Central base of skull meningioma

Case contributed by Dr Nikola Todorovic
Diagnosis almost certain

Presentation

Follow-up examination for suprasellar meningioma treated 5 years ago with gamma knife.

Patient Data

Age: 50 years
Gender: Female

There is an expansive extra-axial lesion in the middle cranial fossa, mostly suprasellar, with the involvement of the sella, cavernous sinus, sphenoid sinus bilaterally, and prepontine cistern, with encasement of the carotid arteries, more pronounced on the left, but with no signs of infiltration.

The lesion measures approximately 44 x 30 x 40 mm, with intensive post-contrast enhancement of the lesion and the adjacent dura.

Case Discussion

The patient underwent gamma knife treatment for a lesion described as meningioma 5 years ago.

Now on the regular follow-up examination, we can see residual tumor with the involvement of the described structures, having signal intensity and enhancement characteristics consistent with a meningioma.

The lesion is of approximately the same size and characteristics as it was on the previous MRI. The patient's tumor has shown growth arrest post-treatment, with no significant change in size ever since, so this result is actually what we were hoping for. 

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