In a series of 44 patients with planum sphenoidale and olfactory groove meningiomas from the university of california at san francisco, zygourakis et al. Diagnosis and treatment of orbital optic nerve sheath meningioma. 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. It marks the posterior limit of the anterior skull base, and meningiomas that arise from this site are known as planum. Endoscopic transnasal resection of an anterior planum. Hello johny249, the following information would be of great help. Together with the anterior clinoid processes, it forms the roof of the sphenoid sinus. A 60yearold male presented with complaints of dizziness, which worsened with fatigue and a sense his balance was off. 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. These include meningiomas located at midline anatomic locations, such as olfactory groove, planum sphenoidale, and tuberculum. Planum sphenoidale and tuberculum sella meningiomas arise from the floor of the anterior cranial fossa near the midline and. Planum sphenoidale definition of planum sphenoidale by. Pisapia md 5, apostolos john tsiouris md 4, vijay k.
The risk of meningioma increases with age with a dramatic increase after 65 years. Three patients had posterior communicating pcom artery aneurysm associated with meningioma. Site related relapses with planum sphenoidale or olfactory groove meningioma, tumor recurrence reported in 7. Olfactory groove and planum sphenoidale meningiomas are rare. Role of planum sphenoidale meningioma resection in.
All the lesions were successfully managed surgically. Coincidental pituitary adenoma and planum sphenoidale. Exposure to ionizing radiation, especially high doses, has been associated with a higher incidence of intracranial tumors, particularly meningiomas. Endoscopic endonasal resection of a synchronous pituitary. Meningiomas of the tuberculum sellae and planum sphenoidale. 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.
Endoscopic endonasal versus transcranial approach to tuberculum sellae and planum sphenoidale meningiomas in a similar cohort of patients evan d. The tumor was totally resected using a left pterional approach. Arise from the flat part of the sphenoid bone anterior to the chiasmatic sulcus. New concepts in the management of optic nerve sheath. The diaphragm of the sellae creates a roof to the pituitary fossa stretching from the tuberculum over the sella turcica to the posterior clinoid processes and covers the pituitary gland, except for the pituitary stalk. The location of the meningioma was clinoidal 2, planum sphenoidale 1, petroclival 1 and pterional 1. Current and emerging principles in surgery for meningioma. Occasionally seizures, dementia, trouble talking, vision problems, one sided weakness, or. A new classification system that can guide the surgical approach and may predict surgical risk is proposed. Parasellar meningiomas represent 510 percent of all intracranial meningiomas. Meningiomas located at other anatomic locations are more challenging to remove using the endoscope, including tumor extension lateral to the carotid artery or cranial nerves.
Olfactory groove and planum sphenoidale meningiomas occur along the anterior cranial base overlying the area of the cribriform plate of the ethmoid bone. Surgical management of tuberculum sellae and planum. Request pdf role of planum sphenoidale meningioma resection in improving visual function introduction. Mortazavi mm1, brito da silva h1, ferreira m jr1, barber jk1, pridgeon js1, sekhar ln2. New concepts in the management of optic nerve sheath meningiomas. Olfactory groove and planum sphenoidale meningioma. Journal of neurosurgical sciences 2018 jan 04 minerva medica.
Pdf optic nerve haemangioblastoma mimicking a planum. 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. 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. Symptoms depend on the location and occur as a result of the tumor pressing on nearby tissue. Pterional surgery of suprasellar meningiomas of the.
Planum sphenoidale meningiomas are anterior cranial fossa meningiomas, overlying the area of the cribriform plate of the ethmoid bone, sphenofrontal suture, and planum sphenoidale. 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. Case presentation a 64yearold woman presented, 5 years ago. 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. 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. Planum sphenoidale meningioma operative neurosurgery. Planum sphenoidale meningioma leading to visual disturbance ncbi. Paolo perrini azienda ospedaliero universitaria pisana. This case illustrates the typical radiological findings of a planum sphenoidale meningioma.
Optic nerve haemangioblastoma mimicking a planum sphenoidale. Planum sphenoidale meningioma planum sphenoidale meningiomas are anterior cranial fossa meningiomas, overlying the area of the cribriform plate of the ethmoid bone, sphenofrontal suture, and planum sphenoidale. Arising from the weakest part of the skull base makes it prone to infiltration of the underlying bone. Reminder of important clinical lesson planum sphenoidale.
Oct 14, 2015 site related relapses with planum sphenoidale or olfactory groove meningioma, tumor recurrence reported in 7. The lesion was hyperintense on t1weighted imaging with homogenous enhancement and a broad dural attachment to the planum sphenoidale. Initial physical examination was negative and the laboratory testing was unremarkable. Craniotomy for tuberculum sella meningiomas aans neurosurgeon. Meanwhile, histological study demonstrated the coincidence of two contiguous tumors. Planum sphenoidale meningioma leading to visual disturbance. Olfactory groove and planum sphenoidale meningioma ncbi. Read planum sphenoidale and tuberculum sellae meningiomas. This mass was encroaching on the right optic nerve and was thought to represent a meningioma. Feb 04, 2014 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. A delay in the diagnosis or treatment may be detrimental to visual recovery.
Thus, it would appear that some cases of apparently bilateral onsms are truly bilateral, whereas others represent either the spread of a planum sphenoidale meningioma to both optic canals or of a unilateral onsm across the planum to the contralateral optic. 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. Delay in the diagnosis of meningiomas of the tuberculum sellae and planum sphenoidale is detrimental to the patient in terms of visual recovery, morbidity and mortality. Mri revealed an extraaxial mass which extended into the pituitary fossa and caused compression of the pituitary. Frontotemporal craniotomy for planum sphenoidale meningioma. The limbus sphenoidaledentified as a small borderline separating the planum sphenoidale and chiasmatic sulcus. Eisenhardt believed meningioma arises from arachnoid cap cells that are particularly abundant in the arachnoid granulation. Unenhanced axial ct of the base of the skull shows a hyperdense midline mass white arrows arising from the planum sphenoidale region. Many of the histological variants are also discussed separately. Following an eyebrow skin incision and a d shaped supraorbital craniotomy, meningiomas of the tuberculum sellae and planum sphenoidale can be approached without brain retraction, only by optico. 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.
Olfactory grooveplanum sphenoidale meningiomas springerlink. Additionally, there was a broadbased extraaxial lesion at the planum sphenoidale eccentric to the right, which enhanced homogenously and measured 1. 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. This article is a general discussion of meningioma focusing on typical primary intradural meningiomas and the imaging findings of intracranial disease. Twentyseven patients were found to have tumors arising mainly from the planum sphenoidale or the tuberculum sellae. Sekharmortazavi tumor classification was applied to classify these tumors and evaluate the outcome. Salinero, coincidental pituitary adenoma and planum sphenoidale meningioma mimicking a single tumor, endocrinologia y nutricion, vol. Planum sphenoidale meningioma planum sphenoidale meningiomas are anterior cranial fossa meningiomas, overlying the area of the. 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. Improvement of visual acuity was noted and the postoperative computertomography investigation showed total surgical removal with no residual tumor.
We report a modern surgical technique specific for planum sphenoidale and tuberculum sellae meningiomas with associated outcome. Planum sphenoidale and tuberculum sellae meningiomas. The planum sphenoidale meningioma was successfully resected using a left pterional approach. Endoscopic endonasal versus transcranial approach to. Feb 01, 2016 read planum sphenoidale and tuberculum sellae meningiomas.
Olfactory groove and planum sphenoidale meningiomas are rare, constituting only 2% of all primary intracranial tumours. Planum sphenoidale meningiomas are located anterior to and in proximity to the olfactory groove. Planum sphenoidale meningiomas are located more anterior and in proximity of the olfactory groove location 4, 10. Mortazavi 1, harley brito da silva, manuel ferreira jr1, jason k. The tumors are usually bilateral based on their midline origin, although they can also be unilateral. The planum sphenoidale or jugum sphenoidale is the planar surface of the sphenoid bone.
A t1weighted, contrastenhanced coronal mri illustrates enhancing mass affecting the planum sphenoidale ps, left inferior orbital fissures iof, and left optic nerve on secondarily. Together with the anterior clinoid process es, it forms the roof of the sphenoid sinus. Role of planum sphenoidale meningioma resection in improving. Virchow was the first to describe the classic pathologic feature of the meningioma with the term psammoma. These tumors grow at a faster rate than benign meningiomas and are often characterized by brain invasion.
Harvey cushing coined the term meningioma to describe a benign globoid tumor arising from the leptomeninges. The postoperative computed tomography ct suggested a tumor remnant at the planum sphenoidale. Operative nuances of a modern surgical technique with outcome and proposal of a new classification system. Optic nerve haemangioblastoma mimicking a planum sphenoidale meningioma. 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. For spinal and primary extradural tumors refer to spinal meningioma and primary extradural meningioma articles respectively. Within weeks, the patient developed bilateral visual field deficits. Operative nuances of a modern surgical technique with outcome and proposal of a new classi. African americans have been observed to have higher rates of meningioma than other ethnic groups in the u. Atypical meningiomas who grade ii, which account for 18% of meningioma cases exhibit increased tissue and cell abnormalities. They are typically slowgrowing tumors, explaining why some patients remain asymptomatic and, therefore, undiagnosed for extended periods of time. They may arise from the diaphragma sella, tuberculum sellae, planum sphenoidale, medial lesser wing of sphenoid, anterior clinoid, clivus, and cavernous sinus smith 2005.