Melanotic neuroectodermal tumor of infancy arising in the skull: a case report.

Melanotic neuroectodermal tumor of infancy is a rare and usually benign neoplasm occurring in children of young age. This pigmented tumor typically presents in the head and neck region, but other locations may be involved. We report in this article a rare case of a 3-month-old girl presenting with a slowly growing mass localized in the anterior fontanelle. The patient's magnetic resonance imaging (MRI) showed a mass extending both extracranial and intracranial, and compressing the adjacent structures. The patient underwent subtotal resection of the mass and a histological study confirmed the diagnosis of melanotic neuroectodermal tumor of infancy. The patient presented later on with a recurrence. An early diagnosis and surgical management for these tumors remain the only guarantees to limit the progression and prevent their recurrence and metastasis.

Deep Frontal Lipoma With Frontal Bone Invasion: Report of a Rare Case.

Lipomas are benign masses of fatty tissue, and in the forehead, they may develop in the subcutaneous or deep fat tissue. While subcutaneous lipomas are common, deep forehead lipomas are unusual and rarely invade the underlying bone. Only a few cases have been reported in the literature, and even fewer cases are reported in children. We present a case of a slowly growing frontal mass corresponding to a deep lipoma responsible for frontal bone invasion, resulting in a bony defect reaching the dural space. Through this case, we aim to emphasize forehead lipomas' clinical and surgical characteristics.

Pediatric Hydatid Cyst of the Neck Mimicking a Cystic Tumor: A Report of a Rare Case.

Hydatidosis is a parasitic infection caused by the cestode Echinococcus granulosus usually occurring in the liver and lungs. Hydatid cyst of the neck is a rarely described location and more so on the back of the neck. We present a case of a six-year-old girl with a slowly evolving mass on the back of her neck. Medical investigations revealed a secondary asymptomatic liver cyst. MRI of the neck mass was consistent with a cystic lesion. Surgical removal of the neck cyst was performed. Pathological examination results confirmed the diagnosis of hydatid cyst. The patient was put on medical treatment with a complete recovery and uneventful follow-up.

Peri-orbital Masson's tumor: a case report and literature review.

Masson tumor is a benign vascular lesion characterized by an intravascular papillary endothelial hyperplasia. Peri orbital locations are rare. We report a case of Masson tumor localized in the upper internal angle of the left orbit revealed by progressive ocular proptosis. Orbital computed tomography (CT) scan and magnetic resonance imaging (MRI) showed a vascular mass in the left internal canthus mimicking an arterioveinous malformation. The patient underwent total removal of the lesion with a favorable postoperative follow up. Histological examination found an intravascular papillary endothelial hyperplasia without atypical features corresponding to Masson tumor. A thorough literature review of Masson tumor is presented with a discussion of clinical findings and management.

Management of Central Nervous System Cavernomas: An Experience of the Department of Neurosurgery at the Ibn Tofail Hospital, Mohammed VI University Hospital.

INTRODUCTION: Central nervous system cavernomas are congenital vascular anomalies posing a challenge not only in their diagnosis but also in their therapeutic management. The latter depends largely on their natural evolution and specifically their hemorrhagic potential. MATERIAL AND METHODS: This paper reports the experience of the Department of Neurosurgery at the Ibn Tofail Hospital, Mohammed VI University Hospital at Marrakech in the management of central nervous system cavernomas from January 2011 to December 2018. We collected and analyzed epidemiological, clinical, radiological, therapeutic, and evolution data from 16 cases of central nervous cavernomas using a pre-established sheet.  Results: Sixteen cases of cavernomas were treated in a period of eight years; 14 patients had cerebral cavernomas and two had brainstem cavernomas. The sex ratio was 1.66 with a male predominance, and the mean age of our patients was 42 years. The clinical presentation was dominated by epileptic seizures. Cerebral MRI was performed on all our patients. In all 16 cases, the cavernomas were solitary with the majority being supra-tentorial (13 cases) and bleeding was apparent on imaging in one case. Microsurgery was performed in 13 cases, while three patients benefited from stereotactic radiosurgery. Complete resection was obtained in all patients and pathology examination showed a radio-histological correlation in 87.5% of cases. The overall evolution in operated patients was favorably marked by neurological improvement in 87.5% of cases, deterioration in 6.2% of cases, and no clinical improvement in 6.2% of the cases. CONCLUSION: Early diagnosis coupled with macroscopically complete resection and long-term follow-up with MRI are all crucial steps to ensure the proper management of central nervous cavernomas, especially considering their risk of recurrence.

Surgical Technique and Review of Management of Frontoethmoidal Encephalocoele - A Case Report.

THE RATIONALE: Encephalocoele is a herniation of the brain formed during embryonic development, because of the incomplete closure of Neural Tube. It is a rare skull defect and most cases are located in the occipital bone. Frontal encephalocoeles are very rare and they may involve the ethmoid bone, nasal bones and/or the orbits. Surgical repair is complex and usually requires a multidisciplinary approach. PATIENT CONCERNS: We present a case of a 6-month-old baby girl with a congenital frontoethmoidal encephalocoele. DIAGNOSIS: The diagnosis was made by computed tomography scan that showed a defect on the frontoethmoidal zone. TREATMENT: Cranial approach was employed using standard bicoronal access. The malformation was removed and the defect was repaired by using an autologous parietal bone graft, without any complication in the follow-up. OUTCOMES AND TAKE-AWAY LESSONS: The goal of the surgery is to reconstruct the normal anatomy, to achieve a good cosmetic repair, and to avoid a cerebrospinal fluid leak. A description of the case and the surgical technique is presented with a review of literature.

Total Removal of a Giant Frontal Sinus Osteoma with Orbital Extension - A Case Report.

The Rationale: Osteomas are benign tumours that are usually asymptomatic. However, giant osteomas can lead to severe complications. We report here the management of a giant frontal sinus osteoma with orbital extension. Patient Concerns: We present the case of a 17-year-old patient presenting with rapidly progressive isolated right exophthalmos. Diagnosis: A cerebral computed tomography scan was performed and showed a giant osteoma of the right frontal sinus extending to the orbit and massively eroding the anterior wall of the frontal sinus. Treatment and Outcomes: The patient underwent surgery and a complete removal of the osteoma was accomplished via an open approach, but without performing a bone flap. No recurrence was observed after 2 years of follow-up. Take-away Lessons: Although rare, giant frontal osteomas can cause severe functional impairment due to their proximity to noble structures. Therefore, open approach remains the mainstay of therapy.

The surgery of intra-orbital hydatid cyst: a case report and literature review.

Intra-orbital hydatid cyst is a very rare pathological entity that affects children and the young adults; it is secondary to the development in the orbit of the echinococcus granulosis tapeworm. Its frequency does not exceed 1% of all cases of hydatid disease. Clinical presentation of intra-orbital hydatid cyst is dominated by proptosis and a decrease in visual acuity, complete surgical excision is difficult, evolution is generally better when the treatment is early before the installation of irreversible optic atrophy. We report one case of a 3 years old girl operated for right intra-orbital hydatid cyst who presented with proptosis and blindness. Complete removal was difficult and puncture of the cyst was performed followed by excision of its membrane with good post-operative results. We also discuss the different epidemiological, clinical, radiological and therapeutic aspects of intra-orbital hydatid cyst and a review of literature of this rare pathology.