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Schroeder JA, Sabawi M, Masaadeh AH, Eschbacher KL, Shekhrajka N, Duarte ML, Freitas LF. Acquired intradiploic epidermoid cyst: A rare case report with literature review. J Neuropathol Exp Neurol 2024:nlae106. [PMID: 39394733 DOI: 10.1093/jnen/nlae106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2024] Open
Affiliation(s)
- Jacob A Schroeder
- Division of Neuroradiology, Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
| | - Mohammed Sabawi
- Division of Neuroradiology, Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
| | - Amr H Masaadeh
- Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
| | - Kathryn L Eschbacher
- Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
| | - Nitesh Shekhrajka
- Division of Neuroradiology, Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
| | - Márcio Luís Duarte
- Department of Radiology, Universidade de Ribeirão Preto-Campus Guarujá, Guarujá, São Paulo, Brazil
- Department of Radiology, Diagnósticos da América S.A., São Paulo, SP, Brazil
| | - Leonardo Furtado Freitas
- Division of Neuroradiology, Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
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2
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Yufeng Z, Xiaoqing J, Lulu X, Pei H, Shengwu L, Zhongsheng L. Giant epidermoid cyst penetrating the skull: a case report and literature review. Br J Neurosurg 2023; 37:1693-1698. [PMID: 34320894 DOI: 10.1080/02688697.2021.1950635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 06/28/2021] [Indexed: 10/20/2022]
Abstract
Intracranial epidermoid cyst is a rare pseudotumor of the nervous system, accounting for 0.2%-1.8% of all intracranial tumors. It is usually located in the cerebellopontine Angle or parasellar area, with insipid onset, slow growth and usually less than 2 cm in diameter. Giant epidermoid cysts that invade the bone have rarely been reported in the literature. Herein, we report a case of giant ECs extradural to the parietal bone, penetrating the skull and continuing to expand outward. In addition, a systematic search of four authoritative databases was conducted to collect the relevant reports of giant epidermoid cyst with diameter > 5cm for the first time, and to discuss the clinical and radiographic features of patients with giant epidermoid cyst and the influence of treatment options.
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Affiliation(s)
- Zhu Yufeng
- Department of Graduate School, Qinghai University, Xining, China
| | - Jin Xiaoqing
- Department of neurosurgery, Qinghai Provincial People's Hospital, Xining, China
| | - Xu Lulu
- Department of Geriatric Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Han Pei
- Department of neurosurgery, Qinghai Provincial People's Hospital, Xining, China
| | - Lin Shengwu
- Department of Graduate School, Qinghai University, Xining, China
| | - Lu Zhongsheng
- Department of neurosurgery, Qinghai Provincial People's Hospital, Xining, China
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3
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Zhang X, Zhan A, He D, Wei Z, Pan Y, Li X. Epidermoid cyst in atypical intracranial areas transformed to epidermoid carcinoma: a case report. J Int Med Res 2023; 51:3000605221148146. [PMID: 36624959 PMCID: PMC9834806 DOI: 10.1177/03000605221148146] [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] [Indexed: 01/11/2023] Open
Abstract
Intracranial epidermoid cysts, also known as epidermal cysts, grow slowly and may be occult. When small, epidermoid cysts are usually clinically unremarkable or cause no definitive symptoms. At typical sites, they are easily found through magnetic resonance imaging, which aids evaluation before surgery. However, in rare cases, epidermoid cysts are situated in unusual locations or transformed to malignancy, and preoperative misdiagnosis is possible. Here, the case of a 58-year-old male patient who presented with weakness in the left lower limb and was diagnosed with a malignant epidermoid cyst in the right frontoparietal lobe, right lateral ventricle, is reported. Surgery was performed to remove the tumour followed by radiotherapy, and the patient was reported to be living independently after approximately 11 months of follow-up.
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Affiliation(s)
- Xiaoli Zhang
- Department of Neurosurgery,
People’s Hospital of Leshan, Leshan, China
| | - Ao Zhan
- Department of Neurosurgery,
People’s Hospital of Leshan, Leshan, China
| | - Deping He
- Department of Pathology, People’s
Hospital of Leshan, Leshan, China
| | - Zhenghong Wei
- Department of Neurosurgery,
People’s Hospital of Leshan, Leshan, China
| | - Yawen Pan
- Department of Neurosurgery, Lanzhou
University Second Hospital, Lanzhou, China
| | - Xinlong Li
- Department of Neurosurgery, Lanzhou
University Second Hospital, Lanzhou, China,Xinlong Li, Department of Neurosurgery,
Lanzhou University Second Hospital, 82 Cuiyingmen, Lanzhou, Gansu 730030, China.
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Mliyh L, Di Perri D, Onofrj V. Intracranial squamous cell carcinoma of the cerebello-pontine angle mimicking a cystic acoustic schwannoma. A case report with discussion of differential diagnosis and review of literature. Radiol Case Rep 2022; 18:753-756. [PMID: 36582755 PMCID: PMC9792751 DOI: 10.1016/j.radcr.2022.11.048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/10/2022] [Accepted: 11/16/2022] [Indexed: 12/23/2022] Open
Abstract
We report a case of a primary intracranial squamous cell carcinoma (SCC) of the cerebello-pontine angle extending through the internal auditory canal, with the unusual presentation of a completely cystic lesion with no diffusion restriction, internal necrotic-hemorrhagic changes and peripheral enhancement, mimicking a cystic acoustic schwannoma. The lack of diffusion restriction and the peripheral enhancement along the lesion, 2 unique findings, supposedly reflected complete cancerization of the epidermoid cyst from which the SCC originated. We discuss the differential diagnosis and review the literature on primary intracranial SCC.
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Affiliation(s)
- Lina Mliyh
- Department of Radiology, Cliniques universitaires Saint-Luc, Avenue Hyppocrate 10, 1200 Bruxelles, Belgium
| | - Dario Di Perri
- Department of Radiotherapy, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - Valeria Onofrj
- Department of Radiology, Cliniques universitaires Saint-Luc, Avenue Hyppocrate 10, 1200 Bruxelles, Belgium,Corresponding author.
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Gabay S, Serafimova M, Raz M, Roth J. Concurrent occurrence of squamous cell carcinoma in a cerebellopontine angle epidermoid cyst: A case report and review of the literature. Surg Neurol Int 2022; 13:500. [DOI: 10.25259/sni_726_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 10/13/2022] [Indexed: 11/04/2022] Open
Abstract
Background:
Intracranial epidermoid cysts are rare benign lesions. Cases of malignant transformation (MT) into squamous cell carcinoma (SCC) have rarely been reported. We present a case of concurrent occurrence of SCC diagnosed during primary resection of epidermoid cyst (EC) and a relevant literature review.
Case Description:
A 61-year-old patient was diagnosed with a right cerebellopontine angle (CPA) lesion after suffering from vertigo, diplopia, and right trigeminal (V2) hypoesthesia. Brain magnetic resonance imaging (MRI) showed a lesion consistent with an EC, demonstrating restricted diffusion with rim-enhancing area on the medial side of the cyst. During resection, two different tissue pathologies were observed, one consistent with an epidermoid (which was completely removed) and an additional firm tissue adherent to the brainstem, preventing gross total resection. Pathological evaluation confirmed two separate histologies – epidermoid and SCC. The patient never recurred to complete the recommended radiotherapy. Eleven months following surgical resection, a follow-up MRI showed local massive recurrence of the enhancing lesion. He was, further, treated with radiotherapy and is currently being followed up.
Conclusion:
MT of an intracranial EC to SCC is rare and associated with poor prognosis. SCC may be found incidentally at time of primary resection or arise from a remnant of previously operated EC. Thus, aggressive complete resection should be intended, and separate pathological specimens should be sent from any abnormal region of the tumor.
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Affiliation(s)
- Segev Gabay
- Department of Neurosurgery, Tel Aviv Medical Center, Dana Children’s Hospital, Tel Aviv, Israel
| | - Marga Serafimova
- Department of Neurosurgery, Tel Aviv Medical Center, Dana Children’s Hospital, Tel Aviv, Israel
| | - Michal Raz
- Department of Pathology, Tel Aviv Medical Center, Dana Children’s Hospital, Tel Aviv, Israel
| | - Jonathan Roth
- Departments of Neurosurgery and Pediatric Neurosurgery, Dana Children’s Hospital, Tel Aviv, Israel
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Horcajadas Almansa A, Jorques Infante AM, Chamorro Santos CE, Román Cutillas AM. Brain lymphoma development related to a long lasting epidermoid cyst. NEUROCIRUGIA (ENGLISH EDITION) 2022; 33:204-208. [PMID: 35256326 DOI: 10.1016/j.neucie.2022.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/10/2021] [Accepted: 02/12/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Epidermoid cysts (EC) are benign and slow growing lesions. A primary brain lymphoma development related to a EC is presented, second case described in literature. CASE PRESENTATION A woman 40 years old, harbouring a EC for more than 20 years, develops a fast growing brain lesion next to the EC. Surgery was performed and diagnosis was primary diffuse B cells lymphoma. DISCUSSION Malignant transformation of EC has been described, usually to squamous cells carcinoma, and much less frequently, to another tumours. Inflammatory mechanisms have been advocated to explain this evolution. Chronic inflammation and lymphoma genesis are related, and this could be the mechanism behind this rare evolution of an EC. CONCLUSIONS Even being benign lesions, EC can develop malignant tumours due to the chronic inflammation secondary to them.
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Zuo P, Sun T, Wang Y, Geng Y, Zhang P, Wu Z, Zhang J, Zhang L. Primary Squamous Cell Carcinomas Arising in Intracranial Epidermoid Cysts: A Series of Nine Cases and Systematic Review. Front Oncol 2021; 11:750899. [PMID: 34765553 PMCID: PMC8576414 DOI: 10.3389/fonc.2021.750899] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 09/30/2021] [Indexed: 11/26/2022] Open
Abstract
Objective Primary squamous cell carcinomas (PSCCs) arising in intracranial epidermoid cysts (IECs) are very rare, and their management and prognostic factors remain unclear. This study aimed to enunciate the clinical features and suggest a treatment protocol based on cases from the literature and the cases from our institution. Methods The clinicoradiological data were obtained from nine patients with PSCCs arising in IECs, who underwent surgical treatment at Beijing Tiantan Hospital between July 2012 and June 2018. We also searched the PubMed database using the keywords “epidermoid cyst(s)” or “epidermoid tumor(s)” combined with “malignant” or “malignancy” or “intracranial” or “brain” or “squamous cell carcinoma” between 1960 and 2020. Risk factors for overall survival (OS) were evaluated in the pooled cohort. Results The mean age of our cohort was 51.2 ± 8.3 years (range: 39–61 years), which included eight males and one female. Gross total resection (GTR) was achieved in three patients, while non-GTR was achieved in six patients. Radiotherapy was administered to five patients. After a median follow-up of 16.7 ± 21.6 months (range: 3–72 months), eight patients died with a mean OS time of 9.75 ± 6.6 months (range: 3–23 months). In the literature between 1965 and 2020, 45 cases of PSCCs arising in IECs were identified in 23 males and 22 females with a mean age of 55.2 ± 12.4 years. GTR, non-GTR, and biopsy were achieved in six (13.3%), 36 (80%), and three (6.7%) cases, respectively. After a mean follow-up of 12.7 ± 13.4 months (range: 0.33–60 months), 54.1% (20/37) patients died, and recurrence occurred in 53.6% (15/28) patients. A multivariate analysis demonstrated that postoperative radiotherapy (p = 0.002) was the only factor that favored OS. The Kaplan–Meier analysis showed that, compared with no radiotherapy (median survival time: 4 months), radiotherapy (median survival time: 24 months) had significantly prolonged OS (p = 0.0011), and GTR could not improve OS (p = 0.5826), compared with non-GTR. The 1-year OS of patients with or without radiotherapy was 72.5% or 18.2%, respectively. Conclusion Malignant transformation of IEC into PSCC was prevalent in elderly patients, with slight male predominance. GTR of previous benign IECs is recommended. For remnant benign IECs, close follow-up should be performed. Postoperative radiotherapy for PSCCs could bring survival benefit. GTR of these malignant intracranial tumors is difficult when they involve important brain structures. Future studies with larger cohorts are necessary to verify our findings.
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Affiliation(s)
- Pengcheng Zuo
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Tao Sun
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yi Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yibo Geng
- Department of Neurosurgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Peng Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhen Wu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Junting Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Liwei Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Beijing Key Laboratory of Brain Tumor, Beijing, China
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Kozák J, Šurkala J, Novotný M, Švajdler M. Hemorrhagic Epidermoid Cyst in Cerebellar Vermis: Case Report and Review of the Literature. J Neurol Surg Rep 2021; 82:e6-e10. [PMID: 33816050 PMCID: PMC8013783 DOI: 10.1055/s-0041-1726286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 10/28/2020] [Indexed: 11/05/2022] Open
Abstract
Intracranial epidermoid cysts are slow growing congenital avascular neoplasms that spread across the basal surface of the brain. They most commonly occur in the paramedial region in the cerebellopontine angle and the parasellar region. Despite its generally benign nature, sporadically they can be accompanied with hemorrhage or very rarely undergo malignant transformation. The authors present a case report of a patient with a hemorrhagic vermian epidermoid cyst and a review of all published similar cases.
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Affiliation(s)
- Ján Kozák
- Department of Neurosurgery, Faculty of Medicine Comenius University and University Hospital Bratislava, Slovakia
| | - Jozef Šurkala
- Department of Neurosurgery, Faculty of Medicine Comenius University and University Hospital Bratislava, Slovakia
| | - Martin Novotný
- Department of Neurosurgery, Faculty of Medicine Comenius University and University Hospital Bratislava, Slovakia
| | - Marián Švajdler
- Biopticka Laborator s.r.o., Pilsen, Czech Republic.,Šikl's Department of Pathology, Charles University, Faculty of Medicine and Faculty Hospital in Pilsen, Pilsen, Czech Republic
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Horcajadas Almansa A, Jorques Infante AM, Chamorro Santos CE, Román Cutillas AM. Brain lymphoma development related to a long lasting epidermoid cyst. Neurocirugia (Astur) 2021; 33:S1130-1473(21)00028-2. [PMID: 33745844 DOI: 10.1016/j.neucir.2021.02.003] [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: 10/30/2020] [Revised: 01/10/2021] [Accepted: 02/12/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Epidermoid cysts (EC) are benign and slow growing lesions. A primary brain lymphoma development related to a EC is presented, second case described in literature. CASE PRESENTATION A woman 40 years old, harbouring a EC for more than 20 years, develops a fast growing brain lesion next to the EC. Surgery was performed and diagnosis was primary diffuse B cells lymphoma. DISCUSSION Malignant transformation of EC has been described, usually to squamous cells carcinoma, and much less frequently, to another tumours. Inflammatory mechanisms have been advocated to explain this evolution. Chronic inflammation and lymphoma genesis are related, and this could be the mechanism behind this rare evolution of an EC. CONCLUSIONS Even being benign lesions, EC can develop malignant tumours due to the chronic inflammation secondary to them.
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10
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Yanagawa N, Nishiya M, Sato Y, Sugimoto R, Osakabe M, Uesugi N, Beppu T, Ogasawara K, Sugai T. Undifferentiated carcinoma arising from intracranial epidermoid cyst. Pathol Int 2021; 71:281-283. [PMID: 33559277 DOI: 10.1111/pin.13071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 01/04/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Naoki Yanagawa
- Departments of Molecular Diagnostic Pathology, Iwate Medical University, Iwate, Japan
| | - Masao Nishiya
- Departments of Molecular Diagnostic Pathology, Iwate Medical University, Iwate, Japan
| | - Yuichi Sato
- Departments of Neurosurgery, Iwate Medical University, Iwate, Japan
| | - Ryo Sugimoto
- Departments of Molecular Diagnostic Pathology, Iwate Medical University, Iwate, Japan
| | - Mitsumasa Osakabe
- Departments of Molecular Diagnostic Pathology, Iwate Medical University, Iwate, Japan
| | - Noriyuki Uesugi
- Departments of Molecular Diagnostic Pathology, Iwate Medical University, Iwate, Japan
| | - Takaaki Beppu
- Departments of Neurosurgery, Iwate Medical University, Iwate, Japan
| | | | - Tamotsu Sugai
- Departments of Molecular Diagnostic Pathology, Iwate Medical University, Iwate, Japan
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Surgery and dose-escalated radiotherapy for a de novo intracranial squamous cell carcinoma of the cerebellopontine angle. Clin Transl Radiat Oncol 2021; 27:99-102. [PMID: 33553696 PMCID: PMC7851331 DOI: 10.1016/j.ctro.2021.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 01/20/2021] [Accepted: 01/21/2021] [Indexed: 11/20/2022] Open
Abstract
We report an extremely rare case of de novo intracranial squamous cell carcinoma of the cerebellopontine angle. The patient underwent craniotomy for debulking of the lesion to relieve mass effect on the brainstem and to establish a tissue diagnosis. Cancer staging revealed no other primary cancers and no evidence of metastatic disease. Postoperatively, he received image-guided intensity-modulated radiotherapy to the tumor bed followed by fractionated radiosurgery boost to the gross residual disease for a total average dose of 7000 cGy. He had a complete response to radiation and remains 42-months' disease-free post-treatment.
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Pisano P, Lombardi F, Bongetta D, La Rocca G, Della Pepa GM, Zoia C. Primary Intracranial Squamous Cell Carcinoma with a Fatal Course. Asian J Neurosurg 2020; 15:722-725. [PMID: 33145239 PMCID: PMC7591225 DOI: 10.4103/ajns.ajns_148_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 04/16/2020] [Accepted: 05/21/2020] [Indexed: 11/13/2022] Open
Abstract
Intracranial squamous cell carcinomas (SCCs) are extremely rare. They can be primary or represent a degeneration of an epidermoid cyst (EC). We report the case of a patient operated, with an endoscopic transnasal approach, for a primary intracranial SCC. The optimal management for patients with primary intracranial SCC or ECs which have undergone malignant degeneration has yet to be identified.
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Affiliation(s)
- Patrizia Pisano
- Department of Surgical Sciences, Neurosurgery Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Francesco Lombardi
- Department of Surgical Sciences, Neurosurgery Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Daniele Bongetta
- Department of Neurosurgery, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Giuseppe La Rocca
- Institute of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University, Rome, Italy
| | - Giuseppe Maria Della Pepa
- Institute of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University, Rome, Italy
| | - Cesare Zoia
- Department of Surgical Sciences, Neurosurgery Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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