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Abstract: BACKGROUND: An exophytic tumor is defined as a tumor
that has its epicenter in the nervous tissue but grows
outside the anatomical superficial boundaries of the brain
within an adjacent space. Exophytic extension of hemispheric
gliomas is extremely rare. The object of this study is
to describe the exophytic growth pattern of insular gliomas.
- METHODS: A series of 28 insular gliomas operated on
consecutively were analyzed. The definition of exophytic
glioma included these 2 criteria: 1) preoperative magnetic
resonance imaging with evidence of exophytic local tumor
extension outside the anatomical superficial boundaries of
the brain; and 2) surgical identification of piamater and
arachnoid invasion, with tumor growth to the adjacent
- RESULTS: A series of 6 exophytic gliomas (21.4%) are
reported, among a series of 28 consecutive insular gliomas
operated. The exophytic component originated from the
posterior portion of the basal frontal lobe, with extension to
the sphenoidal compartment of the sylvian cistern, reaching
the temporal pole. All exophytic tumors were type 5A in
Yasargil classification. The histologic diagnosis was World
Health Organization grade II glioma in 3 cases and anaplastic
glioma in 3 cases. All patients underwent surgery, and the
exophytic component was removed completely.
- CONCLUSIONS: Radiologic features that define the
exophytic growth pattern in insular gliomas are the posterior
displacement of the middle cerebral artery and a sharp
subarachnoid margin that separates the exophytic tumor
from the temporal pole. Contrary to the tumor that infiltrates
the anterior perforating substance, the exophytic tumor is
amenable for safe and complete resection.
Fuente: World Neurosurg. (2016) 87:200-206
Año de publicación: 2016
Nº de páginas: 7
Tipo de publicación: Artículo de Revista
CARLOS JOSE VELASQUEZ RODRIGUEZ
HUGO DANIEL CABALLERO ARZAPALO
ALFONSO VAZQUEZ BARQUERO
RIAL, JUAN C.
MARIA DEL CARMEN CARCEDO BARRIO
JUAN MARTINO GONZALEZ