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김승민(Seong-Min Kim),정승영(Seung-Young Chung),정성삼(Sung-Sam Jung),박문선(Moon-Sun Park) 대한두개저학회 2006 대한두개저학회지 Vol.1 No.2
Intraparenchymal cavernous hemangioma(CH) of central nervous system(CNS) was already well known to us, but the intradural and extra-axial CH was not and very rare. This case summarizes our surgical experience intradural-extramedullary CH on foramen magnum. A 44-year-old man complained occipital headache. Magnetic resonance imaging(MRI) showed a 15mm sized well enhancing mass that slightly displaced the medulla to the right side. An angiogram showed tumor staining with feeding artery from left posterior cerebellar artery(PICA). Our diagnosis with imaging studies was extra-axial tumor including meningioma, hemangiopericytoma. A suboccipital craniectomy and C1 laminectomy were performed. An encapsulated, highly vasculized mass was visualized and removed. Mass was purely extra-axial and pathological evaluation demonstrated a CH. So this case of CH reminds the neurosurgical community to consider CH in the differential diagnosis for extra-axial mass on foramen magnum.
내시경을 이용하여 경접형동 접근술로 치료한 여포 자극 호르몬 분비 뇌하수체 샘종
정종철(Jong Chul Chung),김승민(Seong Min Kim),정성삼(Sung Sam Jung),정승영(Seung Young Chung),김병준(Byung Joon Kim) 대한두개저학회 2007 대한두개저학회지 Vol.2 No.2
Follicle-stimulating hormone-secreting pituitary adenomas are rarley diagnosed and likely considered as a non-functioning pituitary tumor. Because they usually do not present until of sufficient size to cause neurologic deficits by mass effect or hypopituitarism, whereas other functioning tumors - acromegaly, prolactinoma, Cushing s disease - frequently present earlier with symptoms caused by physiologic effects of excess hormones that they secrete. 62-year-old man suffered from visual disturbance. Endocrinologic evaluation showed high serum FSH level. Suprasellar extended pituitary mass with compression to optic chiasm & cavernous sinus was imaged on MRI and removed by endoscope assisted endonasal transsphenoidal surgery. It was composed of gonadotroph showed strong immunohistochemical reactivity against FSH and LH. Uncommon pituitary tumors such as FSH-secreting adenomas can be defined early and accurately through correlation between their clinical, endocrionological, radiographic and immunohistochemical characteristics.
뇌하수체 거대선종으로 오인된 안장가로막 뇌수막종과 뇌하수체 선종 1례
오정태(Jung Tae Oh),정승영(Seung Young Chung),김승민(Seong Min Kim),박문선(Moon Sun Park),정성삼(Sung Sam Jung),박기석(Ki Suk Park) 대한두개저학회 2009 대한두개저학회지 Vol.4 No.1
The coexistence of a pituitary adenoma and another intracranial tumor is an uncommon finding. We report a rare case of diaphragm sellae meningioma and pituitary adenoma mimicking pituitary macroadenoma in a 41-year-old woman. The patient presented with bitemporal hemianopsia and was pregnant. Magnetic resonance imaging demonstrated a bright, homogeneously enhancing intra- and suprasellar mass, which was interpreted as a pituitary macroadenoma. Transsphenoidal extirpation was used on 1st operation and Orbitozygomatic craniotomy(transcavernous approach) was done on 2nd operarion because of a suspicion of nonsecreting pituitary macroadenoma. Histopathologically, the tumor was diagnosed as a pituitary adnoma and a meningothelial meningioma. Common carotid angiography before the second surgery revealed that the mass was supplied by the left opthalmic artery. The tumor was near-totally removed via a transcranial route, and she had lost her left vision after a second surgical procedure. It is difficult to make a differential diagnosis between nonsecreting pituitary macroadenomas with suprasellar extension and diaphragma sellae meningiomas preoperatively from the viewpoint of neuroimaging. Preoperative differentiation is essential, because the transsphenoidal approach is used for surgical removal of adenomas, while meningiomas are approached via a craniotomy.
손희언(Hee Eon Son),정승영(Seung young Chung),김승민(Seong Min Kim),박문선(Moon Sun Park) 대한두개저학회 2008 대한두개저학회지 Vol.3 No.2
Clival pseudomeningocele is an extremly rare lesion. A 21-year-old man with headache was found to have a clival pseudomeningocele. At first, this lesion was misunderstood to clival chordoma or chondrosarcoma, due to Magnetic resonance imaging (MRI) and 3-dimensional computerized tomography(CT) finding. At operation, by a extended transsphenoidal approach, clival pseudomeningocele was diagnosed grossly, and confirmed by pathologic finding. This is the first case of clival pseudomeningocele in an adult, congenitally. Clival pseudomeningocele should be taken into consideration in patient with clival chordoma or chondrosarcoma
임상 : 전방 두개저부 병변에 대한 두개 안면 접근법; 합병증
김근식 ( Geun Sik Kim ),김승민 ( Seong Min Kim ),정승영 ( Seung Young Chung ),정성삼 ( Sung Sam Jeong ),박문선 ( Moon Sun Park ),하호균 ( Ho Gyun Ha ),김한규 ( Han Kyu Kim ) 대한뇌종양학회 2005 대한뇌종양학회지 Vol.4 No.2
Objective£ºThe purpose of this study is to describe the commom complications of craniofacial approaches to lesion on anterior skull base and some technical refinements to prevent the complications. Methods£ºAuthors reviewed medical records and radiological findings of 21 operations(including 2 reoperations) of 19 patients having anterior skull base tumors treated by craniofacial approaches from 1998 to 2004 . Results£ºTwenty-one operations showed several complications. Those were cerebrospinal fluid leakage(3), meningitis(1), anosmia(3), epidural hematoma(1), pneumocephalus(1). Cerebrospinal fluid leakage was treated by lumbar drainage. Meningitis was treated by lumbar drainage and appropriate antibiotics. Epidural hematoma and pneumocephalus were resolved spontaneously. The complication of transfrontal and transnasomaxillary approach was none. The complications of transfrontal nasal approach were anosmia(1) and epidural hematoma(1). Cerebrospinal fluid leakage(3), meningitis(1), anosmia(2), and pneumocephalus(1) arose in the transfrontal nasal-orbital approach. Conclusion£ºMotality and morbidity of craniofacial approach is relative low. Water-tight duroplasty, strong reconstrucion of anterior skull base and lumbar drainage are important for prevention of cerebrospinal leakage. We think that the lesion of anterior skull base is safely performed by appropriate craniofacial approach and reconstruction.
안장호(Jang Ho Ahn),이도성(Do Seong Lee),박기석(Ki Suk Park),정승영(Seung Young Chung),박문선(Moon Sun Park),김승민(Seong Min Kim) 대한두개저학회 2016 대한두개저학회지 Vol.11 No.2
Chondroblastoma is a rare, benign primary bone tumor that typically develops the epiphyses of long bones. Chondroblastoma of the skull is very rare and it had been reported that the most cases of the skull occurred in the squamous portion of the temporal bone. We reported the very rare case of chondroblastoma of the sphenoid sinus presenting right sided optic neuropathy that was treated with endoscopic surgery, followed by open craniotomy and tumor removal.
김상용(Sang Yong Kim),김승민(Seong Mim Kim),김한규(Han Kyu Kim),박문선(Moon Sun Park),정승영(Seong Young Chung),정성삼(Sung Sam Jung),박기석(Ki Suk Park) 대한두개저학회 2010 대한두개저학회지 Vol.5 No.1
Epidermoid tumor rarely arises within the cavernous sinus and produce clinical symptoms. This 21-year old man presents with 6-year history of headache, diplopia, and ptosis. An evaluation revealed a mass located in the right cavernous sinus and he underwent gamma knife radiosurgery. But the symptoms did not improved, and there was slight increase in size of mass in follow-up evaluation. So, he underwent operation, the tumor was near-totally removed after surgery, and histologic finding revealed an epidermoid tumor. The patient was discharged with no newly developed neurologic deficits. In later three years follow-up, there was no evidence of recurrence. Magnetic resonance imaging, especially diffusion-weighted image, is a valuable tool in diagnosis of intracerebral epidermoid tumors. Radiotherapy is known to be ineffective for epidermoid tumors. Surgical removal should be attempted, but a less aggressive surgical strategy should be considered if there is strong adherence between the tumor capsule and the brain parenchyme particularly in eloquent areas. Regular long term follow-up is necessary for evaluation of recurrence.