Skull base meningioma with infratemporal extension
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Large destructive skull base meningioma (biopsy proven) demonstrated. The tumour extends into the ethmoid and sphenoid sinuses, left maxillary sinus, nasal cavity, pituitary fossa, left petrous apex and clivus. There is involvement of the left orbital apex with mild proptosis of the left globe and extension into the pterygopalatine fossa. Mass effect on the left mesial temporal lobe and inferior frontal lobe. The mass extends into the prepontine cistern. The tumour encases the intracranial left ICA and extends into the middle cranial fossa . There is extension of the tumour into the suprahyoid aspect of the neck.
Meningiomas are the most common extra-axial tumours of the central nervous system and account for 14-20% of all intracranial neoplasms . They are a non-glial neoplasm that originates from the arachnoid cap cells of the meninges.
Many small meningiomas are found incidentally and are entirely asymptomatic. Larger tumours, or those with adjacent oedema or abutting particularly sensitive structures can present with a variety of symptoms.
Meningiomas are located anywhere that meninges are found, and in some places where only rest cells are presumed to be located. Locations include:
- 85-90% supratentorial
- 5-10% infratentorial
- < 5% miscellaneous intracranial
- <1% "extra dural"