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  1. Article ; Online: A Frontal Route to Middle and Posterior Cranial Fossa: Quantitative Study for the Lateral Transorbital Endoscopic Approach and Comparison with the Subtemporal Approach.

    García-Pérez, Daniel / Abarca, Javier / González-López, Pablo / Nieto, Juan / Lagares, Alfonso / Paredes, Igor

    World neurosurgery

    2022  Volume 167, Page(s) e236–e250

    Abstract: Background: Skull base lesions within the middle cranial fossa (MCF) remain challenging. Recent reports suggest that transorbital endoscopic approaches (TOEAs) might be particularly suitable to access the MCF and expose the lateral wall of the cavernous ...

    Abstract Background: Skull base lesions within the middle cranial fossa (MCF) remain challenging. Recent reports suggest that transorbital endoscopic approaches (TOEAs) might be particularly suitable to access the MCF and expose the lateral wall of the cavernous sinus and the Meckel's cave.
    Methods: The present study was developed to compare the nuances of the subtemporal approach (STA) with those of the lateral TOEA (LTOEA) to the MCF and posterior cranial fossa (PCF) in cadaveric specimens. After orbital craniectomy, interdural opening of the cavernous sinus lateral wall (CSlw), exposure of the Gasserian ganglion, and extradural elevation of the temporal lobe was performed. Next, anterior endoscopic petrosectomy was performed and the PCF was accessed. We quantitatively analyzed and compared the angles of attack and distances between LTOEA and STA to different structures at the CSlw, petrous apex (PA), and PCF.
    Results: Cadaveric dissection through the LTOEA completely exposed the CSlw and PA. LTOA exhibited larger distances than the STA to all targets. Importantly, these differences were greater at the PA and its surrounding key anatomic landmarks. The horizontal and vertical angles of attack allowed by the LTOA were smaller both for the CSlw and PA. However, these differences were not significant for the vertical angle of attack at the CSlw.
    Conclusions: LTOEA provides a direct ventral route to the medial aspect of MCF, PA, and PCF. Although TOEAs are versatile approaches, the unfamiliar surgical anatomy and limited instrument maneuverability demand extensive cadaveric dissection before moving to the clinical setting.
    MeSH term(s) Humans ; Skull Base/surgery ; Skull Base/anatomy & histology ; Cranial Fossa, Posterior/surgery ; Cranial Fossa, Posterior/anatomy & histology ; Endoscopy/methods ; Cranial Fossa, Middle/surgery ; Cranial Fossa, Middle/anatomy & histology ; Cadaver
    Language English
    Publishing date 2022-08-06
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2534351-8
    ISSN 1878-8769 ; 1878-8750
    ISSN (online) 1878-8769
    ISSN 1878-8750
    DOI 10.1016/j.wneu.2022.07.129
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1159: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  2. Article: Treatment of Chordomas and Chondrosarcomas With CyberKnife Robotic Hypofractionated Radiosurgery: A Single Institution Experience.

    Sallabanda, Morena / Garcia, Rafael / Lorenzana, Luis / Santaolalla, Iciar / Abarca, Javier / Sallabanda, Kita

    Cureus

    2021  Volume 13, Issue 8, Page(s) e17012

    Abstract: Introduction The aim of this study is to determine the efficacy and safety of CyberKnife® (Accuray, Inc., Sunnyvale, CA) hypofractionated radiosurgery (HfRS) in the treatment of chordomas and chondrosarcomas. Methods A total of 24 patients ... ...

    Abstract Introduction The aim of this study is to determine the efficacy and safety of CyberKnife® (Accuray, Inc., Sunnyvale, CA) hypofractionated radiosurgery (HfRS) in the treatment of chordomas and chondrosarcomas. Methods A total of 24 patients retrospectively identified with chordomas (19 patients) or chondrosarcomas (five patients) were treated between 2012 and 2019 with HfRS as monotherapy or an adjuvant, rescue, or combination therapy. Tumors were located in the skull base (75%) and vertebral spine (25%). Of these, 19 patients underwent previous partial resection and four patients received previous conventional external beam radiation therapy (EBRT) (60-74 Gy). Exclusive or rescue HfRS (20 patients) was administered in five fractions with a median dose of 37.5 Gy (30-40 Gy). Combined tomotherapy-EBRT treatment (median dose: 54 Gy) and HfRS (16.5-30 Gy in 3-12 fractions) were performed in four patients with bulky chordomas. Results The median follow-up from HfRS was 28 months. During clinical follow-up, no deaths were registered with overall survival (OS) of 100% and the actuarial local recurrence-free survival (LRFS) was 93% at one year, 85% at three years, and 68% at five years. Acute toxicity related to HfRS was present in a single patient. Conclusions It is seen that HfRS is effective and safe for chordomas and chondrosarcomas, with rates of LRFS comparable to other radiation modalities.
    Language English
    Publishing date 2021-08-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.17012
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Conference proceedings: One-bone forearm technique for chronic post-traumatic forearm instability: a case report

    Puig De La Bellacasa, Inma / Quintas, Saioa / Salvador, Jordi / Castillon, Pablo / Abarca, Javier

    2020  , Page(s) IFSSH19–1492

    Event/congress 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT); Berlin; ; International Federation of Societies for Hand Therapy; 2019
    Keywords Medizin, Gesundheit ; one bone forearm ; longitudinal instability ; lateral elbow pain
    Publishing date 2020-02-06
    Publisher German Medical Science GMS Publishing House; Düsseldorf
    Document type Conference proceedings
    DOI 10.3205/19ifssh0078
    Database German Medical Science

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  4. Article ; Online: A Very Rare Case of Right Insular Lobe Langerhans Cell Histiocytosis (CD1a

    Bärtschi, Patrick / Luna, Enrique / González-López, Pablo / Abarca, Javier / Herrero, Joaquín / Costa, Estela / Paya, Artemio / Sales, Juan / Moreno, Pedro

    World neurosurgery

    2018  Volume 121, Page(s) 4–11

    Abstract: Background: Langerhans cell histiocytosis (LCH) is a multisystemic dendritic cell proliferation that is relatively uncommon in adults. Central nervous system LCH outside the pituitary gland is even more uncommon.: Case description: We report the case ...

    Abstract Background: Langerhans cell histiocytosis (LCH) is a multisystemic dendritic cell proliferation that is relatively uncommon in adults. Central nervous system LCH outside the pituitary gland is even more uncommon.
    Case description: We report the case of a 42-year-old man who had complained of right-side hemicranial pain and left arm minor paresis. The symptoms were due to a right insular lobe heterogeneous-enhancing lesion associated with extensive vasogenic edema. The first diagnostic impression suggested glioblastoma multiforme or localized metastasis. The thoracic, abdominal, pelvic computed tomography scan only detected small upper lung inactive nodules suggesting silent focal LCH. A very hard lesion was almost completely removed through a pterional craniotomy approach, with no fluorescence after aminolevulinic acid infusion. The intraoperative biopsy findings ruled out glioma but could not confirm lymphoma. The definitive cerebral biopsy findings showed lymphocytes and histiocytes (CD1a
    Conclusions: The present case is so rare it should not be used as a guide. We probably will never see a single intraparenchymal supratentorial central nervous system LCH lesion. However, we hope our report will help colleagues in the future with the thought process.
    MeSH term(s) Adult ; Antigens, CD1/metabolism ; Brain Neoplasms/diagnostic imaging ; Brain Neoplasms/physiopathology ; Brain Neoplasms/secondary ; Cerebral Cortex/diagnostic imaging ; Cerebral Cortex/pathology ; Glioblastoma/diagnostic imaging ; Glioblastoma/secondary ; Glioblastoma/surgery ; Histiocytosis, Langerhans-Cell/complications ; Histiocytosis, Langerhans-Cell/diagnostic imaging ; Histiocytosis, Langerhans-Cell/pathology ; Histiocytosis, Langerhans-Cell/surgery ; Humans ; Lung/diagnostic imaging ; Lung Neoplasms/diagnostic imaging ; Lung Neoplasms/physiopathology ; Lung Neoplasms/surgery ; Magnetic Resonance Imaging ; Male ; Tomography Scanners, X-Ray Computed
    Chemical Substances Antigens, CD1 ; CD1a antigen
    Language English
    Publishing date 2018-09-24
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 2534351-8
    ISSN 1878-8769 ; 1878-8750
    ISSN (online) 1878-8769
    ISSN 1878-8750
    DOI 10.1016/j.wneu.2018.09.093
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1159: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  5. Article ; Online: Proposal of a clinically relevant working classification of pituitary neuroendocrine tumors based on pituitary transcription factors.

    Silva-Ortega, Sandra / García-Martinez, Araceli / Niveiro de Jaime, María / Torregrosa, María Eugenia / Abarca, Javier / Monjas, Irene / Picó Alfonso, Antonio / Aranda López, Ignacio

    Human pathology

    2020  Volume 110, Page(s) 20–30

    Abstract: The immunohistochemistry (IHC) characterization of pituitary transcription factors (PTFs) PIT1, TPIT, and SF1, which enable the identification of three different adenohypophyseal cell lines, has been incorporated into the latest classification system of ... ...

    Abstract The immunohistochemistry (IHC) characterization of pituitary transcription factors (PTFs) PIT1, TPIT, and SF1, which enable the identification of three different adenohypophyseal cell lines, has been incorporated into the latest classification system of the World Health Organization (WHO) for pituitary adenomas. This change overturns the concept of the adenoma as solely a hormone producer and classifies these tumors based on their cell lineage. The aim of the study was to provide a diagnostic algorithm, based on IHC expression of hypophyseal hormones with potential use in diagnostic practice, contributing to an improved classification of pituitary adenomas. Our sample included 146 pituitary adenomas previously classified based on hormonal subtypes by IHC (former 2004 WHO criteria) and re-evaluated after the IHC quantification of PIT1, TPIT, and SF1 expression, under WHO 2017 recommendations. We assessed the correlation between expression of PTFs and the classification as per hormonal IHC and correlated clinicopathological profiles based on PTFs. The IHC study of PTFs allowed reclassification of 82% of tumors that were negative for all pituitary hormones, with 21 positive cases for SF1 (reclassified as gonadotroph tumors), 1 positive case for TPIT (reclassified as a corticotroph tumor), and 4 positive cases for PIT1. Using SF1 enabled detection of a substantial portion of gonadotroph tumors, reducing the estimated prevalence of null cell tumors to less than 5%, and identification of plurihormonal pituitary neuroendocrine tumors with PIT1-SF1 coexpression and hormone-negative PIT1s, a group in which we did not observe differences in the clinical behavior compared with the rest of the tumors of the same cell lineage.Our results suggest that applying a diagnostic algorithm based on the study of PTFs could contribute to improving the classification of pituitary adenomas. By adding TPIT assessment, we propose a two-step algorithm, with hypophyseal hormones being used in a selective modality, depending on initial results.
    MeSH term(s) Adenoma/metabolism ; Adenoma/pathology ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biomarkers, Tumor/metabolism ; Cell Lineage/physiology ; Female ; Humans ; Immunohistochemistry/methods ; Male ; Middle Aged ; Neuroendocrine Tumors/classification ; Neuroendocrine Tumors/pathology ; Pituitary Neoplasms/classification ; Pituitary Neoplasms/pathology ; Transcription Factors/metabolism ; Young Adult
    Chemical Substances Biomarkers, Tumor ; Transcription Factors
    Language English
    Publishing date 2020-12-13
    Publishing country United States
    Document type Journal Article
    ZDB-ID 207657-3
    ISSN 1532-8392 ; 0046-8177
    ISSN (online) 1532-8392
    ISSN 0046-8177
    DOI 10.1016/j.humpath.2020.12.001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 722: Show issues Location:
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    ab Jg. 2022: Lesesaal (EG)

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