Sphenoid meningioma and carcinoma of caecum sachin et al case. In this chapter, i will discuss techniques for resection of globular meningiomas of the anterior clinoid and medial portions of the sphenoid wing. Sphenoid wing en plaque meningiomas are a subgroup of meningiomas defined by its particular sheetlike dural involvement and its disproportionately large bone hyperostosis. Sphenoorbital meningiomas soms are secondary tumours of the orbit that originate from the dura of the sphenoid wing bone. Original article surgical management of sphenoid wing meningiomas. Meningiomas are relatively common neoplasms that arise from arachnoid cap cells and account for 20% of all primary intracranial tumors. 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. Huang jinbai 1department of radiology, the first affiliated hospital of yangtze university, jingzhou, china 2department of radiology, clinical college of yangtze university, the first affiliated hospital to yangtze university, jingzhou, p.
Meningioma tumor locations brain science foundation. Sphenoid wing meningiomas form on the sphenoid ridge behind the eyes. Hence, meningiomas of the lateral sphenoid wing are often referred to as pterional meningiomas. Spinal meningiomas are less common than other types of skull base meningiomas and typically occur in middleaged women. Meningiomas are presumed to account for 15% of brain tumours and are the most common tumours of the sphenoid wing 21, 22. Meningiomas vary in their symptoms and appropriate treatment options depending on their location. Tuberculum sellae meningiomas tsms are lesions dramatically related to the optic apparatus once the principal clinical complain remains on visual alterations. Meningiomas of the skull base locations constitute 40% of all intracranial meningiomas. Frontal meningioma may present solely withpsychological symptoms that resemble dementia. Eighteen patients with sphenoid wing en plaque meningiomas. Large and giant medial sphenoid wing meningiomas involving vascular structures. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext.
Predictors of visual outcome following surgical resection of. Meningioma im scared to watch and wait mayo clinic connect. A more true medial sphenoid wing clinoidal meningioma with significant medial extension and encasement of the ica is also included lower images. I was told by surgeon and ent that was coincidence. The roof of the optic canal is formed by the lesser wing of the sphenoid bone and proximally by the falciform ligament. The involvement of the sphenoid sinus causes headaches, disturbed vision, double. I am trying to work out best course of action for treatment. Sphenoid wing meningiomas are tumors that typically present with vision deterioration and neurological changes due to their proximity to the sella, cavernous sinus, and other vital structures. Medial sphenoid wing meningioma the neurosurgical atlas, by. Sphenoid wing meningioma presenting as sudden sensorineural. 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. We present the case of a 42yearold man who initially was thought to have dementia, but he was eventually diagnosed with dementia caused by a sphenoid wing meningioma. 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.
Surgical management of sphenoid wing meningiomas clinical gate. Dec 18, 2019 sphenoid wing meningiomas are also known as orbitosphenoid meningiomas, meningiomas en plaque of the sphenoid wing, and sphenoid wing meningiomas with osseous involvement. Following the physical exam, the diagnosis is confirmed with neuroimaging. Meyers is snis 2010 annual meeting chairman announcing dr. Sphenoid wing meningiomas may be associated with hyperostosis of the sphenoid ridge and may be very invasive, spreading to the dura of the frontal, temporal. We used mr imaging to analyze retrospectively the pattern of hyperostosis occurring concomitantly with recurrent sphenoid wing meningiomas. Mr findings in patients with recurrent meningioma of the sphenoid wings k. Of these, about one half occur in the sphenoid wing. Sphenoorbital meningiomas represent a delicate subtype of intracranial meningiomas involving the sphenoid wing, orbit and important neurovascular structures such as cavernous sinus, carotid. Sphenoid wing also called sphenoid ridge problems with vision, loss of sensation in the face, or facial numbness, and seizures. The fifth patient a 42 years woman with tentorial meningioma refused surgery and was lost to follow up.
Details of the image sphenoid wing meningioma modality. The differential diagnosis for sphenoid wing meningioma includes other types of tumors such as optic nerve sheath meningioma, cranial osteosarcoma, metastases, and also sarcoidosis. Yang j, ma sc, liu yh, wei l, zhang cy, qi jf, et al. Fibrous dysplasia of sphenoid bone diagnostic difficulties. Medial sphenoid wing meningioma the neurosurgical atlas. Facial cranial locations are estimated to comprise about 25% of cases of the monoosteotic disorders and ca. Oct 10, 2016 the rate of recurrence for medial sphenoid wing meningiomas is reported as being one of the highest amongst intracranial meningiomas. Reconstruction after resection of sphenoid wing meningiomas. Parafalcine meningioma likely arising from sphenoid wing. Intraosseous meningioma of sphenoid bone request pdf. 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. Postoperative radiation therapy is indicated in cases with residual tumor in these locations. It exerts a compressive effect on the adjacent skull foramina as compression on the optic nerve.
The sylvian middle cerebral artery branches drape over the superior pole of the tumor. Pdf anterior cranial fossa meningioma researchgate. Sphenoid meningioma and carcinoma of caecum sachin et al introduction sphenoid wing meningioma is a common entity in females worldwide. Meningiomas of the skull base pdf free download ebook description meningiomas, the second most frequent of intracranial tumors, are characterized by a protean range of possible locations and appearances, due to their origin from the extensive and intricately formed meninges. Sphenoid wing meningiomas extending to the orbit epmsw are currently.
Sphenoid wing meningiomas can be divided into three main groups based on the site of their origin. Sphenoid wing meningioma presenting as cognitive impairment. Paraclinoid aneurysm concealed by sphenoid wing meningioma. En plaque sphenoid wing meningioma is morphological unique in comparison with other intracranial meningiomas, characterized by a carpetlike usually small soft tissue component which. The tumor has filled the area where the temporal lobe normally lies.
The optic nerve and the ophthalmic artery enter the orbit through the optic canal. Four patients were operated on, three had total excision of the tumor, the fourth, with suprasellar meningioma, had subtotal resection. Recurrence of meningiomas and its management clinical gate. Sphenoid wing foramen magnum any brain tumour can cause these signs and symptoms spinal canal meningioma. Surgical management of giant sphenoid wing meningiomas. Pdf hyperostotic sphenoid wing meningioma en plaque. 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. En plaque sphenoid wing meningioma is morphological unique in comparison with other intracranial meningiomas.
Olfactory groove and sphenoid wing meningiomas columbia. Sphenoid wing meningiomas are tumors that typically present with vision deterioration and neurological changes due to their proximity to the. Meningioma tumours are more common in older people and in women, although they may occur in men and in young people too. Sphenoid wing en plaque meningiomas surgical neurology. As cushing and eisenhardt 5 put it in their monography published in 1938. Total removal of sphenoid wing en plaque meningiomas is difficult due to its extensive bone and dural involvement. 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. Also known as sphenoorbital meningiomas or hyperostotic meningiomas of the sphenoid wing, enplaque meningiomas refer to tumors with a carpetlike dural growth, which are associated with a reactive hyperostosis that, in most cases, is marked and principally responsible for clinical manifestations 5, 6. Radiation effective for sphenoid wing meningiomas, orbital. Below is a listing of locations where meningiomas are found. Sphenoidal ridge meningiomas originate from this sharp limit separating the subfrontal region from the temporal fossa. Total surgical resection is difficult and therefore these tumors have high recurrence rates.
These meningiomas can cause visual problems and facial numbness. 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. Feb 16, 2017 these images demonstrate a hyperdense infiltrative mass located in the anterior right middle cranial fossa with impressive reactive hyperostosis involving the greater sphenoid wing with extension. A medial sphenoid wing meningioma with minimal medial extension is shown upper images. Pdf sphenoid wing meningioma presenting as cognitive impairment. Prior to the diagnosis of sphenoid wing meningioma, the patient reported the follow ing symptoms to her physician. Lateral and middle sphenoid wing meningiomas springerlink. Data were collected from the patients medical file. 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. See related sections symptoms and diagnosis and treatments the tumors location is most often included in its description. Meningiomas, meningioma brain tumor mayfield clinic. 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. Mar 01, 2004 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.
Typically, sphenoid wing meningiomas that were believed to be radically removed, were found to recur at high rates. En plaque meningiomas represent 29% of all meningiomas and they are mainly located in the sphenoid wing. Pronounced limb weakness prompted neurological consultation. Cardiac evaluation revealed a normal left ventricular ejection fraction without ischemic, structural, or valvular heart disease. This is sphenoid wing meningioma by surgical neurology international on vimeo, the home for high quality videos and the people who love them. Jul 09, 20 sphenoid wing en plaque meningiomas are also designated by sphenoorbital meningiomas,18 hyperostosing meningiomas of the sphenoid wing, pterional meningioma en plaque, and invading meningioma of the sphenoid ridge. A 57yearold man presented with recurrent episodes of dizziness, weakness of legs, and presyncope. A sphenoid wing meningioma is a benign brain tumor near the sphenoid bone. Pdf paraclinoid aneurysm concealed by sphenoid wing. Objective sphenoid wing meningiomas are a heterogeneous group of tumors with variable surgical risks. Types of meningiomas meningioma types mount sinai new york. Among 108 medial sphenoid wing meningiomas, there were 81 women 75% and 27 men 25%. Dec 18, 2019 benign sphenoid wing meningioma presenting with an acute intracerebral hemorrhage a case report.
Basso and colleagues subdivide meningiomas of the inner third of the sphenoid wing into clinoidal and sphenocavernous tumors. Sphenoid location of fibrous dysplasia is extreme ly rare 4. The electrocardiogram showed a sinus bradycardia and recurrent sinus pauses. 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. Sep 30, 2018 resection of a hyperostotic lateral sphenoid wing meningioma with intraorbital extension sphenoorbital meningioma approximately 15 to 20% of all meningiomas arise from the sphenoid wing, with half of them emanating from the lateral and middle portion of this bone.
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