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J Neurol Surg A Cent Eur Neurosurg
DOI: 10.1055/a-2697-4122
Technical Note

Operative Technique in a Resection of Solitary Fibrous Tumor within the Sigmoid Sinus: Technical Note and Case Presentation

Autor*innen

  • Akinari Yamano

    1   Department of Neurosurgery, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan

  • Masahide Matsuda

    1   Department of Neurosurgery, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan

  • Keiji Tabuchi

    2   Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan

  • Eiichi Ishikawa

    1   Department of Neurosurgery, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan

Funding Information This research was supported in part by Grants-in-Aid for Scientific Research (KAKENHI) to M.M. (No. JP 24K12281) from the Japan Society for the Promotion of Science.
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Abstract

Background

Intracranial solitary fibrous tumors (SFTs) are rare mesenchymal tumors often presenting with dural-based lesions. These tumors can exhibit aggressive characteristics with high recurrence rates and extracranial metastasis. While SFTs occasionally invade venous sinuses, cases where the tumor arises within the venous sinus are rare. This case explores the surgical strategy for removing SFTs occupying the sigmoid sinus and the jugular bulb while preserving the flow of the vein of Labbé.

Clinical Presentation and Surgical Techniques

A 59-year-old woman with progressive left hearing loss and facial nerve palsy was diagnosed with a left temporal bone tumor mainly located in the sigmoid sinus and the jugular bulb. Imaging revealed a vascularized tumor with occlusion of the left sigmoid sinus, and the vein of Labbé was preserved via retrograde perfusion of the transverse sinus. After preoperative embolization, surgery was performed using a trans-sigmoid approach. The tumor was carefully extracted, and the sigmoid sinus was ligated distant from the transverse–sigmoid junction to avoid the occlusion of the vein of Labbé outlet. Subtotal resection was achieved, and the patient experienced full recovery from facial paralysis within 3 weeks. Postoperative radiotherapy was administered, and no recurrence was observed 1 year later.

Conclusion

SFTs arising within venous sinuses are rare but require thorough surgical planning, especially near critical venous structures like the vein of Labbé. This case highlights the feasibility of the operative technique of extracting the tumor from venous sinuses and the importance of individualized strategies for maximizing resection while preserving neurological function and venous patency.

Keywords

cerebral venous sinus - facial nerve palsy - skull base surgery - solitary fibrous tumor - venous congestion

Informed Consent

Informed consent was obtained from the patient. The patient consented to the publication of her images. This study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board of the University of Tsukuba Hospital (protocol code R01-202/approved on January 30, 2020).




Publikationsverlauf

Eingereicht: 26. März 2025

Angenommen: 05. September 2025

Accepted Manuscript online:
09. September 2025

Artikel online veröffentlicht:
18. November 2025

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