We performed a Medline database search The
We performed a Medline database search. The keywords “gliosarcoma”, “skull base”, and “ventricle” were queried individually and also in association. The included limits were “English” for the language category. The date of the latest search was March 2013. There were only five cases of skull lysophosphatidic acid involvement and only four cases of ventricular involvement in the English literature. Moreover, the simultaneous involvement of the skull base and the ventricles has not been previously reported in the English literature. We reviewed age, sex, race, location, treatment, recurrence-free and survival time, and immunohistochemical studies in these cases (Table 1). In the six cases of skull base involvement group (including our patient), the patients comprised four men and two women with a median age of 61.8 years (range 51–82 years). The locations were all in the right temporal region. The median recurrence-free time was 6.6 months (range 1.5–12 months) after the initial treatment, and the survival time ranged from 7 months to 22 months after the initial treatment. In the ventricular involvement group (including our patient; Table 1), there were five patients consisting of four men and one woman with a median age of 51.2 years (range 25–82 years). The tumor(s) were all located in the lateral ventricles: three on the right side, one on the left side, and one on both sides. After the initial treatment, the recurrence-free time ranged from 1.5 months to 2 months, and the survival time ranged from 0.33 months to 9.2 months.
The median actuarial survival is 11.5 months for gliosarcoma patients, 11.0 months for the control group of GBM, and 8.1 months for the entire GBM group. The median survival for the gliosarcoma group does not differ significantly from that of the control GBM group (p = 0.36) or of the entire GBM group (p = 0.16). Median survival for gliosarcoma patients ranges from 6.25 months to 8.75 months with radiation therapy. Sade et al reported a patient with gliosarcoma with infratemporal fossa extension, having completed radiotherapy and chemotherapy, who was recurrence-free at the 12-month follow-up evaluation. Schuss et al reported an unusual case of gliosarcoma that involved the temporal skull base and the dura, having extensive multimodality treatment (partial resection, radiotherapy and chemotherapy with temozolomide, imatinib, hydroxycarbamide, bevacizumab, irinotecan). Their report demonstrated that extensive multimodality treatment might be effective in patients with gliosarcomas who have poor prognostic factors, for example, unmethylated MGMT status (12 months of recurrence-free and 22 months of survival time; Table 2). However, in our case, the patient was subsequently treated with fractionated whole-brain radiation, followed by 5 days of temozolomide. The tumor recurred 1.5 months after his initial treatment, and his survival time was 9.2 months. An analysis of the predominant components of the tumor and whether there is ventricular invasion might be helpful to us for prediction of the prognosis. Gliosarcoma with ventricular involvement might be a poor prognostic factor. However, because of the small number of cases in the literature, this needs to be determined in the future.
Introduction Iatrogenic ureteral injury is a rare but severe complication of lumbar disc surgery. Historically, only 16 such cases have been reported. Although minimal invasive transforaminal lumbar interbody fusion (TLIF) is a modern approach and a good choice for lumbar spondylolisthesis, it does carry a certain surgical risk and can cause complications. Among the serious complications of minimal invasive TLIF is retroperitoneal ureteral injury. The management of such injury includes a ureteral stent, open ureteroureterostomy, hand-assisted laparoscopic ureteroureterostomy, renal autotransplantation, ileal ureteral reposition, and nephrectomy. We hereby report a new approach for the repair of such ureteral injury after lumbar disc surgery.