the literature regarding studies that describe various iterations of EEETO. By its minimally invasive nature, EEETO imposes less morbidity as well as less risk to the patient. It can be readily implemented into algorithms once CSF diversion (for example, lumbar drain) has failed, prior to considering open surgery for repair. Additional studies are warranted to further demonstrate the outcome and cost-saving benefits of EEETO as the data until now have been largely empirical yet very hopeful. The summaries and technical notes described in this paper may serve as a resource for those skull base teams faced with similar challenging and otherwise refractory CSF leaks from a lateral skull base source.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[St] Status:In-Data-Review
[do] DOI:10.3171/2017.12.FOCUS17664

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[PMID]: 29269165
[Au] Autor:Cao KI; Feuvret L; Herman P; Bolle S; Jouffroy T; Goudjil F; Amessis M; Rodriguez J; Dendale R; Calugaru V
[Ad] Address:Protontherapy Centre, institut Curie, 15, rue Georges-Clémenceau, 91400 Orsay, France; Department of Radiation Oncology, institut Curie, 26, rue d'Ulm, 75005 Paris, France. Electronic address: cao.kim@hotmail.fr.
[Ti] Title:Protontherapy of head and neck paragangliomas: A monocentric study.
[So] Source:Cancer Radiother;22(1):31-37, 2018 Feb.
[Is] ISSN:1769-6658
[Cp] Country of publication:France
[La] Language:eng
[Ab] Abstract:PURPOSE: The aim of this study was to assess efficacy and safety of proton beam therapy of paragangliomas of the head and neck, rare benign tumours developed close to crucial structures such as cranial nerves and vascular tissues. PATIENTS AND METHODS: Ten patients with a paraganglioma of the head and neck were treated from 2001 to 2014 with image-guided proton therapy. Neurological and ear nose throat symptoms were collected in addition to audiometric testing, before and after the treatment. Acute and late toxicities were assessed according to the Common Terminology Criteria for Adverse Events (CTCAE) v4. RESULTS: Median age at diagnosis was 52.6years (range: 18.2-65.8years). Proton therapy was the exclusive treatment in six patients and four patients had a postoperative radiotherapy. Median dose was 50.4Gy relative biological effectiveness (RBE; range: 45.0-67.0Gy). With a median follow-up of 24.6months (range: 6.7-46.2 months), local tumour control rate was 100% (stable, n=10). No upper grade 2 acute toxicity was reported. To the latest news, seven patients had controlled symptoms (improved, n=1, stabilized, n=6). One patient out of seven with initial tinnitus had a decrease in his symptoms, while the six other patients had a sustained stabilization. CONCLUSION: Proton beam therapy is an effective and well-tolerated treatment modality of skull base paragangliomas, with documented functional benefit. A longer follow-up is planned in order to assess local control and long-term toxicities.
[Mh] MeSH terms primary: Head and Neck Neoplasms/radiotherapy
Paraganglioma/radiotherapy
Proton Therapy
Radiotherapy, Image-Guided
[Mh] MeSH terms secundary: Adolescent
Adult
Aged
Follow-Up Studies
Humans
Middle Aged
Quality of Life
Retrospective Studies
Tinnitus/etiology
Tinnitus/therapy
Young Adult
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180220
[Lr] Last revision date:180220
[Js] Journal subset:IM
[Da] Date of entry for processing:171223
[St] Status:MEDLINE

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[PMID]: 29454125
[Au] Autor:Priddy BH; Otto BA; Carrau RL; Prevedello DM
[Ad] Address:The Ohio State University, College of Medicine, Columbus, Ohio, USA.
[Ti] Title:Management of Skull Base Tumors in the Obstetric Population: a Case Series.
[So] Source:World Neurosurg;, 2018 Feb 14.
[Is] ISSN:1878-8769
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Neoplasms rarely present during pregnancy. However, increase in plasma volume, hormone release induced growth, and tumor hypervascularity, can cause rapid symptoms. These range from not requiring intervention to necessitating emergent operations. OBJECTIVE: We describe an algorithm for the management of symptomatic neoplasm in the obstetric population, and provide recommendations regarding surgical indications and timing. METHODS: Patients who presented to a skull base clinic from 2010-2016 at large tertiary care hospital were reviewed to identify patients who presented with a skull base tumor during pregnancy. RESULTS: Our cohort comprises ten women with skull base tumors during pregnancy. Four presented symptoms that required emergent skull base surgery, six underwent surgery after delivery or continued surveillance. All patients were found to have WHO Grade I or II meningioma or schwannomas. There were no maternal complications. Through this experience, a management algorithm was created. CONCLUSION: Management of a symptomatic tumor during pregnancy requires balancing the potential to cure the mother and to harm the fetus. Trimester of pregnancy is the most critical factor in evaluating the need for urgent management. Surgery during the second trimester is the optimal time, as it is associated with the least risk for spontaneous abortion or preterm birth. The first and third trimesters are associated with increased risk of miscarriage and preterm labor respectively. Induction of labor for preterm delivery, followed by surgery, may be appropriate in early third trimester. Nonetheless, any pregnant woman with an emergent presentation should be offered surgery, regardless of trimester.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180217
[Lr] Last revision date:180217
[St] Status:Publisher

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[PMID]: 29361006
[Au] Autor:Beccaria K; Tauziède-Espariat A; Monnien F; Adle-Biassette H; Masliah-Planchon J; Pierron G; Maillot L; Polivka M; Laquerrière A; Bouillot-Eimer S; Gimbert E; Gauchotte G; Coffinet L; Sevestre H; Alapetite C; Bolle S; Thompson D; Zérah M; Sainte-Rose C; Puget S; Varlet P
[Ad] Address:Department of Pediatric Neurosurgery, Necker Hospital, APHP, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
[Ti] Title:Pediatric Chordomas: Results of a Multicentric Study of 40 Children and Proposal for a Histopathological Prognostic Grading System and New Therapeutic Strategies.
[So] Source:J Neuropathol Exp Neurol;77(3):207-215, 2018 Mar 01.
[Is] ISSN:1554-6578
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Pediatric chordomas are rare malignant neoplasms, and few data are available for optimizing therapeutic strategies and outcome. This study aimed at evaluating how best to manage them and to identify prognostic factors. This multicentric retrospective study included 40 children diagnosed with chordomas between 1966 and 2012. Clinical, radiological, and histopathological data, treatment modalities, and outcomes were reviewed. The median age was 12 years old. Most chordomas were histologically classical forms (45.5%) and were mostly located at the skull base (72.5%). The overall survival (OS) was 66.6% and 58.6%, and progression-free survival (PFS) was 55.7% and 52% at 5 and 10 years, respectively. Total resection was correlated with a better outcome (p = 0.04 for OS and PFS, log-rank). A histopathological/immunohistochemical grading system recently crafted for adults was applied. In a multivariate analysis, it significantly correlated with outcome (PFS and OS, p = 0.004), and the loss of BAF47 immunoexpression appeared to be a significant independent prognostic factor (PFS, p = 0.033). We also identified clinical and histopathological parameters that correlated with prognosis. A new grading system combined with the quality of surgical resection could help classify patients to postpone radiotherapy in case of low risk. Targeted therapy and reirradiation at recurrence may be considered as potential therapeutic strategies.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180216
[Lr] Last revision date:180216
[St] Status:In-Data-Review
[do] DOI:10.1093/jnen/nlx118

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[PMID]: 29449729
[Au] Autor:Rocca BJ; Gini A; Calandra C; Ginori A; Crivelli F
[Ad] Address:Pathology Unit, ASST Valle Olona, Busto Arsizio, Italy.
[Ti] Title:Parotid metastasis of renal cell carcinoma, mimicking primary clear cell oncocytoma: report of a case and brief review of the literature.
[So] Source:Pathologica;109(4):384-388, 2017 Dec.
[Is] ISSN:0031-2983
[Cp] Country of publication:Italy
[La] Language:eng
[Ab] Abstract:Malignancies of the parotid gland are relatively uncommon, accounting for only 3-6% of all head and neck cancers. Most of them are primary neoplasms, metastases are uncommon. Renal cell carcinoma (RCC) represents 3% of adult malignancies, the clear cell type comprises up to 70% of all RCC. RCC has an unpredictable behavior and the unique potential to metastasize to nearly every organ in the body. Though not as frequent, metastatic RCC to the head and neck has been identified in the thyroid, salivary glands, skull base, sinuses, pharynx, tonsils, tongue, lip and skin. Metastasis to the parotid gland is very rare. Here, we report the case of a clear cell type RCC metastatic to the parotid gland and mimicking a primary clear cell oncocytoma. Differential diagnoses and a brief review of the literature are added.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180216
[Lr] Last revision date:180216
[St] Status:In-Data-Review

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[PMID]: 29390546
[Au] Autor:Wu G; Liang Q; Liu Y
[Ad] Address:Department of Neurosurgery.
[Ti] Title:Primary osteosarcoma of frontal bone: A case report and review of literature.
[So] Source:Medicine (Baltimore);96(51):e9392, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:RATIONALE: Primary osteosarcomas of the skull and skull base are rare, comprising <2% of all skull tumors. Primary osteosarcomas of the skull are aggressive neoplasms composed of spindle cells producing osteoid which have poor outcome. PATIENT CONCERNS: A 33-year-old woman was admitted to our hospital with a major complaint of a growing mass on her left frontal region of the skull for 10 months. Prior to the accurate diagnosis, the mass on her skull was considered to be eosinophilic granuloma. DIAGNOSES: Computerized tomogram (CT) scan of skull revealed a lytic lesion causing destruction of left frontal bone with surrounding soft tissue mass. The histological examination of the lesion showed typical features of osteosarcoma. INTERVENTIONS: The patient received 3 surgeries and adjuvant chemotherapy and radiotherapy for the frontal bone lesion. OUTCOMES: At the last follow-up, after 4 years, the patient was free of disease both clinically and on imaging by magnetic resonance imaging (MRI) scan after 4 years. LESSONS: Because osteosarcoma of skull is a rare disease, the early recognition and correct diagnosis are very important for a better prognosis. It is therefore imperative that clinicians recognize osteosarcoma early to make an accurate diagnosis and complete surgical resection followed by combined chemo-radiation is proved to be one of the most optimal treatment regimens.
[Mh] MeSH terms primary: Frontal Bone/diagnostic imaging
Osteosarcoma/diagnostic imaging
Skull Neoplasms/diagnostic imaging
Tomography, X-Ray Computed
[Mh] MeSH terms secundary: Adult
Female
Frontal Bone/pathology
Humans
Osteosarcoma/pathology
Skull Neoplasms/pathology
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Entry month:1802
[Cu] Class update date: 180214
[Lr] Last revision date:180214
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009392

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[PMID]: 29191538
[Au] Autor:Oushy S; Graffeo CS; Perry A; Morris JM; Carlson ML; Van Gompel JJ
[Ad] Address:Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
[Ti] Title:Collet-Sicard Syndrome Attributable to Extramedullary Plasmacytoma of the Jugular Foramen.
[So] Source:World Neurosurg;110:386-390, 2018 Feb.
[Is] ISSN:1878-8769
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Collet-Sicard syndrome is a rare manifestation of skull base disease involving the jugular and hypoglossal foramina. We report the first case of Collet-Sicard attributable to extramedullary plasmacytoma-multiple myeloma (EP-MM) and the second case of EP-MM precipitating a jugular foramen syndrome (JFS)-spectrum disorder. CASE DESCRIPTION: A 59-year-old woman presented with 4 months of left aural fullness and pulsatile tenderness, positional vertigo, hoarseness, and dysphagia. Examination identified left tongue weakness and nonspecific sensory abnormalities of the ear, pharynx, and throat localizing to cranial nerves IX-XII. Imaging revealed a 3.4 × 1.4 × 2.8 cm lytic lesion extending from the left jugular foramen into the posterior fossa, for which she was referred to neurosurgery and otolaryngology for consideration of resection. A second, much smaller (1.1-cm) lytic lesion in the left posterior occipital bone was incidentally discovered by the surgeon during preoperative consultation. A stereotactic biopsy of the occipital lesion was subsequently recommended, which identified plasma cell neoplasm. Serum studies and skeletal survey were consistent with MM, and a definitive pathologic diagnosis of MM with cranial EP was confirmed by bone marrow biopsy. CONCLUSION: Tumors of the jugular foramen present with a diverse array of lower cranial nerve deficits, including Collet-Sicard syndrome, a rare subset of JFS-spectrum diseases. Paragangliomas are the most common jugular foramen neoplasms, followed by schwannomas and meningiomas; however, many other rare entities have been reported as masqueraders, and diligent work-up with consideration for preliminary biopsy is recommended, particularly in the presence of additional lesions, equivocal imaging findings, or cases arousing high suspicion.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180213
[Lr] Last revision date:180213
[St] Status:In-Data-Review


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