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We perform surgery for skull base tumors such as meningiomas, acoustic neuromas (acoustic neurinomas and vestibular schwannomas), pituitary adenomas, and craniopharyngiomas.
For gliomas, glioblastomas, and metastatic brain tumors, we conduct genetic testing of tumor cells and provide multidisciplinary treatment in collaboration with the Department of Medical Oncology and Department of Radiation Therapy.
We also provide specialized surgical treatment for tumors of the spine (backbone) from the cervical vertebrae to the sacral vertebrae, as well as spinal cord tumors.
The necessity of surgery is determined based on symptoms, neurological abnormalities, imaging tests such as CT and MRI, and the results of physiological tests.
To ensure safe surgery, we use surgical support devices and systems such as neuromonitoring, navigation systems, high-precision microscopes (Orb Eye), neuroendoscopes, intraoperative fluorescent diagnostics indocyanine green (ICG) and 5-aminolevulinic acid (Arabel®), and even awake surgery.
Acoustic neuromas are treated in collaboration with the otolaryngology department.
For pediatric brain tumors such as germ cell tumors, we work in collaboration with pediatrics departments to treat not only surgery but also high-dose chemotherapy using peripheral blood stem cell transplants. Our hospital is a nationally registered facility for pediatric brain tumors.
Meningiomas are benign brain tumors that are sometimes discovered by chance during brain checkups. We will treat you based on your age, the presence or absence of symptoms, size, location, etc.
Meningiomas that develop in the skull base grow while compressing cranial nerves such as the optic nerve, blood vessels in the brain, and the central part of the brain. When skull base meningiomas grow large, surgery to remove them requires advanced surgical equipment and techniques. Our hospital has extensive experience in treating skull base meningiomas and offers treatment methods using skull base surgical techniques.
This tumor often appears on the vestibular nerve, which runs parallel to the nerve related to hearing (cochlear nerve). Hearing is often impaired at the time of onset, and it is generally diagnosed by an otolaryngologist. As the tumor grows, it can impair the function of the trigeminal nerve, facial nerve, glossopharyngeal nerve, and even the cerebellum, and can also cause hydrocephalus. In addition to surgical removal, there are options such as stereotactic radiotherapy, a combination of surgery and stereotactic radiotherapy, and follow-up observation.
Large acoustic neuromas require advanced surgical equipment and techniques to remove them without damaging the facial nerve or other cranial nerves. Our hospital has extensive experience in treating the facial nerve and trigeminal nerve, and we perform many surgeries in the areas where acoustic neuromas occur. We also perform surgery in collaboration with otolaryngology.
The pituitary gland is a part of the brain that produces and secretes hormones related to growth and milk production. It also secretes hormones that regulate the function of the thyroid gland, adrenal cortex, and gonads, as well as diuresis. When a tumor develops in the pituitary gland, it becomes a pituitary adenoma. There are pituitary adenomas that secrete pituitary hormones and pituitary adenomas that do not.
These tumors originate from cells that produce the pituitary hormone prolactin, accounting for approximately 25-30% of all pituitary tumors. In women, the primary symptoms are amenorrhea, menstrual irregularities, and lactation, while in men, erectile dysfunction and lactation are the primary symptoms. In men, the tumor may not be detected until it has grown significantly, potentially resulting in visual and visual field impairment. A definitive diagnosis is made through MRI, CT scans, and blood tests to measure lactation hormone levels. Treatment begins with medical treatment, as oral medications such as cabergoline can improve hormone levels and shrink tumors. Oral administration requires at least several years, and gastrointestinal symptoms such as nausea and constipation may occur as side effects. Furthermore, long-term use of cabergoline can cause valvular disease, which causes the heart valves to stiffen and become less flexible. Regular cardiac examinations are required for long-term use. Surgery is an option for visual and visual field impairment, pituitary apoplexy, or when medical treatment is ineffective or causes side effects.
These tumors originate from cells that produce growth hormone, a pituitary hormone, and account for approximately 20-25% of pituitary adenomas. Excessive production of growth hormone results in gigantism and acromegaly, resulting in disfigurement, including tall stature, distinctive facial features, and enlarged limbs. They also present with various complications, including hypertension, diabetes, sleep apnea, and colon cancer. These systemic complications shorten lifespan, necessitating treatment. Lowering blood growth hormone levels through treatment can improve these complications. Surgical removal is the first choice of treatment. If complete removal is not feasible, residual tumors can be treated with radiation therapy, injectables such as Sandostatin (octreotide acetate), Somatuline (lanreotide acetate), Somavatar (pegvisomant), and Signifor (pasireotide pamoate), or oral medications such as Parlodel and Cabasar to lower growth hormone levels.
It accounts for approximately 5% of pituitary tumors, and its main symptoms include moon face, central obesity, high blood pressure, diabetes, and muscle weakness. Surgical removal is the first choice of treatment. Stereotactic radiotherapy has also been reported to be effective, but there is a risk of pituitary dysfunction in the long term.
Since there are no symptoms due to excessive hormone production, the tumor often grows and compresses the optic nerve, causing loss of visual field and decreased vision.
The diagnosis is confirmed by measuring pituitary hormone levels with CT or MRI scans and blood tests. If the condition is discovered by chance during a brain checkup, imaging follow-up is generally performed. Surgery is required if there is visual field impairment, if the condition shows signs of enlargement, or if pituitary apoplexy has occurred.
Our hospital is a facility where you can observe and practice transsphenoidal pituitary surgery, organized by the Japanese Society of Diencephalo-Pituitary Tumors. We provide treatment in cooperation with the Department of Endocrinology.
The surgery is performed by a certified neurosurgeon from the Japanese Society of Neuroendoscopy, using a neuroendoscope. The endoscope is inserted through the nostrils and reaches the tumor via the sphenoid sinus, leaving almost no scars on the body surface. The endoscope ensures a wide field of view, allowing for safe removal of the maximum amount of tumor. Because large pituitary tumors have a high rate of complications, this procedure is performed in combination with endoscopic transnasal surgery and craniotomy.
It arises from remnants of the fetal craniopharyngeal duct and accounts for approximately 3% of primary brain tumors (approximately 0.3 cases per 100,000 per year), with peak incidence in childhood and adulthood. Symptoms include impaired visual field and pituitary dysfunction, and in children, short stature. Treatment involves surgical removal of as much of the tumor as possible, with additional radiation therapy (including stereotactic radiation therapy) being added if any remains. Although it is a benign tumor, treatment is not easy as it originates adjacent to important areas such as the hypothalamus.
Gliomas arise from glial cells in the brain and account for approximately 30% of primary brain tumors. Typical tumors include glioblastoma, astrocytoma, oligodendroglioma, and ependymoma. Gliomas are classified into grades ranging from low grade 1 to high grade 4.
In addition to the usual pathological examination, our hospital also requests genetic testing of tumor cells from a specialized institution for diagnosis. Our department has a track record of treating an average of 30 patients with glioma each year.
These include pilocytic astrocytoma (grade 1), diffuse astrocytoma (grade 2), and oligodendroglioma (grade 2). Maximum tumor removal is said to improve prognosis. At the same time, we strive to reduce surgical complications. We perform tumor removal as safely as possible using monitoring and awake surgery. Radiation therapy and anticancer drugs such as temozolomide (Temodar) may be used on residual tumors.
These include anaplastic astrocytoma (grade 3), anaplastic oligodendroglioma (grade 3), and glioblastoma (grade 4).
Treatment involves surgical removal of as much of the tumor as possible, the anticancer drug temozolomide (Temodar), and radiation therapy. Bevacizumab (Avastin) may also be used. Additionally, treatments using carmustine (Gliadel) during surgery and a device called Optune® (Novo TTF) are also available.
For both ependymoma (grade 2) and anaplastic ependymoma (grade 3), the goal is complete removal by surgery. Dissemination, a phenomenon in which tumor cells are dispersed into the cerebrospinal fluid and the lesion spreads to the cerebrospinal cord, is observed in approximately 10% of cases. Anaplastic ependymoma (grade 3) is treated with radiation chemotherapy in the same way as malignant glioma.
Cancer metastasis to the brain occurs in approximately 20-40% of all cancer patients, and 20% of all brain tumors are metastatic brain tumors. Brain metastasis is common from lung cancer and breast cancer, but metastasis from colon cancer, kidney cancer, and bladder cancer is also encountered. If anti-cancer drugs are ineffective against metastatic brain tumors, surgery or radiation therapy is performed. Treatment is provided in cooperation with the department of the primary lesion, the radiology department, and the medical oncology department.
It accounts for approximately 3% of primary brain tumors, is common among the elderly, and the number of patients has been increasing in recent years (0.3 per 100,000 people per year). Most are B-cell lymphomas. They occur in various parts of the brain, are infiltrative, and may be detected by memory loss or impaired consciousness. Treatment involves a surgical biopsy to confirm the diagnosis, and a combination of chemotherapy and radiation therapy. In collaboration with the Department of Hematology, treatments include high-dose methotrexate (MTX) therapy (multidrug combination therapy), rituximab (Rituxan), an anti-CD20 monoclonal antibody that attacks B-cell lymphoma, and tirabrutinib (Velexbru), a Bruton's tyrosine kinase inhibitor.
The six types of brain tumors - germinoma, embryonal carcinoma, yolk sac tumor, choriocarcinoma, teratoma, and mixed germ cell tumor - are collectively called germ cell tumors.
This tumor accounts for 15-20% of pediatric brain tumors. It is more common in boys and rarely occurs in adults.
The most common sites of occurrence are the pineal gland and the area near the pituitary gland. When it occurs in the pineal gland, it is accompanied by impaired upward gaze and hydrocephalus, while when it occurs near the pituitary gland, it is accompanied by diabetes insipidus, impaired visual field and pituitary dysfunction.
Germ cell tumors and mature teratomas have a good prognosis. Only mature teratomas can be cured completely with surgery. Other germ cell tumors require radiation chemotherapy.
Cavernous hemangiomas are so named because they have a sponge-like structure when viewed under a microscope. Although the word "tumor" is included in the name, they are technically considered a type of vascular malformation, not a tumor. Therefore, unlike other tumors, they rarely grow rapidly through cell division. Instead, they grow due to repeated bleeding within and outside the hemangioma, which can cause neurological symptoms and seizures. While asymptomatic cavernous hemangiomas that do not bleed do not require treatment, those that bleed repeatedly are dangerous and require surgical removal. Hemangiomas in the brainstem require particular attention, as the rebleeding rate is high, at over 30% per year. Because the brainstem is a critical region, surgery carries certain risks. However, surgery is considered when frequent bleeding threatens serious complications.
