Mortazavi mm1, brito da silva h1, ferreira m jr1, barber jk1, pridgeon js1, sekhar ln2. Endoscopic ant fossa meningioma excision intraventricular tumor management may 2, 2020 covid19 recommendations for neurosurgeons may 1, 2020 may 6, webinar the art of approaching skull base surgery prof. Current and emerging principles in surgery for meningioma. A delay in the diagnosis of meningiomas of the tuberculum sellae and planum sphenoidale can lead to poor surgical results in terms of visual prognosis, morbidity, and mortality. Frontotemporal craniotomy for planum sphenoidale meningioma. Planum sphenoidale meningioma is the meningioma attached to the dura of the planum sphenoidale, lying on the midline posterior to the olfactory nerve meningiomas and anterior to the tuberculum sella meningiomas.
Meningiomas of the midline anterior skull base such as the olfactory groove meningioma presented in this case report are a rare clinical entity and represent about 10% of all intracranial meningiomas. It encompasses the clinoid processes and extends through the greater sphenoid wings. Pdf anterior cranial fossa meningioma researchgate. Arising from the weakest part of the skull base makes it prone to infiltration of the underlying bone. The tumor capsule is bipolar coagulated medial to the ipsilateral on and the tumor is debulked. The extent of visual deficit is the single most important reason for surgical treatment, and visual. They often are mentioned in the same context as meningiomas originating from tuberculum sellae, diaphragma sellae, planum sphenoidale, or optic canal meningiomas. The tuberculum sellae meningioma tsm arises from the tuberculum sellae, chiasmatic sulcus, and limbus sphenoidale. We report a case of tuberculum sellae meningioma with optic tract edema. Anterior interhemispheric approach for tuberculum sellae.
Download fulltext pdf optic nerve haemangioblastoma mimicking a planum sphenoidale meningioma article pdf available in british journal of neurosurgery 235. Now live wfns neurosurgical anatomy webinar may 12, 2020. Role of planum sphenoidale meningioma resection in. Unenhanced axial ct of the base of the skull shows a hyperdense midline mass white arrows arising from the planum sphenoidale region. A series of 83 consecutive patients operated on for these lesions at the neurological institute of. We report a patient with a tuberculum sella meningioma with aca encasement, in whom a gross total excision was achieved through an endonasal endoscopic transsphenoidal transtuberculum, transplanum approach. Jan 27, 2017 endoscopic endonasal versus transcranial approach to tuberculum sellae and planum sphenoidale meningiomas in a similar cohort of patients evan d. The tumor was totally resected using a left pterional approach. Supra orbital procedure for planum sphenoidale meningioma. The association of pituitary adenoma and meningioma has been well described, especially in patients previously irradiated for the pituitary tumor who develop intracranial meningiomas years after treatment.
Coexistence of ghproducing pituitary macroadenoma and meningioma in a patient with multiple endocrine neoplasia type 1 with hyperglycemia and ketosis as first clinical sign. Meningioma, also known as meningeal tumor, is typically a slowgrowing tumor that forms from the meninges, the membranous layers surrounding the brain and spinal cord. To demonstrate by examples the common mimics of meningioma with the differentiating features. A, after dissection of the anterior interhemispheric fissure, the tumor was found to extend to the planum sphenoidale and was exposed in the center of the surgical field. Management of intracranial meningiomas using keyhole techniques. It seems possible to distinguish both groups clinically and.
Operative nuances of a modern surgical technique with outcome and proposal of a new classification system world neurosurgery volume 86, february 2016, pages 270286 martin m. Planum sphenoidale and tuberculum sellae meningiomas. Operative nuances of a modern surgical technique with outcome and proposal of a new classi. Olfactory groove and planum sphenoidale meningiomas occur along the anterior cranial base overlying the area of the. Surgical management of tuberculum sellae and planum. Jun 21, 2019 pa tho physiology of meningioma edited version pdf free download. In order to decrease intraoperative bleeding, early interception of these feeding arteries is essen tial.
We read with keen interest the article by bander et al. Olfactory grooveplanum sphenoidale meningiomas springerlink. A sharp radiolucent defect in the region of the planum sphenoidale seen in a number of patients with and without head trauma was thought to be secondary to a developmental failure of osseous fusion of the planum sphenoidale with the chiasmatic sulcus in association with prominence of the sulcus. Planum sphenoidale meningioma leading to visual disturbance.
A delay in the diagnosis or treatment may be detrimental to visual recovery. May 25, 2018 if the inline pdf is not rendering correctly, you can download the pdf file here. Roentgenologic analysis of 66 patients with proved midline subfrontal meningioma indicates a very high incidence of hyperostosis. Conversely, for olfactory groove or frontal sinus meningiomas, it. Meningiomas of the tuberculum sellae and planum sphenoidale. The postoperative computed tomography ct suggested a tumor remnant at the planum sphenoidale. In their small singleinstitution study of similar cohorts of patients with tuberculum sellae and. Olfactory groove meningioma ogm originates from the anterior cranial base, commonly at the cribriform plate of the ethmoid bone, planum sphenoidale or the frontospenoidal suture. The mass effect conditions a marked deformity of the anterior portion of the brain, with transtentorial descending herniation and herniation of the third ventricle to the prepontine.
Cranial aspergilloma masquerading as meningioma bmj case. Meningioma in posterior fossa, at the level of brain stem. Pisapia md 5, apostolos john tsiouris md 4, vijay k. This case illustrates the typical radiological findings of a planum sphenoidale meningioma. They may arise from the diaphragma sella, tuberculum sellae, planum sphenoidale, medial lesser wing of sphenoid, anterior clinoid, clivus, and. Olfactory groove and planum sphenoidale meningiomas occur along the anterior cranial base overlying the area of the cribriform plate of the ethmoid bone, frontosphenoid suture, and planum sphenoidale. Coincidental pituitary adenoma and planum sphenoidale. The extended pterional approach allows excellent results. Many of the histological variants are also discussed separately. Optic nerve haemangioblastoma mimicking a planum sphenoidale. Thus, it would appear that some cases of apparently bilateral onsms are truly bilateral, whereas others represent either the spread of a planum sphenoidale meningioma to both optic canals or of a unilateral onsm across the planum to the contralateral optic. Optic tract edema in a meningioma of the tuberculum sellae. Planum sphenoidale meningioma learning radiology meningioma. Oct 14, 2015 site related relapses with planum sphenoidale or olfactory groove meningioma, tumor recurrence reported in 7.
In the 10 patients treated, 1 experienced pneumocephalus and 1 developed a small pseudomeningocele. In a series of 44 patients with planum sphenoidale and olfactory groove meningiomas from the university of california at san. The tumors are usually bilateral based on their midline origin, although they can also be unilateral. Endoscopic endonasal versus transcranial approach to tuberculum. Current and emerging principles in surgery for meningioma surgical treatment for meningioma is nearly as old as contemporary neurosurgery itself and rests upon a keen understanding of the goals of surgery, meningioma growth patterns and biological behavior, and the advantages and limitations of available surgical techniques. Cureus management of intracranial meningiomas using. Tsms represent approximately 3 to 10% of all intracranial meningiomas. Pa tho physiology of meningioma edited version pdf free download. A delay in the diagnosis of meningiomas of the tuberculum sellae and planum sphenoidale can lead to poor surgical results in terms of visual prognosis.
Endoscopic endonasal versus transcranial approach to tuberculum sellae and planum sphenoidale meningiomas in a similar cohort of patients. Case presentation a 64yearold woman presented, 5 years ago. Olfactory groove and planum sphenoidale meningiomas are rare. Today surgery on lesions involving the cavernous sinus a personal viewpoint may 12, 2020. Endoscopic endonasal versus transcranial approach to. Planum sphenoidale meningioma leading to visual disturbance ncbi. For spinal and primary extradural tumors refer to spinal meningioma and primary extradural meningioma articles respectively. Meanwhile, histological study demonstrated the coincidence of two contiguous tumors.
The pathogenesis of this edema in meningioma is controversial. Pdf optic nerve haemangioblastoma mimicking a planum. Role of planum sphenoidale meningioma resection in improving. According to the attachment and blood supply they differentiate two varieties, the planum sphenoidale meningioma pm and the olfactory meningioma om. The association of pituitary adenoma and meningioma has been well described, especially in patients previously irradiated for the pituitary tumor who develop intracranial meningiomas years after. Pdf surgical management of tuberculum sellae and planum. Hello johny249, the following information would be of great help. This article is a general discussion of meningioma focusing on typical primary intradural meningiomas and the imaging findings of intracranial disease. We consider that it could be advantageous for planumtuberculum sellae tumors. Sekhar background the resection of planum sphenoidale and. Subperiosteal, subperiorbital dissection and division of the anterior and posterior ethmoid arteries for meningiomas of the cribriform plate and planum sphenoidale. Of all cranial meningiomas, about 20% of them are in the sphenoid wing. However, longer followups are necessary to better define the appropriate indications and ideal patient population mdningioma will benefit from the use of these newer techniques. Mar 01, 2011 intraoperative photograph of a tuberculum sellae meningioma via the anterior interhemispheric approach.
Operative nuances of a modern surgical technique with outcome and proposal of a new classification system. Mortazavi 1, harley brito da silva, manuel ferreira jr1, jason k. Endoscopic transnasal suprasellar approach for anterior. Additionally, there was a broadbased extraaxial lesion at the planum sphenoidale eccentric to the right, which enhanced homogenously and measured 1. Arise from the flat part of the sphenoid bone anterior to the chiasmatic sulcus. Endonasal endoscopic transsphenoidal resection of tuberculum. Planum sphenoidale ps and tuberculum sellae ts meningiomas cause visual symptoms due to compression of the optic chiasm.
The planum sphenoidale or jugum sphenoidale is the planar surface of the sphenoid bone. In this series, the supraorbital approach was utilized to resect meningiomas of the olfactory groove, planum sphenoidale, tuberculum sella, some tumors of the medial sphenoid wing, and posterior clinoid figure 6. Jan 25, 2018 demonstrates the technique of and exposure afforded by a frontotemporal pteryonal craniotomy for resection of planum sphenoidale meningioma. Meningiomas involving the optic canal dunn laboratory brigham. Olfactory groove and planum sphenoidale meningioma ncbi. Site related relapses with planum sphenoidale or olfactory groove meningioma, tumor recurrence reported in 7. Anterior cerebral artery aca encasement is often considered a contraindication for an endonasal endoscopic transsphenoidal approach. A cerebral mri is performed identifying a large extraaxial mass with an enostotic spur in the planum sphenoidale fig. We report a modern surgical technique specific for planum sphenoidale and tuberculum sellae meningiomas with associated outcome. In some cases, deletions involving chromosome 22 are involved. Planum sphenoidale definition of planum sphenoidale by.
Any information contained in this pdf file is automatically generated from digital material. Planum sphenoidale meningiomas are located more anterior and in proximity of the olfactory groove location 4, 10. Demonstrates the technique of and exposure afforded by a frontotemporal pteryonal craniotomy for resection of planum sphenoidale meningioma. New concepts in the management of optic nerve sheath. These include meningiomas located at midline anatomic locations, such as olfactory groove, planum sphenoidale, and tuberculum.
Request pdf role of planum sphenoidale meningioma resection in improving visual function introduction. Meningiomas are much more common in females, and are more common after 50 years of age. Although our series of patients is focused on planum sphenoidale and tuberculum sellae meningiomas using our own particular cranial operative technique, we did not find an increased incidence of csf leakage related to sinus opening or complications and higher recurrence rates related to the. Salinero, coincidental pituitary adenoma and planum sphenoidale meningioma mimicking a single tumor, endocrinologia y nutricion, vol. Although our series of patients is focused on planum sphenoidale and tuberculum sellae meningiomas using our own particular cranial operative. Cureus endonasal endoscopic transsphenoidal resection of. Cranial aspergillosis may present as meningitis, cerebral abscess, cerebral infarctshaemorrhages or extraaxial mass. Planum sphenoidale meningiomas account for 510% of all intracranial meningiomas. Twentyseven patients were found to have tumors arising. Mortazavi harley brito da silva manuel ferreira jr. Meningiomas located at other anatomic locations are more challenging to remove using the endoscope, including tumor extension lateral to the carotid artery or cranial nerves.
Contrary to a prior report on this topic, edema along the optic tract is not only seen in craniopharyngiomas but may be seen although rarely in other common parasellar tumors, as in our case of a tuberculum sellae meningioma. They are typically slowgrowing tumors, explaining why some patients remain asymptomatic and, therefore, undiagnosed for extended periods of time. Symptoms depend on the location and occur as a result of the tumor pressing on nearby tissue. Planum sphenoidale meningioma planum sphenoidale meningiomas are anterior cranial fossa meningiomas, overlying the area of the cribriform plate of the ethmoid bone, sphenofrontal suture, and planum sphenoidale. A new classification system that can guide the surgical approach and may predict surgical risk is proposed. New concepts in the management of optic nerve sheath meningiomas. This mass was encroaching on the right optic nerve and was thought to represent a meningioma.
The lesion also pushed against the left cavernous sinus, without evidence of invasion. Endoscopic transnasal resection of an anterior planum. A total of 63 patients 95% showed varying degrees of hyperostosis involving the cribriform plate, planum sphenoidale, or tuberculum sellae including the chiasmatic sulcus. The diagnostic value of hyperostosis in midline subfrontal. Extraaxial cranial aspergilloma may mimic meningioma owing to masslike characteristics and intense contrast enhancement on mri there by delaying the diagnosis and further worsening the already bad prognosis in these patients. Occasionally seizures, dementia, trouble talking, vision problems, one sided weakness, or. Hyperostosis, intratumoral calcifications angiography. It originates from the arachnoid not the dura, the tissue covering the brain and spinal cord lying deep to the dura. Acms, originating from the arachnoid layer covering the anterior clinoid process acp, has an incidence of 34% to 43. Adanya serabut retikulin yang berlebihan dan serabut kolagen yang menjadi sskep antara sel pada meningioma tipe ini, merupakan tanda yang khas.
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