Department of Neurosurgery, Health Science University Gazi Yasargil Education Research Hospital, Diyarbakir, Turkey,
Department of Neurosurgery, Dicle University Medical Faculty, Diyarbakir, Turkey.
Pediatr Neurosurg. 2020;55(5):309-312. doi: 10.1159/000511282. Epub 2020 Nov 18.
Primary intradiploic meningiomas account for <1% of all osseous calvarial lesions and are categorized as bone tumors. They are frequently observed in the frontotemporal region of the calvarium, anterior cranial fossa, and orbit. We present a case of intradiploic meningioma of the orbital roof, which is rarely observed in the pediatric age-group; it was surgically treated with a unique minimally invasive approach.
A 16-year-old male with chief complaints of headache on the right side for approximately 1 year was presented to our clinic. Cranial MRI revealed an intradiploic mass with homogeneous, hypointense contrast patterns on the T1W and T2W images of the right orbital roof. A skin incision was made through the right eyebrow, and the frontal sinus anterior wall was opened by craniotomy. Gross total resection was achieved by reaching the tumor present in the orbital roof. The mass was characterized as psammomatous meningioma by a pathological examination.
DISCUSSION/CONCLUSION: In cranial oncologic surgery, lesion localization and possible pathological diagnosis are essential for the determination of the correct surgical technique. In particular, in pediatric cases, selecting a method that will reduce the need for transfusion, shorten the surgical time, minimize the chances of facial deformity, and facilitate postoperative care will ensure compliance with the correct and appropriate treatment process.
原发性板内脑膜瘤占颅骨病变的<1%，归类为骨肿瘤。它们常发生于颅骨额颞部、前颅窝和眼眶。我们报告一例罕见的儿童眶顶板内脑膜瘤病例，采用独特的微创方法进行手术治疗。
一名 16 岁男性，主要诉右侧头痛约 1 年，就诊于我院。头颅 MRI 显示右侧眶顶板内肿块，T1W 和 T2W 图像上呈均匀、低信号强化模式。通过右眉弓切口，行开颅术打开额窦前壁。通过到达位于眶顶的肿瘤，实现了大体全切除。病理检查显示该肿块为砂粒体型脑膜瘤。
讨论/结论：在颅神经肿瘤外科手术中，明确病变定位和可能的病理诊断对于确定正确的手术技术至关重要。特别是在儿科病例中，选择一种可减少输血需求、缩短手术时间、降低面部畸形风险、并便于术后护理的方法，将确保符合正确和适当的治疗过程。
