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Int J Surg Case Rep. 2015;12:117-9. doi: 10.1016/j.ijscr.2015.05.017. Epub 2015 May 14.

Double concentric craniotomy: Safe and effective technique to achieve an en bloc resection of tumor involving both skull and duraa.

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University of Torino, Dept. Of Neuroscience, Institute of Neurosurgery, Italy.
University of Torino, Dept. Of Neuroscience, Institute of Neurosurgery, Italy. Electronic address:



Many tumors can involve the skull. Meningiomas are one of the most common intracranial neoplasms and invasion of the bone was described in 49% of cases. Other neoplastic lesions that can arise in bone, or involve it, are metastases, hemangiomas, aggressive cutis carcinomas and sarcomas. Radical excision is the golden standard of treatment but elevating a bone flap when the tumor involves both the skull and the dura could represent a technical challenge.


We report the technical details of our approach to remove a meningioma involving both skull and dura in a man aged 45. Patient underwent gross total excision and cranioplasty with PEEK custom made prothesis (Synthes™).


We describe a double concentric craniotomy (DCC) technique where the tumor involving the bone is before left in situ, exposing normal dura, to perform afterwards en-bloc excision with minimal traction of brain surface.


DCC is a safe and effective technique to remove tumor involving both skull and dural structures under direct vision.


Brain tumor; Concentric craniotomy; En bloc resection; Skull tumor

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