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Antonakakis et al: Use of a telovelar approach for complete resection of a choroid plexus tumor in a dog
Veterinary Surgery 8, 2022

🔍 Key Findings

  • Telovelar approach enabled complete resection of a fourth ventricle choroid plexus tumor in a dog without postoperative complications.
  • Postoperative MRI confirmed gross total tumor removal, and the dog remained neurologically normal 28 months post-surgery.
  • The tela choroidea was used as a surgical landmark and incised to allow atraumatic access to the tumor.
  • Cerebellum was spared using this technique, minimizing risk of cerebellar injury (e.g., cerebellar mutism).
  • No hemorrhagic complications were noted during surgery due to dissection through avascular planes.
  • Histopathology favored choroid plexus carcinoma based on mitotic index (9/10 HPFs), though definitive diagnosis remained pending.
  • The case highlights the utility of telovelar over transvermian approach, given its minimally traumatic nature and improved exposure.
  • Survival beyond 2 years without adjunctive therapy suggests surgical excision alone may be curative in select cases.

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← Articles

Antonakakis et al: Use of a telovelar approach for complete resection of a choroid plexus tumor in a dog
Veterinary Surgery 8, 2022

🔍 Key Findings

  • Telovelar approach enabled complete resection of a fourth ventricle choroid plexus tumor in a dog without postoperative complications.
  • Postoperative MRI confirmed gross total tumor removal, and the dog remained neurologically normal 28 months post-surgery.
  • The tela choroidea was used as a surgical landmark and incised to allow atraumatic access to the tumor.
  • Cerebellum was spared using this technique, minimizing risk of cerebellar injury (e.g., cerebellar mutism).
  • No hemorrhagic complications were noted during surgery due to dissection through avascular planes.
  • Histopathology favored choroid plexus carcinoma based on mitotic index (9/10 HPFs), though definitive diagnosis remained pending.
  • The case highlights the utility of telovelar over transvermian approach, given its minimally traumatic nature and improved exposure.
  • Survival beyond 2 years without adjunctive therapy suggests surgical excision alone may be curative in select cases.

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Multiple Choice Questions on this study

In Antonakakis 2022 et al., on telovelar tumor resection, what advantage did the telovelar approach have over the transvermian approach?

A. Required no dura incision
B. Increased hemorrhage control
C. Preserved cerebellar integrity
D. Avoided anesthesia
E. Shorter surgical time

Answer: Preserved cerebellar integrity

Explanation: The telovelar approach avoids splitting the vermis, minimizing cerebellar injury risk.
In Antonakakis 2022 et al., on telovelar tumor resection, how long did the dog remain neurologically normal after surgery?

A. 3 months
B. 9 months
C. 15 months
D. 24 months
E. 28 months

Answer: 28 months

Explanation: The dog remained neurologically normal 28 months after surgery with no recurrence.
In Antonakakis 2022 et al., on telovelar tumor resection, what histologic feature supported a diagnosis of choroid plexus carcinoma?

A. Fibrous stroma and cysts
B. Minimal mitoses
C. Infiltration of parenchyma
D. High mitotic index (9/10 HPF)
E. E-cadherin positive cells

Answer: High mitotic index (9/10 HPF)

Explanation: The tumor exhibited moderate atypia and a mitotic index of 9 per 10 HPFs, suggestive of carcinoma.
In Antonakakis 2022 et al., on telovelar tumor resection, what postoperative imaging finding confirmed complete resection of the tumor?

A. CT showing no contrast uptake
B. Ultrasound showing hyperechoic fossa
C. MRI showing fluid-filled fourth ventricle
D. Radiographs showing no mass effect
E. PET scan showing hypometabolism

Answer: MRI showing fluid-filled fourth ventricle

Explanation: Postoperative MRI showed the fourth ventricle was filled with fluid and no residual mass.
In Antonakakis 2022 et al., on telovelar tumor resection, what surgical structure was incised to access the fourth ventricle?

A. Caudal cerebellar artery
B. Inferior vermis
C. Tela choroidea
D. Lateral recess
E. Medullary velum

Answer: Tela choroidea

Explanation: The tela choroidea was used as a landmark and incised to access the fourth ventricle in a minimally traumatic way.

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