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KMID : 0942820110100010037
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Journal of Korean Brain Tumor Society
2011 Volume.10 No. 1 p.37 ~ p.41
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Dorsum Sellae Meningioma Which is a Mirror-Image of Tuberculum Sellae Meningioma
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Sim Yang-Won
Min Kyung-Soo
Lee Mou-Seop
Kim Young-Gyu
Kim Dong-Ho
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Abstract
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Most of the parasellar meningiomas are found in the tuberculum sellae, clinoid, diaphragma sellae, and cavernous sinuses. But, meningiomas arising from the dorsum sellae are very rare. There are few reports of surgically treated dorsum sellae meningiomas (DSMs). Sixty-six years old woman complaining of headache for 6 months admitted to our department. Neurological examination and endocrine evaluation showed no abnormalities. Brain magnetic resonance image (MRI) showed a homogeneously enhancing solid mass in the suprasellar area, displacing the pituitary stalk to the left anterolateral side. Epicenter of the mass was dorsum sellae. Cerebral angiography showed intensely staining mass fed by meningohypophyseal artery of right internal carotid artery. The tumor was completely removed by right pterional approach. Due to the violation of sylvian venous drainage, delayed intracerebral hematoma in the right frontotemporal lobe was developed postoperatively. Postoperative morbidities after 6 months were minimal left side weakness and left partial homonymous visual field defect. Because DSMs are rare occurrence, located in the deep critical area, and surrounded by complex neurovascular structures, surgery of DSMs is challenging. Depending on the tumor’s characters and extents, patient’s age and neurologic status, alterative management option such as intentional decompressive tumor debulking for the protection of visual pathways and postoperative radiosurgery should be considered, too.
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KEYWORD
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Dorsum sellae, Meningioma, Pterional approach
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