Intradural Invasion of Chordoma: Two Case Reports

Chordomas are rare tumors of the central nervous system and primarily occur in the extradural space. We report two patients with intracranial chordomas located in the region of the clivus that invaded the prepontine cisterns. The patients, 45 and 62 years old, had histories of cranial neuropathies and headache, respectively. Petrosal approaches were performed in both with radical resection of the tumors. Anatomopathological studies confirmed the diagnosis of chordoma. The symptoms of both patients resolved, and they have had no recurrence after 18 months of follow-up. Intradural chordomas or extradural chordomas that invade the intradural space are difficult to differentiate from ecchordoses physaliphorae, a non-neoplastic entity with similar radiological features. MBI-1 studies were therefore performed to confirm the diagnosis of chordoma. The differential diagnosis for these two entities, the different modalities of treatment, and prognosis are reviewed

CASMIL: a comprehensive software/toolkit for image-guided neurosurgeries This research was supported in part by a research grant from Michigan Life Sciences Corridor (Grant No MEDC-459).

Background CASMIL aims to develop a cost-effective and efficient approach to monitor and predict deformation during surgery, allowing accurate, and real-time intra-operative information to be provided reliably to the surgeon. Method CASMIL is a comprehensive Image-guided Neurosurgery System with extensive novel features. It is an integration of various modules including rigid and non-rigid body co-registration (image-image, image-atlas, and image-patient), automated 3D segmentation, brain shift predictor, knowledge based query tools, intelligent planning , and augmented reality. One of the vital and unique modules is the Intelligent Planning module, which displays the best surgical corridor on the computer screen based on tumor location, captured surgeon knowledge, and predicted brain shift using patient specific Finite Element Model. Also, it has multi-level parallel computing to provide near real-time interaction with iMRI (Intra-operative MRI). In addition, it has been securely web-enabled and optimized for remote web and PDA access. Results A version of this system is being used and tested using real patient data and is expected to be in use in the operating room at the Detroit Medical Center in the first half of 2006. Conclusion CASMIL is currently under development and is targeted for minimally invasive surgeries. With minimal changes to the design, it can be easily extended and made available for other surgical procedures. Copyright © 2006 John Wiley & Sons, Ltd.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/55246/1/87_ftp.pd