1/2. neck pain: common complaint, uncommon diagnosis--symptomatic clival chordoma.patients presenting with neck complaints, such as pain or stiffness, are not uncommon in the Emergency Department. Complaints of neck instability, however, are unusual. We report the case of a 30-year-old woman who presented with multiple neck complaints that included having a "wobbly" sensation of her neck on flexion, feeling as if it were unstable. Our patient indeed had atlanto-occipital instability secondary to a locally destructive tumor of the cranial base, known as a clival chordoma. Chordomas are rare and unique bony tumors that arise along the neural axis and are thought to originate from the nucleus pulposus. The tumors are slow growing; locally invasive; and cause a variety of neurologic, musculoskeletal, cranial, and neck complaints. We describe this unique case and its presentations in an attempt to increase the sensitivity of physicians in early detection of this rare and lethal tumor.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/2. Schwannomas limited to the infratemporal fossa: report of two cases.Schwannomas limited to the infratemporal fossa are rare lesions that may also involve the maxillary sinus, the orbit and the retropharyngeal space. We present two cases of schwannoma arising from the extradural divisions of the trigeminal nerve, with corresponding areas of sensory loss. Both patients had been operated for spinal canal schwannomas previously. Complete tumor removal was accomplished in both cases. The schwannoma of the maxillary division was excised using an orbitozygomatic extradural approach. The schwannoma of the mandibular division was excised using a subtemporal-infratemporal approach. trigeminal nerve function was preserved and complete recovery of function was achieved in each patient. Identification of an infratemporal schwannoma should alert the physician to consider the diagnosis of neurofibromatosis. The literature regarding schwannomas limited to the infratemporal fossa is reviewed.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |