Our Experience of Posterior Fossa Tumors Surgeries
DOI:
https://doi.org/10.36552/pjns.v25i4.619Keywords:
Posterior Fossa, Medulloblastoma, EpendymomaAbstract
Objective: In Neurosurgery Unit III, Punjab Institute of Neurosciences, Lahore, we evaluated our posterior fossa tumor surgery results, complications, and surgical outcomes.
Materials and Methods: Between January 2017 and September 2021, 80 patients with posterior fossa tumors who underwent surgical excision at the Neurosurgery Department-III of the Punjab Institute of Neurosciences in Lahore were studied retrospectively. For each patient, the diagnosis was made clinically and confirmed radiologically and histopathologically.
Results: Males comprised 47 percent (37) of the 80 cases, while females made up 53 percent (43). The average age was 15 (with a range of 6 – 30 years). Medulloblastomas were the most frequent pathology in 25 patients (31%), followed by ependymomas in 21 patients (26%), pilocytic astrocytomas in 19 patients (24%), and hemangioblastomas in 7 individuals (8.8%). There were four cases of metastatic brain cancers (5%), two cases of choroid plexus papilloma (2.5%), one case of ganglioglioma (1.3%), and one case of Dermoid cyst (1.3%). In 90 percent of the cases (72 cases), gross total resection was obtained, while subtotal excision was performed in 10% of the cases (8 cases). The best results were seen in pilocytic astrocytoma surgery, followed by ependymoma surgery, whereas the worst results were seen in medulloblastoma surgery.
Conclusion: The surgical treatment of posterior fossa tumors still poses a significant challenge to neurosurgeons. Our experience shows that accepted results, complications, and surgical outcomes can be obtained by meticulous surgical techniques from previous clinical studies.
References
2. Ramanan M, Chaseling R. Paediatric brain tumours treated at a single, tertiary paediatric neurosurgical referral centre from 1999 to 2010 in Australia. J Clin Neurosci. 2012; 19: 1387-91.
3. Witt H, Mack SC, Ryzhova M, Bender S, Sill M, Isserlin R, et al. Delineation of two clinically and molecularly distinct subgroups of posterior fossa ependymoma. Cancer Cell, 2011; 20: 143-57.
4. Mpairamidis E, Alexiou GA, Stefanaki K, Manolakos I, Sfakianos G, Prodromou N. Posterior fossa tumor in a 12 year-old boy. Brain Pathol. 2009; 19: 341-2.
5. MacDonald T. Medulloblastoma. eMedicine; 2009. Available from:
http://emedicine.medscape.com/article/987886-print. [Last Accessed on 2014 Nov 11].
6. Soffietti R, Baumert BG, Bello L, von Deimling A, Duffau H, Frénay M, et al. Guidelines on management of low – grade gliomas: Report of an EFNS-EANO task force. Eur J Neurol. 2010; 17: 1124-33.
7. Stupp R, Brada M, van den Bent MJ, Tonn JC, Pentheroudakis G. ESMO Guidelines Working Group. High-grade glioma: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2014; 25 Suppl. 3: iii 93-101.
8. Wright KD, Gajjar A. Current treatment options for pediatric and adult patients with ependymoma. Curr Treat Options Oncol. 2012; 13: 465-77.
9. Steinbok P, Mangat JS, Kerr JM, Sargent M, Suryaningtyas W, Singhal A, et al. Neurological morbidity of surgical resection of pediatric cerebellar astrocytomas. Childs Nerv Syst. 2013; 29: 1269-75.
10. Kakar J, Ashraf J, Khan AA, Imran M, Rehmani MA, Ghori SA, Ali MF. The satisfactory surgical outcome of posterior fossa brain tumors in children at civil hospital, Karachi. Asian Journal of Neurosurgery, 2020 Apr; 15 (2): 377.
11. Ries LA, Smith MA, Gurney JG, Linet M, Tamra T, Young JL, et al., editors. Cancer Incidence and Survival Among Children and Adolescents: United States SEER Program, 1975 – 1995.
12. Akay KM, Izci Y, Baysefer A, Atabey C, K?smet E, Timurkaynak E. Surgical outcomes of cerebellar tumors in children. Pediatric Neurosurgery, 2004; 40 (5): 220-5.
13. Essa AE, Hamdan AR. Posterior fossa intra-axial tumors: surgical outcomes. The Medical Journal of Cairo University, 2018 Dec. 1; 86 (December): 3433-9.
14. Shih RY, Smirniotopoulos JG. Posterior fossa tumors in adult patients. Neuroimaging Clinics, 2016 Nov. 1; 26 (4): 493-510.
15. Sawaya R, Hammoud M, Schoppa D, Hess KR, Wu SZ, Shi WM, WiIdrick DM. Neurosurgical outcomes in a modern series of 400 craniotomies for treatment of parenchymal tumors. Neurosurgery, 1998 May 1; 42 (5): 1044-55.
16. ESSA AE, HAMDAN AR. Posterior fossa intra-axial tumors: surgical outcomes. The Medical Journal of Cairo University. 2018 Dec. 1; 86 (December):
3433-9.
17. Dubey A, Sung WS, Shaya M, Patwardhan R, Willis B, Smith D, Nanda A. Complications of posterior cranial fossa surgery—an institutional experience of 500 patients. Surgical Neurology, 2009 Oct. 1; 72 (4): 369-75.
Downloads
Published
Issue
Section
License
Copyright (c) 2022 Pakistan Journal Of Neurological Surgery
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The work published by PJNS is licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). Copyrights on any open access article published by Pakistan Journal of Neurological Surgery are retained by the author(s).
