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Sphenoid wing meningiomas with osseous involvement
Florian Roser1, Makoto Nakamura, Cornelius Jacobs
1Department of Neurosurgery, Klinikum Hannover Nordstadt, 30167 Hannover, Germany. f.roser@gmx.de
Surgical Neurology
|July 5, 2005
Summary
Sphenoid wing meningiomas (SWMs) with bone invasion have higher recurrence rates. Extensive surgical removal and bony decompression are crucial for good outcomes, especially with cavernous sinus involvement.
Area of Science:
- Neurosurgery
- Oncology
- Radiology
Background:
- Sphenoid wing meningiomas (SWMs) with osseous involvement present significant neurosurgical challenges due to skull base location and high recurrence rates.
- Extensive surgical exposure is necessary for adequate resection of these tumors.
Purpose of the Study:
- To analyze the radiological appearance of SWMs with osseous involvement and its impact on surgical management.
- To evaluate recurrence rates and outcomes in patients with osseous-involved SWMs.
Main Methods:
- Retrospective review of 82 patients with osseous-involved SWMs.
- Analysis of surgical records, clinical reports, histological examinations, imaging studies, and questionnaires.
Main Results:
- 94% of tumors were World Health Organization grade I, with 100% bone infiltration and a 2.2% Ki-67 proliferation rate.
- Magnetic resonance imaging showed varied densities and Gd enhancement within the affected bone.
- Recurrence rates were over 30% for osseous-involved SWMs, compared to 11.6% for those without bone involvement.
Conclusions:
- Osseous involvement in SWMs is associated with lower resection rates and higher recurrence compared to meningiomas in other locations.
- Subtotal removal with bony decompression of cranial nerves offers good functional and cosmetic results in cases involving the cavernous sinus.