Deep sylvian meningioma: a case report and review of literature

Kumar, G Samson Sujit; Rajshekhar, Vedantam

doi:10.1007/s00381-008-0686-5

Cited by 14 publications

(26 citation statements)

References 9 publications

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“…Deep sylvian meningiomas are a very rare entity. 2 To our knowledge, including the present case, only 27 cases are reported in the international literature (►Table 1). According to some authors, these meningiomas probably arise from arachnoid cap cells that are found in the Virchow-Robin spaces along the cerebral vasculature.…”

Section: Discussionmentioning

confidence: 72%

Deep Sylvian Meningioma: A Case Report and Review of the Literature

Matar

Maamri

Boubaker

et al. 2016

IJNS

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Introduction?Meningiomas are extra-axial tumors. They usually display a dural attachment, although meningiomas without dural attachment are extremely rare and reported only occasionally in the literature. In this article, the authors present a new case of a deep sylvian meningioma and briefly review the relevant literature. Case Report?We present the case of a 39-year-old man presented with 1- month history of headache associated with an episode of generalized tonic?clonic seizure. Neurological examination showed no abnormality. Magnetic resonance imaging (MRI) demonstrated a lesion located in the right temporo-frontal region which was isointense on T1 and hypointense on T2 with homogeneous enhancement after gadolinium administration. Coronal, axial, and sagittal MRI revealed no dural attachment and the mass appeared to be completely surrounded by brain parenchyma. Intraoperatively, the lesion was presented as a subcortical mass and was mainly in the posterior part of right sylvian fissure. The histological diagnosis showed a World Health Organization grade I meningioma, transitional type. Conclusion?Deep sylvian meningiomas are a rare entity. Preoperative diagnosis is difficult. Nevertheless, neurosurgeons and neuropathologists should be aware of this possibility and should include this hypothesis in the differential diagnosis of an intraparenchymal tumor.

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Section: Discussionmentioning

confidence: 72%

Deep Sylvian Meningioma: A Case Report and Review of the Literature

Matar

Maamri

Boubaker

et al. 2016

IJNS

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“…Microsurgical resection of these tumors has been reasonably successful in reducing seizures, especially when complete resection is achieved. 5,11,17,23 Our patient who underwent total resection of the meningioma has remained seizure-free for 10 years, but the other patient with subtotal resection has continued to experience seizures associated with tumor recurrence and progression from WHO grade I to grade II histology. Although complete resection was difficult in this second patient because of the intraparenchymal location, the main reason it was deemed high risk was dense adherence of the tumor to the distal MCA branches in the dominant hemisphere.…”

Section: Discussionmentioning

confidence: 94%

“…[1][2][3][4] Sylvian fissure meningiomas are extremely rare, with only 24 previously reported cases in the world literature, almost all occurring in children. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] We report two additional cases of children with deep sylvian fissure meningiomas without dural attachment and an additional case of meningioangiomatosis (MA) in the perisylvian region. The literature is also reviewed regarding similarities and differences with the other small number of cases previously described.…”

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confidence: 99%

Pediatric Meningeal Tumors of the Sylvian Fissure Region without Dural Attachment: A Series of Three Patients and Review of the Literature

Donovan

Thavapalan

2016

Surg J

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Pediatric meningeal tumors are rare, but those in the region of the sylvian fissure without dural attachment are extremely rare, with only 24 previously reported cases in the world literature. In this series, we report two additional cases of sylvian fissure meningioma without dural attachment and one case of perisylvian meningioangiomatosis in the medial temporal lobe. All three patients presented with complex partial seizures, but the diagnosis was delayed in each case because the symptoms were misinterpreted to be behavioral rather than epileptic. The seizures were eventually confirmed with electroencephalogram, and subsequent imaging showed enhancing masses within the sylvian fissure region that were at least partially calcified in all three cases. Each patient underwent craniotomy. In the first case, gross total resection was achieved, and in the second case, a small residual portion of tumor was densely calcified and adherent to the middle cerebral artery branches. Both of these were World Health Organization (WHO) grade I meningiomas. The third patient underwent biopsy and limited resection of meningioangiomatosis. No dural attachments were noted in any of the tumors, but one of the meningiomas was intraparenchymal in location, surrounding the sylvian fissure in both the frontal and temporal lobes, which has been described in only a small number of these cases previously. The patients underwent pre-and postsurgical neuropsychiatric testing and did not experience any significant cognitive deficits. At 10-year follow-up, the patient who had gross total resection of the tumor has had no recurrence and is seizure-free without anticonvulsant medications. The incompletely resected intraparenchymal meningioma in the second patient recurred after 5 years, however, and at repeat surgery was found to have transformed to a WHO grade II tumor. Radiation therapy was delivered and the tumor has been stable for 2 years, but the patient continues to have occasional seizures despite medication. The patient with meningioangiomatosis has had no further growth and has excellent control of seizures but remains on medication. We review the clinical presentation of these rare tumors and discuss the treatment, outcomes, and possible relationship of meningiomas to meningioangiomatosis.

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“…However, its radiological appearance is frequently non-specific and a definitive preoperative diagnosis is difficult. Out of the 25 cases of deep sylvian meningiomas that have been reported in the literature2,8,9,12), benign histology is the most common diagnosis (97%)4).…”

Section: Discussionmentioning

confidence: 99%

Experience with 5-Aminolevulinic Acid in Fluorescence-Guided Resection of a Deep Sylvian Meningioma

Chae

Song

Park

et al. 2012

J Korean Neurosurg Soc

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The 5-aminolevulinic acid (5-ALA)-induced tumor fluorescence is a useful intraoperative marker for the diagnosis and the detection of various malignancies, but its use in meningioma is only reported infrequently. In meningioma, a complete resection of the tumor mass is crucial for the prevention of recurrence and postoperative morbidities. Deep sylvian meningioma is a rare type of meningioma where complete tumor removal is complicated by its deep anatomical location and close involvement with the middle cerebral artery. From our experience, 5-ALA-mediated fluorescence facilitated a safe excision whilst preserving critical neurovascular structures. To our best knowledge, this is first report from use of 5-ALA in a deep sylvian meningioma.

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Deep sylvian meningioma: a case report and review of literature

Abstract: At 4-year follow-up, he was asymptomatic, and there was no tumor recurrence.

Cited by 14 publications

References 9 publications

Deep Sylvian Meningioma: A Case Report and Review of the Literature

Deep Sylvian Meningioma: A Case Report and Review of the Literature

Pediatric Meningeal Tumors of the Sylvian Fissure Region without Dural Attachment: A Series of Three Patients and Review of the Literature

Experience with 5-Aminolevulinic Acid in Fluorescence-Guided Resection of a Deep Sylvian Meningioma

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