PMC3985359_01
Illustrative case - Patient 1-An 11-year-old girl presented in our outpatient clinic with history of an expansible mass and local pain at the dorsal portion of her neck for the last 4 months (a and b) Computed tomography (CT) scan three-dimensional reconstruction was compatible with an expansible lesion in the craniocervical junction. (c and d) CT scan was compatible with an intrinsic, expansible bone lesion, with multiple cysts, in the posterior aspect of the atlas. (e and f) CT scan showing the bone erosion of the posterior aspect of the atlas
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F1
A CT scan was compatible with an intrinsic bone lesion, with multiple cysts, in the posterior aspect of the atlas [Figure 1].
Illustrative case - Patient 1-Intraoperative illustrations. (a) Aneurysmal bone cyst of the atlas. (b) Initial resection with the exposure of the arterial feeders. (c) Final aspect after total resection
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F2
Using a head holder, the patient was positioned prone and a midline incision with a transverse extension directed to the posterior aspect of the left mastoid was performed [Figure 2e].
Illustrative case - Patient 2-A 28-year-old man presented at the emergency room with an important headache, somnolence, and nausea. Concomitantly, he complained of a mass growing in the back of his head for the last 6 months and reported having had a severe head injury 1 year prior to admission. (a and b) Computed tomography (CT) scan compatible with a posterior expansible lesion on the left side of his posterior fossa. (c and d) Magnetic resonance imaging T1-weighted with contrast compatible with an expansible bone tumor, with cystic walls, filled with blood vascularized. (e) Patient position. (f-h) Intraoperative illustrations with total resection (i and j) Postoperative CT scan showing total resection
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F3
A CT scan was compatible with an important hydrocephalus and a posterior expansible lesion on the left side of his posterior fossa [Figures 3a and b]. MRI disclosed an expansible bone tumor, with cystic walls, filled with blood and extremely vascularized [Figure 3c and d]. A subperiosteal dissection was then performed, exposing the tumor limits [Figure 3f and g]. The bony parts of the tumor were then resected piecemeal, drilling the residual intact bone edges until total tumor resection was evident [Figure 3h]. There was no recurrence after 7 months of follow-up [Figure 3i and j].
PMC3985359_02
Illustrative case - Patient 1-Intraoperative illustrations. (a) Aneurysmal bone cyst of the atlas. (b) Initial resection with the exposure of the arterial feeders. (c) Final aspect after total resection
JNRP-5-55-g002.jpg
PMC3985359_02_JNRP-5-55-g002.jpg
F2
Using a head holder, the patient was positioned prone and a midline incision with a transverse extension directed to the posterior aspect of the left mastoid was performed [Figure 2e].
Illustrative case - Patient 2-A 28-year-old man presented at the emergency room with an important headache, somnolence, and nausea. Concomitantly, he complained of a mass growing in the back of his head for the last 6 months and reported having had a severe head injury 1 year prior to admission. (a and b) Computed tomography (CT) scan compatible with a posterior expansible lesion on the left side of his posterior fossa. (c and d) Magnetic resonance imaging T1-weighted with contrast compatible with an expansible bone tumor, with cystic walls, filled with blood vascularized. (e) Patient position. (f-h) Intraoperative illustrations with total resection (i and j) Postoperative CT scan showing total resection
JNRP-5-55-g003.jpg
PMC3985359_02_JNRP-5-55-g003.jpg
F3
A CT scan was compatible with an important hydrocephalus and a posterior expansible lesion on the left side of his posterior fossa [Figures 3a and b]. MRI disclosed an expansible bone tumor, with cystic walls, filled with blood and extremely vascularized [Figure 3c and d]. A subperiosteal dissection was then performed, exposing the tumor limits [Figure 3f and g]. The bony parts of the tumor were then resected piecemeal, drilling the residual intact bone edges until total tumor resection was evident [Figure 3h]. There was no recurrence after 7 months of follow-up [Figure 3i and j].