CLINICAL AND SURGICAL CHARACTERISTICS OF POSTERIOR FOSSA TUMORS IN ADULTS - SINGLE-CENTER EXPERIENCE OF SURGICAL MANAGEMENT/KLINICKE I KIRURSKE ZNACAJKE TUMORA STRAZNJE LUBANJSKE JAME U ODRASLIH -INSTITUCIJSKO ISKUSTVO KIRURSKOG LIJECENJA

• Published in: Acta clinica Croatica (Tisak) Vol. 62; no. 3; p. 502
• Main Authors: Jankovic, Dragan, Ahmetspahic, Adi, Splavski, Bruno, Schmidt, Leon, Rotim, Kresimir, Tomasovic, Sanja, Arnautovic, Kenan
• Format: Journal Article
• Language: English
• Published: Klinicki bolnicki centar Sestre milosrdnice 01.09.2023
• Subjects: Brain tumors; Care and treatment; Diagnosis; Patient outcomes; Croatia
• ISSN: 0353-9466; 1333-9451
• DOI: 10.20471/acc.2023.62.03.12

In contrast to tumors in children, between 6% and 20% of all brain tumors in adults arise solitary in the posterior cranial fossa. Given their rarity in adults, as well as the importance and complexity of their treatment, this paper reviews and discusses the clinical and surgical characteristics of such tumors. In a retrospective single-institution observational study, adult patients with posterior fossa tumors treated surgically over a ten-year period were analyzed. The characteristics observed were age and gender distribution, clinical symptoms, histopathologic tumor type, tumor size, location and extent of surgical resection, tumor recurrence and postoperative complications, as well as surgical outcome. Sixty-six patients who underwent surgical treatment were diagnosed with a tumor in the posterior fossa. The mean age was 63 years, and patients were evenly distributed by gender. The most common histopathologic type was metastatic tumor (59.1%), whereas meningioma was the most common primary brain tumor (16.6%) recorded. Most patients presented with vegetative and cerebellar symptoms in general and cranial nerve palsy, especially in the occurrence of vestibular schwannoma. In conclusion, posterior fossa tumors grow in a confined space and therefore may directly threaten vital centers in their immediate vicinity. Thus, it is crucial to schedule an appropriate surgical intervention as soon as possible, as it can significantly improve treatment outcome and prognosis of the disease. If possible, meticulous total tumor resection should be the treatment of choice. In the case of hydrocephalus, a ventriculoperitoneal shunt should be considered as an alternative surgical option after tumor resection. Key words: Cranial fossa, posterior; Outcome; Surgical management; Symptoms; Tumor, infratentorial Za razliku od tumora u djece, samo 6% do 20% svih tumora mozga u odraslih nastaje u straznjoj lubanjskoj jami. S obzirom na njihovu rijetkost, ali i slozenost i vaznost lijecenja tumora straznje lubanjske jame u odraslih, ovdje raspravljamo i osvrcemo se na klinicke i kirurske znacajke takvih tumora. U opservacijskoj retrospektivnoj studiji analizirani su odrasli bolesnici s tumorom straznje jame koji su kirurski lijeceni tijekom desetogodisnjeg razdoblja. Ispitivane su znacajke bile dob i spolna distribucija, histopatoloski tip tumora te klinicki simptomi, velicina tumora, lokacija i opseg kirurske resekcije, recidiv tumora i poslijeoperacijske komplikacije te uspjesnost kirurskog lijecenja. Tumor straznje jame dijagnosticiran je u 66 bolesnika koji su podvrgnuti kirurskom lijecenju. Prosjecna dob bila je 63 godine, a bolesnici su bili ravnomjerno rasporedeni prema spolu. Najcesci histopatoloski tip bio je metastatski tumor (59,1%), dok je meningiom bio najcesci primarni tumor mozga (16,6%). Vecina bolesnika imala je vegetativne i cerebelarne simptome te ispad vestibularnog zivca u slucaju vestibularnog svanoma. U zakljucku, buduci da tumori straznje jame rastu u ogranicenom prostoru i stoga mogu izravno ugroziti vitalne centre smjestene u njihovoj neposrednoj blizini, kljucno je sto prije zapoceti s odgovarajucim kirurskim lijecenjem, sto moze znacajno poboljsati uspjesnost lijecenja i prognozu bolesti. Ako je moguce, precizna i potpuna resekcija tumora treba biti metoda izbora u kirurskom lijecenju. U slucaju hidrocefalusa, ventrikuloperitonejska likvorska drenaza moze biti alternativa u nadopuni tumorske resekcije. Kljucne rijeci: Kirursko lijecenje; Lubanjska jama, strainja; Simptomi; Tumor, infratentorijski; Uspjesnost lijecenja