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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

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Recurrent Sphenocavernous Meningioma.

Mizuho Inoue¹, Mohamed Labib², Alexander Yang¹

¹Department of Neurosurgery, University of Colorado, Aurora, Colorado, United States.

Journal of Neurological Surgery. Part B, Skull Base

|September 7, 2022

Summary

This summary is machine-generated.

This case study details the successful gross total resection of a recurrent sphenocavernous meningioma (WHO grade I) in a 42-year-old male after initial near-total resection and radiotherapy. The patient experienced no new neurological deficits post-surgery.

Keywords:

cavernous sinus meningioma recurrent sphenocavernous

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Area of Science:

Neurosurgery
Neuro-oncology
Skull Base Surgery

Background:

Sphenocavernous meningiomas are rare tumors requiring complex surgical approaches.
Recurrence necessitates careful consideration of treatment strategies, including repeat resection and radiotherapy.

Purpose of the Study:

To present a case of recurrent sphenocavernous meningioma.
To describe the surgical technique for achieving gross total resection in a complex recurrent case.
To highlight the management of residual tumor after initial treatment.

Main Methods:

Initial diagnosis via MRI showing a large left sphenocavernous meningioma.
First surgery: Frontotemporal craniotomy with near-total resection.
Second surgery: Left frontotemporal craniotomy with pretemporal transcavernous approach, optic canal decompression, and gross total resection.

Main Results:

Initial surgery achieved near-total resection with residual tumor.
Intensity modulated radiotherapy was administered for residual tumor growth.
Second surgery achieved gross total resection of the recurrent tumor.
Patient had an unremarkable postoperative course with no new neurological deficits.

Conclusions:

Gross total resection is achievable for recurrent sphenocavernous meningiomas.
A multi-modal approach involving surgery and radiotherapy can manage recurrent tumors.
Complex skull base techniques are crucial for successful outcomes in recurrent meningiomas.