Falcotentorial meningiomas: Optimal surgical planning and intraoperative challenges – case report
DOI:
https://doi.org/10.37085/jmmv3.n2.2021.pp.23-28Keywords:
Falcotentorial meningioma, Occipital transtentorial approach, Pineal region meningiomaAbstract
Meningiomas arising from the falcotentorial junction are rare, and the selection of the optimal surgical approach is essential. We report a 41-year-old man presented with progressive left paresis in the lower limbs. An MRI showed a solid mass inside the third ventricle in contact with the falcotentorial dural junction. The tumor was removed by the transtentorial/transfalcine occipital approach, performed with the patient in the three-quarter prone position. The tumor was devascularized from the tentorium, then debulked and finally dissected. The affected falx and tentorium were resected, but all of patent dural venous sinuses were preserved. The tumor was a subtotal resect. Choosing the surgical approach is essential for the safe and effective removal of an FTM and preoperative imaging analysis should identify the tumor’s anatomical relations and guide toward the least disruptive route that preserves the neurovascular structures. This article aims to report a successfully treated FTM.
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Behari S, Das KK, Kumar A, et al. Large/giant meningiomas of posterior third ventricular region: Falcotentorial or velum interpositum? Neurol India. 2014;62(3):290-295. doi:10.4103/0028-3886.136934.
Hong CK, Hong JB, Park H, et al. Surgical treatment for falcotentorial meningiomas. Yonsei Med J. 2016;57(4):1022-1028. doi:10.3349/ymj.2016.57.4.1022.
Guttmann E. Zur pathologie und Klinik der Meningiome. Zeitschrift für die gesamte Neurologie und Psychiatrie. 1930;123(1):606-625.
Ito J, Kadekaru T, Hayano M, et al. Meningioma in the tela choroidea of the third ventricle: CT and angiographic correlations. Neuroradiology. 1981;21(4):207-211. doi:10.1007/BF00367342.
Bassiouni H, Asgari S, König HJ, Stolke D. Meningiomas of the falcotentorial junction: selection of the surgical approach according to the tumor type. Surg Neurol. 2008;69(4):339-349. doi:10.1016/j.surneu.2007.02.029.
Quiñones-Hinojosa A, Chang EF, Chaichana KL, McDermott MW. Surgical considerations in the management of falcotentorial meningiomas: Advantages of the bilateral occipital transtentorial/transfalcine craniotomy for large tumors. Neurosurgery. 2009;64(SUPPL. 5):260-268. doi:10.1227/01.NEU.0000344642.98597.A7.
Sekhar LN, Goel A. Combined supratentorial and infratentorial approach to large pineal-region meningioma. Surg Neurol. 1992;37(3):197-201. doi:10.1016/0090-3019(92)90230-K.
Asari S, Maeshiro T, Tomita S, et al. Meningiomas arising from the falcotentorial junction: Clinical features, neuroimaging studies, and surgical treatment. J Neurosurg. 1995;82(5):726-738. doi:10.3171/jns.1995.82.5.0726.
Sung DI, Harisiadis L, Chang CH. Midline pineal tumors and suprasellar germinomas: Highly curable by irradiation. Radiology. 1978;128(3):745-751. doi:10.1148/128.3.745.
Lozier AP, Bruce JN. Meningiomas of the velum interpositum: surgical considerations. Neurosurg Focus. 2003;15(1):1-9. doi:10.3171/foc.2003.15.1.11.
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