title: Transforaminal Resection of Cervical Dumbbell Schwannomas in Patients with Additional Tumors.
abstract: BACKGROUND
  It is rare for 2 primary tumors to occur simultaneously in a patient. Management of cervical dumbbell schwannomas (CDSs) with concurrent tumors (CTs) requires a specific neurosurgical strategy. The primary objective of this study is to investigate surgical strategies for CDSs with CTs while preserving as much of the mechanically relevant bone structures as possible.
  
  
  METHODS
  Twelve patients with concurrent CTs and CDSs were identified from 3 medical centers. Surgical strategies for CDSs were based on accurate preoperative images and subsequent treatment considerations for CTs. All patients received surgical treatment for CDSs and CTs. Clinical features, surgical considerations for a transforaminal approach (TA), and ultimate outcome were studied retrospectively.
  
  
  RESULTS
  Gross total resection of CDSs was achieved with endoscopic and microscopic assistance in 9 cases, and subtotal resection was achieved in 3 cases after the head and neck surgeons exposed and removed the extraforaminal anatomy. One patient required an additional hemilaminectomy for the resection of the intraspinal segment. After wound healing, patients were transferred to the appropriate surgical department for surgery on CTs with cervical spine stabilization after a transforaminal approach.
  
  
  CONCLUSIONS
  In most patients, the stability of the cervical spine can be preserved with low invasive microsurgical or endoscopic transforaminal resection. CTs could be surgically treated sequentially after microscopic- and endoscopic-assisted resection of CDSs.
authors.affiliation: Department of Neurosurgery, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
authors.forename: Ji
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
authors.forename: Xiang-Heng
authors.initials: XH
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
authors.forename: Zi-Feng
authors.initials: ZF
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
authors.forename: You-Ping
authors.initials: YP
authors.lastname: Li
authors.affiliation: Department of Neurosurgery, Tumor Hospital Affiliated of Xinjiang Medical University, Xinshi District, URUMQI, Xinjiang, China.
authors.forename: Zheng-Quan
authors.initials: ZQ
authors.lastname: Zhu
authors.affiliation: Department of Neurosurgery, Liao Ning Tie Fa Coal Group Hospital, Diao Bing Shan City, Tie Ling City, Liao Ning, China.
authors.forename: Ji-Cheng
authors.initials: JC
authors.lastname: Sun
authors.affiliation: Department of Neurosurgery, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
authors.forename: Zheng-He
authors.initials: ZH
authors.lastname: Chen
authors.affiliation: Department of Neurosurgery, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
authors.forename: Shao-Yong
authors.initials: SY
authors.lastname: Wu
authors.affiliation: Department of Neurosurgery, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
authors.forename: Ke
authors.initials: K
authors.lastname: Sai
authors.affiliation: Department of Neurosurgery, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
authors.forename: Yong-Gao
authors.initials: YG
authors.lastname: Mou
authors.affiliation: Department of Neurosurgery, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China. Electronic address: chenzhp@sysucc.org.cn.
authors.forename: Zhong-Ping
authors.initials: ZP
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000601:surgery; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D021621:Imaging, Three-Dimensional; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000000981:diagnostic imaging / Q000601:surgery*; D009442:Neurilemmoma / Q000000981:diagnostic imaging / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D013120:Spinal Cord Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult
keywords: Cervical dumbbell schwannoma; Concurrent tumors; Endoscopy; Transforaminal approach