Atsufumi Nagahama1, Takeo Goto2, Alhusain Nagm3, Yuta Tanoue2, Yusuke Watanabe2, Hironori Arima2, Kosuke Nakajo2, Hiroki Morisako2, Takehiro Uda2, Tsutomu Ichinose2, Kazuhiro Yamanaka2, Kenji Ohata2. 1. Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan. Electronic address: naga.atsu0327@gmail.com. 2. Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan. 3. Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan; Department of Neurosurgery, Al-Azhar University Faculty of Medicine-Nasr City, Cairo, Egypt; Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan.
Abstract
OBJECTIVE: Spheno-orbital meningioma (SOM) is a rare intracranial tumor that arises at the sphenoid wing, extends into the orbit, and is associated with hyperostosis of the sphenoid bone. These tumors often invade important neurovascular structures around the orbital apex, superior orbital fissure, and cavernous sinus. Aggressive tumor removal could achieve acceptable control; however, residual tumor can regrow. In this article, our surgical management and long-term outcomes are described. METHODS: Retrospectively, 12 patients with SOM who were treated surgically over a 21-year period were included. The clinical features and long-term tumor control were evaluated. RESULTS: Participants comprised 12 patients (5 men and 7 women). Mean follow-up was 74.4 months (range, 10-262 months). Ten patients (83%) were identified as World Health Organization grade 1 (WHO-I), and 2 patients (17%) were identified as WHO grade 2 (WHO-II). We encountered 4 recurrences, 2 of which needed additional surgeries. One patient with WHO-I (10%) experienced recurrence 10 years after the initial surgery and required a second surgery. Two patients with WHO-I (20%) showed slight regrowth of residual tumor around the superior orbital fissure; nevertheless, additive therapy was not recommended. Despite radical tumor resection, including eyeball and adjunctive radiotherapy for 1 patient with WHO-II, tumor recurrence in the posterior fossa was documented 19 years after the initial aggressive surgery. CONCLUSIONS: SOM follows a relatively benign clinical course given the invasive radiologic findings. Abnormal bone resection is paramount to prevent early-stage recurrence. Although intradural residual tumor might regrow, additional surgery could achieve reasonable long-term tumor control with better outcome.
OBJECTIVE:Spheno-orbital meningioma (SOM) is a rare intracranial tumor that arises at the sphenoid wing, extends into the orbit, and is associated with hyperostosis of the sphenoid bone. These tumors often invade important neurovascular structures around the orbital apex, superior orbital fissure, and cavernous sinus. Aggressive tumor removal could achieve acceptable control; however, residual tumor can regrow. In this article, our surgical management and long-term outcomes are described. METHODS: Retrospectively, 12 patients with SOM who were treated surgically over a 21-year period were included. The clinical features and long-term tumor control were evaluated. RESULTS:Participants comprised 12 patients (5 men and 7 women). Mean follow-up was 74.4 months (range, 10-262 months). Ten patients (83%) were identified as World Health Organization grade 1 (WHO-I), and 2 patients (17%) were identified as WHO grade 2 (WHO-II). We encountered 4 recurrences, 2 of which needed additional surgeries. One patient with WHO-I (10%) experienced recurrence 10 years after the initial surgery and required a second surgery. Two patients with WHO-I (20%) showed slight regrowth of residual tumor around the superior orbital fissure; nevertheless, additive therapy was not recommended. Despite radical tumor resection, including eyeball and adjunctive radiotherapy for 1 patient with WHO-II, tumor recurrence in the posterior fossa was documented 19 years after the initial aggressive surgery. CONCLUSIONS: SOM follows a relatively benign clinical course given the invasive radiologic findings. Abnormal bone resection is paramount to prevent early-stage recurrence. Although intradural residual tumor might regrow, additional surgery could achieve reasonable long-term tumor control with better outcome.
Authors: Alexandra Gomes Dos Santos; Wellingson Silva Paiva; Leila Maria da Roz; Marcelo Prudente do Espirito Santo; Manoel Jacobsen Teixeira; Eberval G Figueiredo; Vinicius Trindade Gomes da Silva Journal: Surg Neurol Int Date: 2022-07-22
Authors: Waseem Masalha; Dieter Henrik Heiland; Christine Steiert; Marie T Krüger; Daniel Schnell; Christian Scheiwe; Oliver Schnell; Anca-L Grosu; Jürgen Beck; Jürgen Grauvogel Journal: Front Oncol Date: 2021-06-04 Impact factor: 6.244