The patient has given consent for publication of this report. Meningiomas may originate in unexpected locations such as the orbit, paranasal sinus, or ventricles or be entirely intraosseous within the calvaria. Meyers is snis 2010 annual meeting chairman announcing dr. Askep meningioma pdf sphenoorbital meningiomas soms are secondary tumours of the orbit that originate from the dura of the sphenoid wing bone.
Globoid meningiomas 1 deep, inner, or clinoidal 2 middle or alar 3 lateral, outer, or pterional 11. Meningioma tumours are more common in older people and in women, although they may occur in men and in young people too. Olfactory groove and sphenoid wing meningiomas nj surgeon. It originates from the dura mater, the tissue enwrapping the brain and spinal cord.
Reconstruction after resection of sphenoid wing meningiomas. As cushing and eisenhardt 5 put it in their monography published in 1938. Typical, atypical, and misleading features in meningioma. Sphenoid wing meningiomas are tumors that typically present with vision deterioration and neurological changes due to their proximity to the. The rate of recurrence for medial sphenoid wing meningiomas is reported as being one of the highest amongst. Since these tumors can extensively involve the anterior and middle cranial fossae by the time they are detected, a frontotemporal craniotomy with mobilization of the temporalis muscle may be necessary for gross total resection. Original article surgical management of sphenoid wing meningiomas. Pdf sphenoid wing meningioma presenting as cognitive. Wed like to understand how you use our websites in order to improve them. Location of hyperstosis according to frequency lesser wing of the sphenoid bone the greater wing of the sphenoid the roof of the orbit the inferior orbital fissure the infratemporal fossa the orbital rim 10.
Medial sphenoid wing meningiomas are a heterogeneous group of tumors originating from the anterior clinoid and the medial third of the lesser sphenoid wing. Because the surgical outcome has been less favorable in patients with medial. Pdf sphenoid wing meningioma presenting as cognitive impairment. Mr findings in patients with recurrent meningioma of the sphenoid wings k. Mar, 2020 a medial sphenoid wing meningioma with minimal medial extension is shown upper images. 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. All of the grossly visible tumor was resected except the optic strut, the lateral wall of the sphenoid sinus, a portion of the greater sphenoid wing comprising the inferior lateral wall of the superior orbital fissure and posterior lateral wall of the inferior orbital fissure, and an eggshell remnant of the anterior clinoid process overlying the carotid. Meningioma is the most common extraaxial brain tumour in adults and frequently originates in the suprasellar, frontobasal, temporobasal, sphenoid wing, or petroclival regions. Radiation effective for sphenoid wing meningiomas, orbital. En plaque sphenoid wing meningioma is morphological unique in comparison with other intracranial meningiomas, characterized by a.
In some cases, deletions involving chromosome 22 are. Sphenoorbital meningiomas soms are secondary tumours of the orbit that originate from the dura of the sphenoid wing bone. Sphenoid wing meningiomas could pose a unique challenge due to the difficulty associated with gross total resection, particularly in cases of cavernous sinus infiltration. Sphenoid wing meningiomas with osseous involvement.
Medial sphenoid wing meningioma the neurosurgical atlas. Sep 30, 2018 lateral sphenoid wing meningiomas arise from the pterion and typically grow along the sylvian fissure. 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. Management of sphenoid wing meningioma poses a big. Current approach to meningiomas of the medial sphenoid wing and. Sphenoid wing meningioma with rheumatic heart disease. Nov 06, 2015 more than 90% of the tumor was removed. Sphenoidal ridge meningiomas originate from this sharp limit separating the subfrontal region from the temporal fossa. 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. They are considered to be benign tumors arising from cap cells located in clusters around the arachnoid granulations that exist in relation to neural structures and their foramen. Challenging the osseous component of sphenoorbital meningiomas.
Medial sphenoid wing meningiomas are medially located tumors on the sphenoid wing with. The annual incidence of symptomatic meningiomas is approximately 2 cases per 100,000 individuals. Meningiomas are presumed to account for 15% of brain tumors and are the most common tumors of the sphenoid wing. Large and giant medial sphenoid wing meningiomas involving vascular structures. Brotchi j, bonnal j 1991 lateral and middle sphenoid wing meningiomas. Symptoms of olfactory groove and sphenoid wing meningiomas because of the location of acoustic neuromas, the initial symptoms of these tumors involve hearing and balance. 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 commonly arise from or extend into the orbital or temporal fossa, producing the symptoms of proptosis, impaired extraocular movements, and loss of facial sensation, while those involving the optic nerve result in vision deficits. A postoperative scan yields residual tumor in the apex. Intraosseous sphenoid wing meningiomas are indolently growing tumors that often present with symptoms related to orbital compression.
The sylvian middle cerebral artery branches drape over the superior pole of the tumor. It exerts a compressive effect on the adjacent skull foramina as compression on the optic nerve. Lateral and middle sphenoid wing meningiomas springerlink. Sphenoid wing meningiomas still present a difficult surgical challenge especially when they are large in size and involve neurovascular structures. Only few data concerning the visual outcome after surgery of medial sphenoid wing meningiomas exist in the literature 2, 6, 7, 19, 26, 27. Tinnitus ringing in the ears, hearing loss, disequilibrium, and vertigo are common and caused by compression of the eighth cranial nerve. Of all cranial meningiomas, about 20% of them are in the sphenoid wing. Improvement of longterm blindness caused by compression from. Medial displacement of the lateral rectus from the sphenoid wing mass. In this report, we present a case of a patient with a benign lateral sphenoid wing meningioma presenting with a large intracerebral hemorrhage, causing acute onset of symptoms and requiring urgent surgery. In our large experience with sphenoid wing meningiomas at the university of miami, we have never used preoperative embolization and have. Sphenoid wing meningioma presenting as sudden sensorineural. 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. Meningiomas of the anterior skull base constitute 40% of all intracranial meningiomas, and sphenoid wing meningiomas constitute 1120% of intracranial meningiomas.
A sphenoid wing meningioma is a benign brain tumor near the sphenoid bone. We used mr imaging to analyze retrospectively the pattern of hyperostosis occurring concomitantly with recurrent sphenoid wing meningiomas. 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. Meningiomas are much more common in females, and are more common after 50 years of age. The presenting features, operative details and complications were documented. Objective sphenoid wing meningiomas are a heterogeneous group of tumors. Tuberculum sellae meningiomas tsms are lesions dramatically related to the optic apparatus once the principal clinical complain remains on visual alterations.
Yang j, ma sc, liu yh, wei l, zhang cy, qi jf, et al. The gold standard approach for the majority of tumors is the. Pdf hyperostotic sphenoid wing meningioma en plaque. Mar 01, 2004 as an introduction, she offered the hypothetical case of a 40yearold woman who undergoes excision of a sphenoid wing meningioma. This is sphenoid wing meningioma by surgical neurology international on vimeo, the home for high quality videos and the people who love them. Approximately 1520% of all meningiomas arise from the sphenoid wing, with about half of these arising from the medial portion of the wing.
Dec 18, 2019 benign sphenoid wing meningioma presenting with an acute intracerebral hemorrhage a case report. Meningiomas are slowgrowing, expansile benign tumors that can involve the bone and dura. Sphenoid wing meningiomas are tumors that typically present with vision deterioration and neurological changes due to their proximity to the sella, cavernous sinus, and. A more true medial sphenoid wing clinoidal meningioma with significant medial extension and encasement of the ica is also included lower images. Sphenoid wing en plaque meningiomas are a subgroup of meningiomas defined by its particular sheetlike dural involvement and its disproportionately large bone. Sphenoid wing meningioma presenting as cognitive impairment article pdf available in shanghai archives of psychiatry 283. There are several cases of postoperative visual recovery in patients with longterm decreased vision due to innerthird sphenoid wing meningioma, however, we found no reports of patients who improved from longterm blindness. The optic nerve, ophthalmic artery and accompanying sympathetic plexus course through this canal as. Lateral orbitotomy approach for resection of intraosseous. The rate of recurrence for medial sphenoid wing meningiomas is reported as one of the highest for intracranial meningiomas. It originates from the arachnoid not the dura, the tissue. Surgical management of giant sphenoid wing meningiomas. It originates from the arachnoid not the dura, the tissue covering the brain and spinal cord lying deep to the dura.
Transorbital approach to sphenoid wing meningiomas 9 2. Hyperostotic sphenoid wing meningioma en plaque romanian. Total removal of sphenoid wing en plaque meningiomas is difficult due to its extensive bone and dural involvement. 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. Olfactory groove and tuberculum sella meningioma duration. Meningioma im scared to watch and wait mayo clinic connect. Sphenoid wing meningiomas with secondary orbital extension are rare. Sphenoid wing meningioma with rheumatic heart disease challenges and management case report.
Benign sphenoid wing meningioma presenting with an acute. Avid homogenous contrast enhancement of the sphenoid wing mass with significant right proptosis, with the sphenoid wing mass extending into the extraconal space and edema in the inferior temporal lobe. Surgical stratagies for resection of medial sphenoid wing. 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. 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. Optic canal the optic canal is an approximately 10mm bony corridor, the entrance of which is located in the superomedial orbital apex optic foramen. The typical meningioma is a homogeneous, hemispheric, markedly enhancing extraaxial mass located over the cerebral convexity, in the parasagittal region, or arising from the sphenoid wing.
Medial sphenoid wing meningioma the neurosurgical atlas, by. Sphenoid wing also called sphenoid ridge problems with vision, loss of sensation in the face, or facial numbness, and seizures. 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. Most publications are available for download in spanish.
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