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Neurological Surgery 1986-Mar

[Radiosensitive meningioma--report of a case].

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H Koga
K Kinoshita
Y Yamakawa
S Wakisaka

Mo kle

Abstrè

The patient was a 24-year-old male who was admitted to the Dept. of Neurosurgery of Miyazaki Medical College in April of 1982 with a history of generalized convulsive seizures. Neurological examination on admission revealed slight mental disturbance, bilateral marked papilloedema and homonymous right upper quadrantanopsia. Plain skull X-ray films showed a destructive change of the bone in the left sphenoid ridge and sella floor. CT scan showed a huge mass of slightly high density in the left anterior and middle fossae with a marked enhancement with contrast media. It was fed mainly by the left anterior and middle cerebral arteries and partly by the left middle meningeal artery on angiogram. The tumor was considered to be a type of malignant meningioma originating from the left sphenoid ridge. Total removal of the tumor without any morbidity was thought to be difficult because of its size, hypervascularity and location. From clinical and radiological features, this tumor was thought to be an angioblastic meningioma of hemangiopericytoma type and to be radiosensitive. Cobalt-60 irradiation to the tumor was attempted with a total dose of 49 Gy for over a period of 6 weeks. CT scan performed at the stage of 23 Gy-irradiation showed high radiosensitivity of the tumor and CT scan two weeks after the completion of irradiation showed a marked reduction of its volume to one third. The patient became free from headache and memory disturbance after radiotherapy. On the forty eighth day after completion of the irradiation, the tumor was totally removed with ease and minimal bleeding.(ABSTRACT TRUNCATED AT 250 WORDS)

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