Transorbital approach to sphenoid wing meningiomas 9 2. Complete removal is difficult, so these tumors have high rates of. Meningioma tumours are more common in older people and in women, although they may occur in men and in young people too. Sphenoidal ridge meningiomas originate from this sharp limit separating the subfrontal region from the temporal fossa.
Benign sphenoid wing meningioma presenting with an acute intracerebral hemorrhage a case report. Sphenoid wing hyperostosis has been reported as high as 42% of all meningiomas in this area. Reported 3 pts operated for meningioma bw 1903 1932 101016 2. In the case of pure sphenoid wing meningiomas, recurrence rates were. Andersons spasticity program has grown by leaps and bounds aneurysm aneurysm clipping aneurism anuerysm angevine brings spinal deformity expertise to aans 20 ankylosing spondylitis ann riley finck wins columbias clinical nursing excellence award announcement. Sphenoid wing meningiomas could pose a unique challenge due to the difficulty associated with gross total resection, particularly in cases of cavernous sinus infiltration. Types of meningiomas meningioma types mount sinai new york. Sphenoid wing meningioma is a common entity in females worldwide. Sphenoid wing meningiomas swms constitute about 14% to 20% of intracranial meningiomas. The tumor, which was consistent with a sphenoid ridge meningioma, encased and compressed the right ica terminus. Yang j, ma sc, liu yh, wei l, zhang cy, qi jf, et al. Meningiomas are much more common in females, and are more common after 50 years of age. Loss of smell due to compression of the nerves that run between the brain and the nose, and if the tumor grows big enough, visual symptoms can be expressed due to compression of the optic nerve. Nagy and eissa sphenoid wing en plaque meningioma, volume 30 no.
At microsurgical excision, the lesion was firm and relatively avascular. En plaque meningiomas of the sphenoid wing were excluded from the study because they mostly extend along the entire sphenoid wing and do not have a delimited area of dural attachment. Sphenoid ridge meningioma manifesting as subarachnoid hemorrhage korean j radiol 9suppl, july 2008 s finding. Pdf surgical treatment of sphenoorbital meningiomas. Management of meningioma is an inborn challenge, linked to neurosurgeons. Of all cranial meningiomas, about 20% of them are in the sphenoid wing. Total surgical resection is difficult and therefore these tumors have high recurrence rates.
Sharply demarcating frontal from middle basilar fossa, a bony ridge curves outward on a horizontal plane from the anterior clinoidal process toward the lateral aspect of the cranial chamber. Radiation effective for sphenoid wing meningiomas, orbital. En plaque sphenoid wing meningioma is morphological unique in comparison with other intracranial meningiomas, characterized by a carpetlike usually small soft tissue component which. Sphenoidridge meningiomas are slowgrowing benign tumours that may reach massive. Surgical management of medial sphenoid wing meningiomas is challenging because of the closely.
Meningiomas vary in their symptoms and appropriate treatment options depending on their location. The histopathological report revealed s100 positive histiocytic proliferation with lymphophagocytosis emperipolesis characteristic of the rosaidorfman disease. They account for 11% to 18% of cases in large surgical series. They are believed to combine the globular and invasive growth en plaque features of groups. Clinoidal meningiomas, also referred to as medial or inner sphenoid wing meningiomas, are often difficult and challenging to remove completely and safely, especially when they become large enough. Meningiomas are slowgrowing, expansile benign tumors that can involve the bone and dura. Sphenoid wing meningiomas extending to the orbit epmsw are. The diagnostic evaluation and surgical management of this case are reported. An osteolytic meningioma en plaque of the sphenoid ridge. Sphenoid wing en plaque meningiomas are a subgroup of meningiomas defined by its particular sheetlike dural involvement and its disproportionately large bone hyperostosis.
Meningioma im scared to watch and wait mayo clinic. A medial sphenoid wing meningioma with minimal medial extension is shown upper images. Mar, 2020 a medial sphenoid wing meningioma with minimal medial extension is shown upper images. Meningioma im scared to watch and wait mayo clinic connect. We used mr imaging to analyze retrospectively the pattern of hyperostosis occurring concomitantly with recurrent sphenoid wing meningiomas. The meningiomas, their classification, regional behaviour, life history, surgical end results. These meningiomas can cause visual problems and facial numbness. It originates from the arachnoid not the dura, the tissue covering the brain and spinal cord lying deep to the dura. Pdf transzygomatic approach plus minipeeling of middle fossa. Pdf hyperostotic sphenoid wing meningioma en plaque. Extracranial meningioma mimicking a temporomandibular joint. However, acute cerebral infarction, resulting from intracranial arterial occlusion or obstruction related to meningioma is extremely rare 4, 9, 15.
Principal investigator, elizabeth claus, md, phd, publishes two articles on meningiomas. Sphenoorbital meningiomas soms are secondary tumours of the orbit that originate from the dura of the sphenoid wing bone. The rate of recurrence for medial sphenoid wing meningiomas is reported as being one of the highest amongst intracranial meningiomas. Medial sphenoid wing meningioma approximately 1520% of all meningiomas arise from the sphenoid wing, with about half of these arising from the medial portion of the wing.
Tuberculum sellae meningiomas tsms are lesions dramatically related to the optic apparatus once the principal clinical complain remains on visual alterations. While some individuals do not experience meningioma symptoms before or even after they are diagnosed, there are several warning signs that can indicate the need for prompt medical attention. As cushing and eisenhardt 5 put it in their monography published in 1938. In some cases, deletions involving chromosome 22 are involved. Sinq 2016 states that sphenoid wing meningiomas arise in the bone. Lateral sphenoid wing meningiomas arise from the pterion and typically grow along the sylvian fissure. Mar 01, 2004 as an introduction, she offered the hypothetical case of a 40yearold woman who undergoes excision of a sphenoid wing meningioma. The presenting features, operative details and complications were documented. After subtotal resection, most frequently used in sphenoidridge meningioma surgery, 69% of patients are still.
The sylvian middle cerebral artery branches drape over the superior pole of the tumor. Pdf to evaluate the outcome of surgery and radiotherapy in the treatment of. A more true medial sphenoid wing clinoidal meningioma with significant medial extension and encasement of the ica is also included lower images. Challenging the osseous component of sphenoorbital meningiomas. Pdf sphenoid wing meningioma presenting as cognitive. Here, the authors report a case of sphenoid ridge meningioma presenting with acute cerebral infarction caused by middle cerebral artery mca compression. Extracranial meningiomas have been reported around orbit, scalp, paranasal sinuses, as well as handful of cases in the parapharyngeal space and infratemporal fossa.
Meyers is snis 2010 annual meeting chairman announcing dr. In this case, the tumor involved also the sphenoid greater wing with extension into the middle. Case report, abstract a sphenoid wing meningioma causing a progressive painless proptosis is reported in a 5yearold boy. Meningioma brain tumor, meningioma treatment options mayfield. It originates from the dura mater, the tissue enwrapping the brain and spinal cord. Sphenoid wing is the most common location for base of the skull meningiomas. Medial sphenoid wing meningioma the neurosurgical atlas, by. This case demonstrates strong radiological features in keeping with a sphenoid wing meningioma involving the region of the anterior clinoid, adjacent medial sphenoid wing, superior orbital fissure, and cavernous sinus it exerts a compressive effect on the adjacent skull foramina as compression on the optic nerve. The optic nerve, ophthalmic artery and accompanying sympathetic plexus course through this canal as. Mifepristone treatment in patients with surgically incurable sphenoid. This is sphenoid wing meningioma by surgical neurology international on vimeo, the home for high quality videos and the people who love them. Sphenoid wing also called sphenoid ridge problems with vision, loss of sensation in the face, or facial numbness, and seizures. Keep up with the latest news and events happening with the brain science foundation.
En plaque sphenoid wing meningiomas are complex tumors involving the sphenoid wing, the orbit, and sometimes the cavernous sinus. Sphenoid wing meningiomas account for 20% of supratentorial meningiomas. I was told by surgeon and ent that was coincidence. The term sphenoid wing meningioma has been interpreted as an intraosseous meningioma of the sphenoid bone. Large and giant medial sphenoid wing meningiomas involving vascular structures. Prior to the diagnosis of sphenoid wing meningioma, the patient reported the follow ing symptoms to her physician. The highlights of the perioperative management of this patient with mitral valve disease who underwent sphenoid wing meningioma surgery included use of narcotics at induction, lateral positioning for surgery, readily available inotropes, prompt treatment of hypotension, invasive monitoring, etc. Hyperostosis of the skull is one of the characteristic signs of mep. Sphenoid meningioma and carcinoma of caecum sachin et al case.
A benign sphenoid ridge meningioma manifesting as a. The authors retrospectively analyzed 78 consecutive patients with the diagnosis of medial sphenoid wing meningioma who were operated in our department from january 2008 to december 2012. The aim of the study is to shed light on the management of sphenoid wing meningioma, study the outcome of microsurgical resection and factors affecting its resectability. En plaque meningiomas represent 29% of all meningiomas and they are mainly located in the sphenoid wing. The latest cancer research uk statistics show that between a quarter and a third 2533% of all primary brain tumours in adults is a meningioma. Lateral sphenoid wing meningiomas frequently present with localized pain. This bony change can produce clinical symptoms and signs in mep by pressing against adjacent structures. Pdf sphenoid wing meningioma presenting as cognitive impairment. Our main outcome measures were aesthetic evaluation by physicians as well as analysis of tumor control using computed tomographic ct scans, survival time, and complications. Meningioma tumor locations brain science foundation. Mr findings in patients with recurrent meningioma of the sphenoid wings k. Sphenoid wing meningioma with rheumatic heart disease.
Medial sphenoid wing meningioma the neurosurgical atlas. Sphenoid wing meningioma causing a proptosis in a child. Cerebral angiography demonstrated complete occlusion of the right proximal m1 portion with slightly limited collateral circulation to the right mca territory and a radiographic blush from the surrounding meningioma fig. Original article surgical management of sphenoid wing. Lateral transzygomatic approach to sphenoid wing meningiomas. Ocular surgery news in the treatment of sphenoid wing meningiomas, many neurosurgeons have been taught to avoid radiation therapy because of the complications it creates for futures procedures. Rosaidorfman disease mimicking a sphenoid wing meningioma. Typical appearance of a sphenoid ridge meningioma with with extension into the cavernous sinus and pituitary. Dec 18, 2019 benign sphenoid wing meningioma presenting with an acute intracerebral hemorrhage a case report. Sphenoid meningioma and carcinoma of caecum sachin et al. The tumor has filled the area where the temporal lobe normally lies. Surgical management of sphenoid wing meningiomas clinical gate.
A total of 180 patients with a sphenoid wing meningioma were operated during a period of 5 years, with 78 patients having tumors of the medial sphenoid ridge, 11 having optic canaloptic sheath meningiomas, seven with primary cs meningiomas, and the remaining 84 having either a lateral sphenoid ridge or an en plaque tumor. It indents the medial aspect of the left temporal lobe and left lateral aspect of the pons and encroaches upon the left inferior orbital fissure resulting in mild left proptosis. This case report presents the case of a sphenoid wing meningioma in a. Among 108 medial sphenoid wing meningiomas, there were 81 women 75% and 27 men 25%.
Meningioma en plaque mep is a rare tumor characterized more by its clinical and biological behavior than its histological appearance. Optic canal the optic canal is an approximately 10mm bony corridor, the entrance of which is located in the superomedial orbital apex optic foramen. These warning signs can vary widely, however, because each type of meningioma develops in a different part of the brain or spinal cord. Left sphenoidal wing extra axial durally based mass. Basso and colleagues subdivide meningiomas of the inner third of the sphenoid wing into clinoidal and sphenocavernous tumors.
Sphenoid wing meningioma presenting as cognitive impairment. This approach belongs in the armamentarium of surgeons who are involved in the resection of skull base neoplasms. Complete removal at an early stage is the best prognostic factor in treating sphenoid wing meningioma. However, it is known that these tumors may invade bony structures, even in the benign meningotheliomatous type 2. Hyperostosing sphenoid wing meningiomas cause bony hyperostosis that may extend into the orbit, resulting in proptosis, restriction of. Sphenoid wing meningiomas form on the sphenoid ridge behind the eyes. A postoperative scan yields residual tumor in the apex.
A sphenoid wing meningioma is a benign brain tumor near the sphenoid bone. Original article outcome of sphenoid wing en plaque. Sep 30, 2018 lateral sphenoid wing meningiomas arise from the pterion and typically grow along the sylvian fissure. In some cases, deletions involving chromosome 22 are. Meningiomas arising in the sphenoid region are frequently encountered in neurosurgical practice. Reconstruction after resection of sphenoid wing meningiomas. This case demonstrates strong radiological features in keeping with a sphenoid wing meningioma involving the region of the anterior clinoid, adjacent medial sphenoid wing, superior orbital fissure, and cavernous sinus. It exerts a compressive effect on the adjacent skull foramina as compression on the optic nerve.
Below is a listing of locations where meningiomas are found. Medial sphenoid wing meningiomas are a heterogeneous group of tumors originating from the anterior clinoid and the medial third of the lesser sphenoid wing. Spinal meningiomas are less common than other types of skull base meningiomas and typically occur in middleaged women. In contrast, sphenoid meningioma has been interpreted as a meningioma of the sphenoid sinus. See related sections symptoms and diagnosis and treatments the tumors location is most often included in its description. Sphenoid ridge meningioma presenting as acute cerebral. Sphenoid wing meningiomas still present a difficult surgical challenge especially when they are large in size and involve neurovascular structures. Lateral orbitotomy approach for removing hyperostosing en plaque. Sphenoid wing meningioma presenting as cognitive impairment article pdf available in shanghai archives of psychiatry 283. Original article surgical management of sphenoid wing meningiomas. There are no pathologic or genetic features specific to lateral and middle sphenoid wing meningiomas, although world health organization who class ii and iii meningiomas are less common in this region of the brain than over the convexities. Extracranial meningioma mimicking a temporomandibular.
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