Sphenoid wing meningioma

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Sphenoid wing meningioma in magnetic resonance imaging (T1w contrast enhanced)
Sphenoid wing meningioma in computed tomography which shows the reactive orbital hyperostosis

A sphenoid wing meningioma is a

benign brain tumor near the sphenoid bone
.

Pathogenesis

A meningioma is a benign brain tumor. It originates from the arachnoid (not the dura), the tissue covering the brain and spinal cord lying deep to the dura. Meningiomas are much more common in females, and are more common after 50 years of age. Of all cranial meningiomas, about 20% of them are in the sphenoid wing. In some cases, deletions involving chromosome 22 are involved.

Diagnosis

Sphenoid wing meningiomas are diagnosed by the combination of suggestive

Cranial nerve VI is often the first affected, leading to diplopia with lateral gaze. If cranial nerve V-1 is damaged, the patient will have pain and altered sensation over the front and top of the head. Horner's syndrome may occur if nearby sympathetic fibers are involved.[citation needed
]

Classification

Tumors found in the external third of the sphenoid are of two types:

arteries may be used to supplement evaluation of vascular involvement and to determine whether embolization would be helpful if surgery is being considered.[citation needed
]

Treatment

Meningiomas have been divided into three types based on their patterns of growth. Histological factors that increase the grade include a high number of

blindness
as well as paresis of extraocular movements.

Prognosis

Higher grade tumors have been shown to correspond with higher recurrences. Depending on the grade and extent of resection, from less than 1 in 10 to over two-thirds of tumors will recur after surgical excision. Follow-up clinical exams, as well as neuroimaging, can aid in detecting recurrences. As many meningiomas have receptors for

interferon alpha-2b
.

References

  1. PMID 28017748
    .
  • Al-Mefty, O, ed. Meningiomas. New York: Raven Press, 1991.
  • Bonnal J, A Thibaut, J Brotchi, and J Born. Invading Meningiomas of the Sphenoid Ridge. Journal of Neurosurgery. 53(5):587-99, Nov 1980.
  • Kearns, T and H Wagener. Ophthalmologic Diagnosis of Meningiomas of the Sphenoidal Ridge.
    American Journal of the Medical Sciences
    , 226(2):221-8, Aug 1953.
  • Khoromi, S and S. Zachariah. Meningioma, Sphenoid Wing. Emedicine, available online: http://www.emedicine.com/oph/topic670.htm, April 5, 2006.
  • Kleinpeter G and F Bock. Invasion of the Cavernous Sinus by Medial Sphenoid Meningioma--"Radical" Surgery and Recurrence. Acta Neurochirurgica. 103(3-4):87-91, 1990.
  • Miller, N, V Biousse, N Newman, and J. Kerrison, eds. Walsh and Hoyt's Clinical Neuro-Ophthalmology, 6th ed, vol. 2. Philadelphia: Lippincott Williams & Wilkins, 2005.
  • Newman, S. Meningiomas: A Quest for the Optimum Therapy. Journal of Neurosurgery. 80(2):191-4, Feb 1994.
  • Park, J and P Black. Biology and Clinical Features of Meningioma. UpToDate, online, April 7, 2006.
  • Park, J and P Black. Treatment of meningioma. UpToDate, online, April 7, 2006.
  • Schmidek, H. Meningiomas and Their Surgical Management. Philadelphia: W.B. Saunders Company, 1991.
  • Thomas, D, ed. Stereotactic and Image Directed Surgery of Brain Tumors. New York: Churchill Livingstone, 1993.
  • Villavicencio A, P Black, D Shrieve, M Fallon, E Alexander and J Loeffler. Linac Radiosurgery for Skull Base Meningiomas. Acta Neurochirurgica. 143(11):1141-52, Nov 2001.
  • Wilson, WB. Meningiomas of the Anterior Visual System. Survey of Ophthalmology. 26(3):109-27, Nov-Dec 1981.
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