Parasellar Meningiomas
Graillon T, Regis J, Barlier A, Brue T, Dufour H, Buchfelder M (2020)
Publication Type: Journal article, Review article
Publication year: 2020
Journal
Book Volume: 110
Pages Range: 780-796
Journal Issue: 9-10
DOI: 10.1159/000509090
Abstract
Parasellar spaces remain particularly singular, comprising the most important neurovascular structures such as the internal carotid artery and optic, oculomotor, and trigeminal nerves. Meningiomas are one of the most frequent tumors arising from parasellar spaces. In this location, meningiomas remain mostly benign tumors with WHO grade I and a meningothelial subtype. Progestin intake should be investigated and leads mostly to conservative strategies. In the case of benign nonsymptomatic tumors, observation should be proposed. Tumor growth will lead to the proposition of surgery or radiosurgery. In the case of an uncertain diagnosis and an aggressive pattern, a precise diagnosis is required. For cavernous sinus and Meckel's cave lesions, complete removal is rarely considered, leading to the proposition of an endoscopic endonasal or transcranial biopsy. Optic nerve decompression could also be proposed via these approaches. A case-by-case discussion about the best approach is recommended. A transcranial approach remains necessary for tumor removal in most cases. Vascular injury could lead to severe complications. Cerebrospinal fluid leakage, meningitis, venous sacrifice, visual impairment, and cranial nerve palsies are more frequent complications. Pituitary dysfunctions are rare in preoperative assessment and in postoperative follow-up but should be assessed in the case of meningiomas located close to the pituitary axis. Long-term follow-up is required given the frequent incomplete tumor removal and the risk of delayed recurrence. Radiosurgery is relevant for small and well-limited meningiomas or intra-cavernous sinus postoperative residue, whereas radiation therapy and proton beam therapy are indicated for large, extended, nonoperable meningiomas. The place of the peptide receptor radionuclide therapyneeds to be defined. Targeted therapy should be considered in rare, recurrent, and aggressive parasellar meningiomas.
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France (FR)How to cite
APA:
Graillon, T., Regis, J., Barlier, A., Brue, T., Dufour, H., & Buchfelder, M. (2020). Parasellar Meningiomas. Neuroendocrinology, 110(9-10), 780-796. https://doi.org/10.1159/000509090
MLA:
Graillon, Thomas, et al. "Parasellar Meningiomas." Neuroendocrinology 110.9-10 (2020): 780-796.
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