Solitary neurofibromas arising from cranial nerves are rare, and those arising from the peripheral divisions of the trigeminal nerve are even rarer. Although infratemporal fossa (ITF) masses are challenging to remove, certain approaches are considered feasible for this region. The present study reports a rare case of an ITF neurofibroma arising from the inferior alveolar nerve. The 27-year-old male patient presented with numbness of the right jaw. A radiological examination revealed a large mass occupying the ITF, from the mandible to the foramen ovale, originating from the inferior alveolar nerve in the mandible. The tumor was successfully excised via a transtemporal approach followed by a transoral-retromolar approach. A histological examination confirmed the diagnosis of neurofibroma. The present case demonstrates that a combination of the transtemporal and transoral-retromolar approaches may provide wide access to the ITF region.

Background Data: Intradural lumbar cystic schwannomas are very rare entity and only about 10 case reports have been reported in the literature. The diagnosis and management remains a challenge for clinical physicians. Purpose: Our objective in presenting this particular case is to highlight the atypical radiological features of intradural spinal schwannoma and how to deal with it surgically and follow up. Study Design: case report. Material and Methods: A case of cystic intradural lesion in a previously healthy 29 years old male is reported. Low back pain and lately right sciatica were the only symptoms. After pre-operative evaluation and preparation, this patient was operated on prone position under general anesthesia. Results: Although the lesion originates from nerve tissue, only 50% of cases have a direct relation with the nerve. Hence complete excision without sacrificing nerve roots is usually feasible and is curative in most cases as in our case. The patient recovered totally intact without any motor, sensory or sphincteric disturbance. The postoperative histological picture of cystic schwannoma, which was not in the preoperative list of differential diagnoses, is discussed. Conclusion: A successful surgical outcome depends on early diagnosis [before neurological damage has occurred], meticulous investigation [on any intractable nonspecific low back pain], and complete excision. (2014ESJ066)

Background Data: Aneurysmal bone cysts (ABCs) of the spine account for 12 to 30% of all ABC cases. They mostly occur in the lumbar vertebrae, followed by the thoracic, cervical, and sacral vertebrae. Despite being benign, they can be locally expansive and destructive, and can result in pathological fractures of the vertebrae and neurological complications. Treatment modalities include surgical resection, radiotherapy, and embolization with reconstruction. Purpose: To report on a rare case of very large aneurysmal bone cyst originating from the body and the posterior arch of L3 vertebrae and extending from the paraspinal sub-cutaneous tissue posteriorly to the anterior abdominal wall anteriorly and pushing the kidney up and explaining the way of management of such cases. Study Design: Case report and review of literature. Patient and Methods: An 18years old female patient presented with back pain, right lower limb numbness and partial foot drop together with a big abdominal mass. A thorough general and neurological examination proceeded by proper history taking including family history and previous trauma were done. Radiological workup was done in the form of plain X-ray, CT scan, and MRI. Total excision and reconstruction was performed under general anesthesia through a posterior only approach. Results: Post operatively the patient recovered nicely without any neurological deficits within 2 weeks. Post operative CT showed total excision, adequate reconstruction and trans-pedicular screw fixation. This patient was followed up clinically for 8 months till now with very good neurological condition. Conclusion: Proper diagnosis and adequate surgical techniques are mandatory for proper surgical excision of such a very big ABC especially if highly vascular. (2014ESJ083)