Options for the side of lateral approaches usually were restricted for nondominant rightsided craniotomy or to the side of impaired vision ipsilateral approaches. We classified medial sphenoid wing meningiomas into two different groups on the basis of preoperative radiological findings. Although olfactory meningiomas are rare, they are treatable and reversal of dementialike symptoms can be expected. 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.
Acms, originating from the arachnoid layer covering the anterior clinoid process acp, has an incidence of 34% to 43. Planum sphenoidale the planum sphenoidale or jugum sphenoidale is the planar surface of the sphenoid bone connecting the two lesser wings, and lies anterior to the sella turcica. They are a nonglial neoplasm that originates from the arachnoid cap cells of the meninges and are typically benign with a low recurrence rate, but rarely can be malignant. 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. They often are mentioned in the same context as meningiomas originating from tuberculum sellae, diaphragma sellae, planum sphenoidale, or optic canal meningiomas. Endoscopic, endonasal extended transsphenoidal, transplanum. Meningiomas are the most common extraaxial tumors of the central nervous system. Mortazavi mm1, brito da silva h1, ferreira m jr1, barber jk1, pridgeon js1, sekhar ln2. A series of 83 consecutive patients operated on for these lesions at the neurological institute of. Olfactory groove and planum sphenoidale meningiomas occur along the. Radiographic appearance of a sellar and suprasellar meningioma in the current patient a axial t1 mri with gadolinium showing large homogeneously enhancing suprasellar mass.
Meningioma free download as powerpoint presentation. Improvement of longterm blindness caused by compression. We report a case of tuberculum sellae meningioma with optic tract edema. Although the safety and effectiveness of ipsilateral transcranial approach. Patient with growing meningioma of the planum sphenoidale. The differential diagnosis for sphenoid wing meningioma includes other types of tumors such as optic nerve sheath meningioma, cranial osteosarcoma, metastases, and also sarcoidosis. Hello johny249, the following information would be of great help. The planum sphenoidale is the plane surface of the sphenoid bone, in front of the sella. Case report a 66 years old male patient, diagnosed with giant olfactory meningioma operated in 1988, was admitted in our department with bilateral complete chronic nasal obstruction, anosmia and seromucous rhinor. We read with keen interest the article by bander et al. The classification is based on the location of the fibular fracture.
Planum sphenoidale meningiomas are located more anterior and in proximity of the olfactory groove location 4, 10. In some cases, deletions involving chromosome 22 are involved. Total removal of meningiomas of the anterior cranial fossa was obtained in 86. Brain tumors can produce a large variety of clinical presentations, such. This allows to safely approach the sella turcica, optic nerve, tuberculum sella and planum sphenoidale for surgeons, in some lesions including skull base lesions and. In their small singleinstitution study of similar cohorts of patients with tuberculum sellae and planum sphenoidale meningiomas they highlighted. 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.
Surgical management of tuberculum sellae and planum sphenoidale meningiomas adrian bala. Optic nerve atrophy due to longstanding compression by. Visual outcome of planum sphenoidale and tuberculum sellae. Anterior clinoidal meningiomas acms represent special entity of meningiomas that have been referred to as, or grouped with, suprasellar, parasellar, sphenoid wing, or frontal skull base meningiomas. Primary dural lymphoma masquerading as a meningioma. Read planum sphenoidale and tuberculum sellae meningiomas. Operative nuances of a modern surgical technique with outcome and proposal of a new classification system. Following the physical exam, the diagnosis is confirmed with neuroimaging. Coincidental pituitary adenoma and planum sphenoidale. This case illustrates the typical radiological findings of a planum sphenoidale meningioma. 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. Planum sphenoidale ps and tuberculum sellae ts meningiomas cause visual symptoms due to compression of the optic chiasm.
Demonstrates the technique of and exposure afforded by a frontotemporal pteryonal craniotomy for resection of planum sphenoidale meningioma. This case report describes the epidemiology, the clinical presentation as well as the current treatment options for this condition. Cranial aspergillosis may present as meningitis, cerebral abscess, cerebral infarctshaemorrhages or extraaxial mass. 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.
My friend is suffering from headaches for the past 6 months onwards. Endoscopic endonasal versus transcranial approach to tuberculum. 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. Tuberculum sellae and planum sfenoidale meningiomas represent. Optic tract edema in a meningioma of the tuberculum sellae. The midline biorbitofrontal craniotomy approach to meningiomas of the olfactory groove and planum sphenoidale. Oct 14, 2015 site related relapses with planum sphenoidale or olfactory groove meningioma, tumor recurrence reported in 7. Meningiomas are the most common brain tumor in the adult population. Together with the anterior clinoid processes, it forms the roof of the sphenoid sinus. Endoscopic endonasal versus transcranial approach to tuberculum sellae and planum sphenoidale meningiomas in a similar cohort of patients. To illustrate the imaging features of meningiomas arising from the common and. Operative nuances of a modern surgical technique with outcome and proposal of a new classification system, world neurosurgery on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips.
Preoperative sagittal a and coronal b computed tomography scan, and sagittal c and coronal d magnetic resonance imaging postcontrast enhancement evaluations. Of all cranial meningiomas, about 20% of them are in the sphenoid wing. A 36yearold female presented to the oculoplastics service stating that her left eye was bulging and appeared swollen. Diagnostic, prognostic, and therapeutic applications the harvard community has made this article openly available. Meningiomas of the tuberculum sellae and planum sphenoidale. New concepts in the management of onsmsdalia berman and neil r miller 169. Histopathologic and molecular analysis revealed a lowgrade bcell lymphoma. The pittsburgh group has made a contribution to expanding the horizons of such an approach towards different regions of the midline cranial base and the planum sphenoidale. New concepts in the management of optic nerve sheath meningiomas dalia berman, 1md.
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. Therefore, having removed two contiguous lesions of different natures adenoma and meningioma and different localizations sellar and suprasellar, now seems reasonable. Planum sphenoidale meningiomas account for 510% of all intracranial meningiomas. Planum sphenoidale definition of planum sphenoidale by. Read visual outcome of planum sphenoidale and tuberculum sellae meningiomas, clinical neurology and neurosurgery on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips. Sphenoid and middle cranial fossa 1725% fig 9 frontobasal 10% fig 10, 11. The diagnostic value of hyperostosis in midline subfrontal. Optic nerve haemangioblastoma mimicking a planum sphenoidale. Planum sphenoidale meningioma leading to visual disturbance. This suprasellar mass was suggestive of a planum sphenoidale meningioma. Surgical management of tuberculum sellae and planum. Pdf on jan 15, 2014, mayur sharma and others published anterior cranial fossa meningioma find, read. When the tumour spreads to adjacent bone, it may enter the haversian canal system, inciting hyperostosis and bone proliferation.
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. Anterior interhemispheric approach for tuberculum sellae. 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. Jan 25, 2018 demonstrates the technique of and exposure afforded by a frontotemporal pteryonal craniotomy for resection of planum sphenoidale meningioma. Dec 04, 20 a young african american woman presented with progressive left vision loss. Like most meningiomas, meningiomas of the anterior cranial base are typically benign. Recently, an increased incidence of some nonendocrine tumors are reported in patients with multiple endocrine neoplasia type 1 men 1. Clinical and operative data were gathered on all patients treated with keyhole approaches by the senior author from january 2012 to june 20. 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. Request pdf planum sphenoidale and tuberculum sellae meningiomas. However, after 2 followup mri scans showed slight growth and because of persisting headaches, the patient decided the meningioma should be removed. Keyhole craniotomies are increasingly being used for lesions of the skull base. Meningiomas are much more common in females, and are more common after 50 years of age. From the collection of tabita larisa cazac advantages were planum sphenoidale meningiomas are closely bound with the optic nerves and optic chiasm, pituitary gland, cavernous sinus which.
Roentgenologic analysis of 66 patients with proved midline subfrontal meningioma indicates a very high incidence of hyperostosis. Endoscopic endonasal versus transcranial approach to tuberculum sellae and planum. A large enhancing extraaxial mass is demonstrated along the planum sphenoidale, additionally insinuating into the olfactory groove, consistent with a meningioma. The rate of tumor site appearance and their percentages of recurrence are given in. Chinezu1, dorin nicolae gherasim2 neurosurgery departement, targu mures clinical emergency hospital 16th year neurosurgery resident 22nd year neurosurgery resident abstract introduction. Olfactory groove and planum sphenoidale meningioma. The tumor was internally debulked to preserve the optic nerve. Planum sphenoidale and tuberculum sellae meningiomas. Any information contained in this pdf file is automatically generated from digital material. The studies showed a duralbased lesion involving the lateral aspect of the left cavernous sinus which extended superiorly and crossed the planum sphenoidale to insinuate itself around the contralateral anterior clinoid process. 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 main purpose of surgery for tuberculum sellae meningioma tsm is the improvement andor stabilization of patients visual function. Netter atlas of human anatomy edition pdf netter atlas of human anatomy 6th edition pdf download see more. Group 1 comprised tumors without cavernous sinus involvement.
New concepts in the management of optic nerve sheath. Twentyseven patients were found to have tumors arising mainly from the planum sphenoidale or the tuberculum sellae. It originates from the arachnoid not the dura, the tissue covering the brain and spinal cord lying deep to the dura. Primary dural lymphomas are a distinct entity that may mimic meningioma and cause vision loss. Management of intracranial meningiomas using keyhole techniques. Cranial aspergilloma masquerading as meningioma bmj case. Site related relapses with planum sphenoidale or olfactory groove meningioma, tumor recurrence reported in 7. Dec 23, 2016 meningioma planum sphenoidal leo tomacelli. A total of 63 patients 95% showed varying degrees of hyperostosis involving the cribriform plate, planum sphenoidale, or tuberculum sellae including the chiasmatic sulcus. Scribd is the worlds largest social reading and publishing site.
The lesion also pushed against the left cavernous sinus, without evidence of invasion. Endoscopic transnasal suprasellar approach for anterior. 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. Your story matters citation bi, wenya linda, michael zhang, winona w. Meningiomas may be a component tumor of multiple endocrine. Planum sphenoidale meningioma learning radiology meningioma. 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. Mar 01, 2011 intraoperative photograph of a tuberculum sellae meningioma via the anterior interhemispheric approach. A delay in the diagnosis or treatment may be detrimental to visual recovery.
Ps and ts meningiomas can extend into adjacent areas such as. The extended pterional approach allows excellent results for. Drawings illustrate the weber danisweber classification of ankle fractures, types ac. The eyebrow supraorbital keyhole approach is gradually preferred to treat tuberculum sellae and planum sphenoidale meningiomas as a less invasive approach compared to the more traditional approaches. Olfactory groove and planum sphenoidale meningiomas occur along the anterior cranial. Cureus management of intracranial meningiomas using. Further evaluation showed no evidence of systemic disease. The pterional approach in a case of planum sphenoidale meningioma 119 clinical case the pterional approach in a case of planum sphenoidale meningioma tabita larisa cazac1, d. Download fulltext pdf optic nerve haemangioblastoma mimicking a planum sphenoidale meningioma article pdf available in british journal of neurosurgery 235. The extended pterional approach allows excellent results. Additionally, there was a broadbased extraaxial lesion at the planum sphenoidale eccentric to the right, which enhanced homogenously and measured 1. This mass was encroaching on the right optic nerve and was thought to represent a meningioma. Dumitrescu2 1the university of medicine and pharmacy carol davila, bucharest, romania. Feb 01, 2016 read planum sphenoidale and tuberculum sellae meningiomas.
It marks the posterior limit of the anterior skull base, and meningiomas that arise from this site are known as. Endoscopic endonasal resection of a synchronous pituitary. New concepts in the management of optic nerve sheath meningiomas. Surgery of small anterior skull base meningiomas by. The resection of planum sphenoidale and tuberculum. New concepts in the management of onsmsdalia berman and neil r miller 169 adjacent orbital structures, including fat, extraocular muscles, and bone. The extended pterional approach allows excellent results for removal of anterior. The treatment of choice is surgical removal with the goal of improving vision and achieving complete tumor removal. 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.
If the inline pdf is not rendering correctly, you can download the pdf file here. Pdf anterior cranial fossa meningioma researchgate. Meningioma neurological disorders medical specialties. They are a nonglial neoplasm that originates from the arachnoid cap cells of the meninges and are typically benign with a low recurrence rate, but rarely can be malignant meningiomas occur in a magnitude of locations, one of the less common places being the planum sphenoidale. Meningioma tumours are more common in older people and in women, although they may occur in men and in young people too.
Olfactory grooveplanum sphenoidale meningiomas springerlink. Symptoms depend on the location and occur as a result of the tumor pressing on nearby tissue. The midline biorbitofrontal craniotomy approach to meningiomas of. Unenhanced axial ct of the base of the skull shows a hyperdense midline mass white arrows arising from the planum sphenoidale region. A cerebral mri scan showed a small planum sphenoidale meningioma 15. Brain mri with contrast and perfusion studies were obtained. Among 108 medial sphenoid wing meningiomas, there were 81 women 75% and 27 men 25%. Operative nuances of a modern surgical technique with outcome and proposal of a. We read with great interest the article by bander et al. Meningiomas originating from the tuberculum sellae ts and planum sphenoidale ps account for approximately 15% of who grade i meningiomas and often present with visual disturbance due to compression of the optic nerves and chiasm.
Frontotemporal craniotomy for planum sphenoidale meningioma. Endoscopic endonasal versus transcranial approach to. Like most meningiomas, meningiomas of the anterior cranial base are typically benign and potentially curable. 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 meningioma ncbi. The pterional approach in a case of planum sphenoidale meningioma 123 figure 8 sellar and parasellar region anatomy. There are rare reports of meningiomas and other central nervous system tumors in these patients, but it is unknown if they are more frequent or if allelic loss of the men1 gene is important in their pathogenesis. They are typically slowgrowing tumors, explaining why some patients remain asymptomatic and, therefore, undiagnosed for extended periods of time. Right subfrontal approach to tumor allowed early visualization of the optic nerves. Recurrence was observed in 23% of parasagital meningiomas, 16.