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Efremov KV, Kozlov AV, Tanyashin SV, Kuldashev KA, Zabolotny RV. [Convexity hyperostotic meningioma en plaque: a systematic review]. ZHURNAL VOPROSY NEIROKHIRURGII IMENI N. N. BURDENKO 2024; 88:103-108. [PMID: 38334737 DOI: 10.17116/neiro202488011103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
BACKGROUND Planar hyperostotic meningiomas account for 2-9% of intracranial meningiomas. They are characterized by planar node following the contours of the inner surface of the skull. Hyperostosis is present in most cases. Timely diagnosis of skull base tumors is usually simple due to early involvement of the cranial nerves. However, convexity meningiomas en plaque usually reach large dimensions that complicates surgery and radiotherapy. OBJECTIVE To analyze the current state of diagnosis, molecular biology and surgical treatment of hyperostotic meningiomas en plaque. MATERIAL AND METHODS A systematic review was performed in accordance with the PRISMA guidelines. Searching for literature data included the following keywords: «planar meningioma», «hyperostotic meningioma», «meningioma en plaque», «infiltrative meningioma». We reviewed the PubMed and Google Scholar databases until May 2023 and enrolled only full-text Russian-, English- or French-language reports. RESULTS AND DISCUSSION Among primary 332 reports, 35 references met the inclusion criteria. We found less severity or absence of focal neurological symptoms, comparable incidence of intracranial hypertension and no histological differences between planar and nodular meningiomas. Analysis of molecular biological features of planar meningiomas, including cell cultures, is feasible. There is no consensus regarding surgical treatment and radiotherapy. Most publications are case reports. CONCLUSION The results of treatment of planar hyperostotic meningiomas, especially large and giant ones, are unsatisfactory. There is no a generally accepted algorithm for treating patients in the literature. This problem requires further research.
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Affiliation(s)
- K V Efremov
- Burdenko Neurosurgical Center, Moscow, Russia
| | - A V Kozlov
- Burdenko Neurosurgical Center, Moscow, Russia
- Andijan State Medical Institute, Andijan, Uzbekistan
| | | | - K A Kuldashev
- Andijan State Medical Institute, Andijan, Uzbekistan
| | - R V Zabolotny
- Moscow Multi-field Clinical Center «Kommunarka», Moscow, Russia
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Toader C, Covache-Busuioc RA, Bratu BG, Dumitrascu DI, Serban M, Ciurea AV. Extracranial Meningioma En Plaque With Skull Invasion. Cureus 2023; 15:e50490. [PMID: 38226080 PMCID: PMC10788243 DOI: 10.7759/cureus.50490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2023] [Indexed: 01/17/2024] Open
Abstract
The study reflects on a 69-year-old female patient with a history of cardio-respiratory disorders who was diagnosed with meningioma en plaque. Her clinical management entailed surgical resection of the tumor, which was followed by a complex postoperative course, including cardiorespiratory arrest and respiratory failure. Histologically, extracranial meningiomas are categorized into five subtypes based on predominant cellular morphology, with the meningothelial type being prevalent in this case. The report also examines the significance of complete tumor resection, noting a lower recurrence rate with gross total resection. Additionally, it discusses the increased susceptibility of extracranial meningiomas with advancing age and a higher incidence in females. Data from various studies underscore the importance of a surgical approach and extent of resection in predicting recurrence risk. The case report concludes by highlighting the critical aspects of the pathology of meningiomas and the surgical strategy that ensured the patient's recovery. The findings from this case contribute to the broader understanding of extracranial meningiomas, their diagnosis, and management.
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Affiliation(s)
- Corneliu Toader
- Department of Neurosurgery, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
- Department of Vascular Neurosurgery, National Institute of Neurology and Neurovascular Diseases, Bucharest, ROU
| | | | - Bogdan-Gabriel Bratu
- Department of Neurosurgery, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
| | - David-Ioan Dumitrascu
- Department of Neurosurgery, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
| | - Matei Serban
- Department of Neurosurgery, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
| | - Alexandru Vladimir Ciurea
- Department of Neurosurgery, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
- Department of Neurosurgery, Sanador Clinical Hospital, Bucharest, ROU
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Aoyama S, Nitta N, Moritani S, Tsuji A. Cranial vault lymphoma - A case report and characteristics contributing to a differential diagnosis. Surg Neurol Int 2023; 14:107. [PMID: 37025541 PMCID: PMC10070291 DOI: 10.25259/sni_1040_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 03/11/2023] [Indexed: 04/08/2023] Open
Abstract
Background Lymphomas of the cranial vault are rare and are often misdiagnosed preoperatively as presumptive meningioma with extracranial extension. Case Description A 58-year-old woman was referred and admitted to our department with a rapidly growing subcutaneous mass over the right frontal forehead of 2 months' duration. The mass was approximately 13 cm at its greatest diameter, elevated 3 cm above the contour of the peripheral scalp, and attached to the skull. Neurological examination showed no abnormalities. Skull X-rays and computed tomography showed preserved original skull contour despite the large extra and intracranial tumor components sandwiching the cranial vault. Digital subtraction angiography showed a partial tumor stain with a large avascular area. Our preoperative diagnostic hypothesis was meningioma. We performed a biopsy and histological findings were characteristic of a diffuse large B-cell lymphoma. A very high preoperative level of soluble interleukin-2 receptor (5390 U/mL; received postoperatively) also suggested lymphoma. The patient received chemotherapy but died of disease progression 10 months after the biopsy. Conclusion Several preoperative features of the present case are clues to the correct diagnostic hypothesis of cranial vault diffuse large B-cell lymphoma rather than meningioma, including a rapidly growing subcutaneous scalp mass, poor vascularization, and limited skull destruction relative to the size of the soft-tissue mass.
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Affiliation(s)
- Satoshi Aoyama
- Department of Neurosurgery, Shiga University of Medical Science, Otsu, Japan
| | - Naoki Nitta
- Department of Neurosurgery, Shiga University of Medical Science, Otsu, Japan
- Corresponding author: Naoki Nitta, Department of Neurosurgery, Shiga University of Medical Science, Otsu, Japan.
| | - Suzuko Moritani
- Department of Clinical Laboratory Medicine, Division of Diagnostic Pathology, Shiga University of Medical Science, Otsu, Japan
| | - Atsushi Tsuji
- Department of Neurosurgery, Shiga University of Medical Science, Otsu, Japan
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Montemurro N, Condino S, Carbone M, Cattari N, D’Amato R, Cutolo F, Ferrari V. Brain Tumor and Augmented Reality: New Technologies for the Future. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6347. [PMID: 35627884 PMCID: PMC9141435 DOI: 10.3390/ijerph19106347] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 05/22/2022] [Indexed: 12/26/2022]
Abstract
In recent years, huge progress has been made in the management of brain tumors, due to the availability of imaging devices, which provide fundamental anatomical and pathological information not only for diagnostic purposes [...].
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Affiliation(s)
- Nicola Montemurro
- Department of Neurosurgery, Azienda Ospedaliera Universitaria Pisana (AOUP), University of Pisa, 56100 Pisa, Italy
| | - Sara Condino
- Department of Information Engineering, University of Pisa, 56100 Pisa, Italy; (S.C.); (R.D.); (F.C.); (V.F.)
- EndoCAS Center for Computer-Assisted Surgery, 56100 Pisa, Italy; (M.C.); (N.C.)
| | - Marina Carbone
- EndoCAS Center for Computer-Assisted Surgery, 56100 Pisa, Italy; (M.C.); (N.C.)
| | - Nadia Cattari
- EndoCAS Center for Computer-Assisted Surgery, 56100 Pisa, Italy; (M.C.); (N.C.)
- Department of Translational Research, University of Pisa, 56100 Pisa, Italy
| | - Renzo D’Amato
- Department of Information Engineering, University of Pisa, 56100 Pisa, Italy; (S.C.); (R.D.); (F.C.); (V.F.)
- EndoCAS Center for Computer-Assisted Surgery, 56100 Pisa, Italy; (M.C.); (N.C.)
| | - Fabrizio Cutolo
- Department of Information Engineering, University of Pisa, 56100 Pisa, Italy; (S.C.); (R.D.); (F.C.); (V.F.)
- EndoCAS Center for Computer-Assisted Surgery, 56100 Pisa, Italy; (M.C.); (N.C.)
| | - Vincenzo Ferrari
- Department of Information Engineering, University of Pisa, 56100 Pisa, Italy; (S.C.); (R.D.); (F.C.); (V.F.)
- EndoCAS Center for Computer-Assisted Surgery, 56100 Pisa, Italy; (M.C.); (N.C.)
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Delgado R, Bahmad HF, Bhatia V, Kantrowitz AB, Vincentelli C. Intraosseous meningioma mimicking osteosarcoma. Autops Case Rep 2021; 11:e2021332. [PMID: 34805004 PMCID: PMC8597780 DOI: 10.4322/acr.2021.332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 09/03/2021] [Indexed: 11/23/2022]
Abstract
Background Predominantly intraosseous meningiomas are rare entities that include true primary intraosseous meningiomas (PIM), as well as meningiomas that may show extensive bone involvement, such as en plaque meningiomas. Different hypotheses have been proposed to decipher the origin of PIMs, such as ectopic arachnoid cap cell entrapment during birth or after trauma. Surgical resection is the treatment of choice of such lesions. Case presentation We present a case of a 65-year-old man with an enlarging mass in the parieto-occipital region that grew slowly and progressively over 13 years, following head trauma during a motor vehicle accident. One year prior to presentation, he started experiencing daily holocranial headaches and blurry vision. CT and MRI studies revealed a permeative midline calvarial lesion measuring 14 cm in greatest dimension with extensive periosteal reaction, extension into the subcutaneous soft tissues, subjacent dural thickening and intracranial extension with invasion of the superior sagittal sinus. The favored pre-operative clinical diagnosis was osteosarcoma. The abnormal calvarium was excised and histopathological examination confirmed the diagnosis of a predominantly intraosseous calvarial meningioma, WHO grade I. Conclusions The present case highlights the importance of histopathologic diagnosis in guiding therapeutic decisions and reiterates the necessity of considering PIM or meningiomas with extensive intraosseous component in the differential diagnosis of calvarial masses, even when imaging suggests a neoplasm with aggressive behavior, such as osteosarcoma.
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Affiliation(s)
- Ruben Delgado
- Mount Sinai Medical Center, The Arkadi M. Rywlin M.D. Department of Pathology and Laboratory Medicine, Miami Beach, FL, USA
| | - Hisham F Bahmad
- Mount Sinai Medical Center, The Arkadi M. Rywlin M.D. Department of Pathology and Laboratory Medicine, Miami Beach, FL, USA
| | - Vinay Bhatia
- Mount Sinai Medical Center, Department of Diagnostic Radiology, Miami Beach, FL, USA
| | - Allen B Kantrowitz
- Mount Sinai Medical Center, Division of Neurosurgery, Miami Beach, FL, USA
| | - Cristina Vincentelli
- Mount Sinai Medical Center, The Arkadi M. Rywlin M.D. Department of Pathology and Laboratory Medicine, Miami Beach, FL, USA.,Florida International University, Herbert Wertheim College of Medicine, Miami, FL, USA
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Montemurro N, Condino S, Cattari N, D’Amato R, Ferrari V, Cutolo F. Augmented Reality-Assisted Craniotomy for Parasagittal and Convexity En Plaque Meningiomas and Custom-Made Cranio-Plasty: A Preliminary Laboratory Report. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18199955. [PMID: 34639256 PMCID: PMC8507881 DOI: 10.3390/ijerph18199955] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 09/10/2021] [Accepted: 09/17/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND This report discusses the utility of a wearable augmented reality platform in neurosurgery for parasagittal and convexity en plaque meningiomas with bone flap removal and custom-made cranioplasty. METHODS A real patient with en plaque cranial vault meningioma with diffuse and extensive dural involvement, extracranial extension into the calvarium, and homogeneous contrast enhancement on gadolinium-enhanced T1-weighted MRI, was selected for this case study. A patient-specific manikin was designed starting with the segmentation of the patient's preoperative MRI images to simulate a craniotomy procedure. Surgical planning was performed according to the segmented anatomy, and customized bone flaps were designed accordingly. During the surgical simulation stage, the VOSTARS head-mounted display was used to accurately display the planned craniotomy trajectory over the manikin skull. The precision of the craniotomy was assessed based on the evaluation of previously prepared custom-made bone flaps. RESULTS A bone flap with a radius 0.5 mm smaller than the radius of an ideal craniotomy fitted perfectly over the performed craniotomy, demonstrating an error of less than ±1 mm in the task execution. The results of this laboratory-based experiment suggest that the proposed augmented reality platform helps in simulating convexity en plaque meningioma resection and custom-made cranioplasty, as carefully planned in the preoperative phase. CONCLUSIONS Augmented reality head-mounted displays have the potential to be a useful adjunct in tumor surgical resection, cranial vault lesion craniotomy and also skull base surgery, but more study with large series is needed.
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Affiliation(s)
- Nicola Montemurro
- Department of Neurosurgery, Azienda Ospedaliera Universitaria Pisana (AOUP), University of Pisa, 56100 Pisa, Italy
- Correspondence:
| | - Sara Condino
- Department of Information Engineering, University of Pisa, 56100 Pisa, Italy; (S.C.); (R.D.); (V.F.); (F.C.)
- EndoCAS Center for Computer-Assisted Surgery, 56100 Pisa, Italy;
| | - Nadia Cattari
- EndoCAS Center for Computer-Assisted Surgery, 56100 Pisa, Italy;
- Department of Translational Research, University of Pisa, 56100 Pisa, Italy
| | - Renzo D’Amato
- Department of Information Engineering, University of Pisa, 56100 Pisa, Italy; (S.C.); (R.D.); (V.F.); (F.C.)
- EndoCAS Center for Computer-Assisted Surgery, 56100 Pisa, Italy;
| | - Vincenzo Ferrari
- Department of Information Engineering, University of Pisa, 56100 Pisa, Italy; (S.C.); (R.D.); (V.F.); (F.C.)
- EndoCAS Center for Computer-Assisted Surgery, 56100 Pisa, Italy;
| | - Fabrizio Cutolo
- Department of Information Engineering, University of Pisa, 56100 Pisa, Italy; (S.C.); (R.D.); (V.F.); (F.C.)
- EndoCAS Center for Computer-Assisted Surgery, 56100 Pisa, Italy;
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Elder TA, Yokoi H, Chugh AJ, Lagman C, Wu O, Wright CH, Ray A, Bambakidis N. En Plaque Meningiomas: A Narrative Review. J Neurol Surg B Skull Base 2019; 82:e33-e44. [PMID: 34306915 DOI: 10.1055/s-0039-3402012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 11/03/2019] [Indexed: 10/25/2022] Open
Abstract
Background En plaque meningiomas are a rare subtype of meningiomas that are frequently encountered in the spheno-orbital region. Characterized by a hyperostotic and dural invasive architecture, these tumors present unique diagnostic and treatment considerations. Objective The authors conduct a narrative literature review of clinical reports of en plaque meningiomas to summarize the epidemiology, clinical presentation, diagnostic criteria, and treatment considerations in treating en plaque meningiomas. Additionally, the authors present a case from their own experience to illustrate its complexity and unique features. Methods A literature search was conducted using the MEDLINE database using the following terminology in various combinations: meningioma , meningeal neoplasms, en plaque , skull base , spheno-orbital, and sphenoid wing . Only literature published in English between 1938 and 2018 was reviewed. All case series were specifically reviewed for sufficient data on treatment outcomes, and all literature was analyzed for reports of misdiagnosed cases. Conclusion En plaque meningiomas may present with a variety of symptoms according to their location and degree of bone invasion, requiring a careful diagnostic and treatment approach. While early and aggressive surgical resection is generally accepted as the optimal goal of treatment, these lesions require an individualized approach, with further investigation needed regarding the role of new therapies.
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Affiliation(s)
- Theresa A Elder
- Department of Neurological Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio, United States
| | - Hana Yokoi
- Case Western Reserve University School of Medicine, Cleveland, Ohio, United States
| | - A Jessey Chugh
- Department of Neurological Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio, United States.,Case Western Reserve University School of Medicine, Cleveland, Ohio, United States
| | - Carlito Lagman
- Department of Neurological Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio, United States.,Case Western Reserve University School of Medicine, Cleveland, Ohio, United States
| | - Osmond Wu
- Department of Neurological Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio, United States.,Case Western Reserve University School of Medicine, Cleveland, Ohio, United States
| | - Christina Huang Wright
- Department of Neurological Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio, United States.,Case Western Reserve University School of Medicine, Cleveland, Ohio, United States
| | - Abhishek Ray
- Department of Neurological Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio, United States.,Case Western Reserve University School of Medicine, Cleveland, Ohio, United States
| | - Nicholas Bambakidis
- Department of Neurological Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio, United States.,Case Western Reserve University School of Medicine, Cleveland, Ohio, United States
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Chen CY, Zhong JH, Liu JL. Retrobulbar metastasis and intracranial invasion from postoperative hepatocellular carcinoma: A case report and review of the literature. Oncol Lett 2014; 9:721-726. [PMID: 25624898 PMCID: PMC4301548 DOI: 10.3892/ol.2014.2733] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 11/06/2014] [Indexed: 12/23/2022] Open
Abstract
Hepatocellular carcinoma (HCC) is the most common malignant cancer of the liver and the third ranking cause of cancer-related mortality worldwide. Following the diagnosis of HCC, intrahepatic and extrahepatic metastasis patients account for ~50–75% of all HCC cases, lung and regional lymph nodes metastasis are the most common; metastasis to bone, skin and adrenal glands are rare, orbit metastasis and intracranial invasion are extremely rare. The present study reports the rare case of a patient with HCC that metastasized to the head. The patient presented with retrobulbar and intracranial invasion, and sub-scalp extension. Based on imaging findings, the lesion was initially misdiagnosed as meningioma, however, postoperative pathological examinations resulted in a definitive diagnosis of HCC metastasis. Based on the present case and a review of the relevant literature published since 2009, the current study recommends that metastasis must be considered when diagnosing retrobulbar head lesions in patients with HCC, regardless of contradictory imaging findings and other clinical indicators, which may closely mimic the original head lesion.
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Affiliation(s)
- Chun-Yong Chen
- Department of Neurology, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Jian-Hong Zhong
- Department of Hepatobiliary Surgery, The Affiliated Tumor Hospital, Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Jing-Li Liu
- Department of Neurology, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
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Chen CY, Zhong JH, Liu JL. Retrobulbar metastasis and intracranial invasion from postoperative hepatocellular carcinoma: A case report and review of the literature. Oncol Lett 2014. [PMID: 25624898 DOI: 10.3892/ol] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Hepatocellular carcinoma (HCC) is the most common malignant cancer of the liver and the third ranking cause of cancer-related mortality worldwide. Following the diagnosis of HCC, intrahepatic and extrahepatic metastasis patients account for ~50-75% of all HCC cases, lung and regional lymph nodes metastasis are the most common; metastasis to bone, skin and adrenal glands are rare, orbit metastasis and intracranial invasion are extremely rare. The present study reports the rare case of a patient with HCC that metastasized to the head. The patient presented with retrobulbar and intracranial invasion, and sub-scalp extension. Based on imaging findings, the lesion was initially misdiagnosed as meningioma, however, postoperative pathological examinations resulted in a definitive diagnosis of HCC metastasis. Based on the present case and a review of the relevant literature published since 2009, the current study recommends that metastasis must be considered when diagnosing retrobulbar head lesions in patients with HCC, regardless of contradictory imaging findings and other clinical indicators, which may closely mimic the original head lesion.
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Affiliation(s)
- Chun-Yong Chen
- Department of Neurology, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Jian-Hong Zhong
- Department of Hepatobiliary Surgery, The Affiliated Tumor Hospital, Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Jing-Li Liu
- Department of Neurology, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
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