Deep Sylvian Meningioma: A Case Report and Review of the Literature

Abstract

Introduction Meningiomas are extra-axial tumors. They usually display a dural attachment, although meningiomas without dural attachment are extremely rare and reported only occasionally in the literature. In this article, the authors present a new case of a deep sylvian meningioma and briefly review the relevant literature.

Case Report We present the case of a 39-year-old man presented with 1- month history of headache associated with an episode of generalized tonic–clonic seizure. Neurological examination showed no abnormality. Magnetic resonance imaging (MRI) demonstrated a lesion located in the right temporo-frontal region which was isointense on T1 and hypointense on T2 with homogeneous enhancement after gadolinium administration. Coronal, axial, and sagittal MRI revealed no dural attachment and the mass appeared to be completely surrounded by brain parenchyma. Intraoperatively, the lesion was presented as a subcortical mass and was mainly in the posterior part of right sylvian fissure. The histological diagnosis showed a World Health Organization grade I meningioma, transitional type.

Conclusion Deep sylvian meningiomas are a rare entity. Preoperative diagnosis is difficult. Nevertheless, neurosurgeons and neuropathologists should be aware of this possibility and should include this hypothesis in the differential diagnosis of an intraparenchymal tumor.

Keywords

meningioma - sylvian - dural attachment

• References

• 1 Cushing H, Eisenhardt L. Meningiomas: Their classifications, regional behaviour, live history and surgical results. Charles C Thomas: Springfield; 1938: 133-165
• 2 Samson Sujit Kumar G, Rajshekhar V. Deep sylvian meningioma: a case report and review of literature. Childs Nerv Syst 2009; 25 (1) 129-132
• 3 Cecchi PC, Campello M, Rizzo P, Mair K, Schwarz A. Atypical meningioma of the sylvian fissure. J Clin Neurosci 2009; 16 (9) 1234-1239
• 4 Barcia-Goyanes JJ, Calvo-Garra W. Meningiomas without dural attachment. Acta Neurochir (Wien) 1953; 3: 241-247
• 5 Mori S, Ishihara H, Sogabe T, Kodama Y, Hibino H. A case of deep sylvian meningioma (author's transl) [in Japanese]. No Shinkei Geka 1977; 5 (4) 385-392
• 6 Saito A, Mizuno Y, Adachi Y, Itoh T. Deep Sylvian psammomeningioma, report of a case (author's transl) [in Japanese]. No To Shinkei 1979; 31 (1) 79-83
• 7 Tsuchida T, Ito J, Sekiguchi K, Honda H, Ueki K. A case of deep sylvian meningioma with intracerebral hematoma (author's transl) [in Japanese]. No Shinkei Geka 1981; 9 (3) 395-400
• 8 Okamoto S, Handa H, Yamashita J, Tokuriki Y. Deep sylvian meningiomas. Surg Neurol 1985; 23 (3) 303-308
• 9 Hirao M, Oka N, Hirashima Y, Horie Y, Takaku A. Deep sylvian meningioma: case report and review of the literature [in Japanese]. No Shinkei Geka 1986; 14 (12) 1471-1478
• 10 Silbergeld D, Berger M, Griffin B. Sylvian fissure meningioma in a child: case report and review of the literature. Pediatr Neurosci 1988; 14 (1) 50-53
• 11 Drake JM, Hendrick EB, Becker LE, Chuang SH, Hoffman HJ, Humphreys RP. Intracranial meningiomas in children. Pediatr Neurosci 1985; -1986 12 (3) 134-139
• 12 Cho BK, Wang KC, Chang KH, Chi JG. Deep sylvian meningioma in a child. Childs Nerv Syst 1990; 6 (4) 228-230
• 13 Graziani N, Donnet A, Vincentelli F, Dechambenoit G, Grisoli F. Deep sylvian meningioma. Apropos of a case. Review of the literature [in French]. Neurochirurgie 1992; 38 (3) 179-182
• 14 Mori Y, Shibuya M, Sugita K, Nagasaka T. Deep sylvian meningioma: a case report of a child [in Japanese]. No Shinkei Geka 1994; 22 (12) 1147-1151
• 15 Chiocca EA, Boviatsis EJ, Westmark RM, Short MP, Richardson EP, Zervas NT. Deep sylvian fissure meningioma without dural attachment in an adult: case report. Neurosurgery 1994; 35 (5) 944-946 , discussion 946
• 16 Matsumoto S, Yamamoto T, Ban S , et al. A case of deep sylvian meningioma presenting temporal lobe epilepsy [in Japanese]. No To Shinkei 1995; 47 (5) 503-508
• 17 Cooper JR, Marshman LA, Smith CM, Powell T. Case report: sylvian fissure meningioma without dural attachment in a 4-year-old child. Clin Radiol 1997; 52 (11) 874-876
• 18 Mitsuyama T, Kasuya H, Kubo O, Hirasawa K, Hori T. Left Sylvian fissure meningioma in a one-year-eight-month old child [in Japanese]. No Shinkei Geka 2000; 28 (5) 459-464
• 19 Kaplan SS, Ojemann JG, Park TS. Pediatric sylvian fissure meningioma. Pediatr Neurosurg 2002; 36 (5) 275-276
• 20 Chang JH, Kim JA, Chang JW, Park YG, Kim TS. Sylvian meningioma without dural attachment in an adult. J Neurooncol 2005; 74 (1) 43-45
• 21 McIver JI, Scheithauer BW, Atkinson JL. Deep sylvian fissure chordoid meningioma: case report. Neurosurgery 2005; 57 (5) E1064 , discussion E1064
• 22 Eghwrudjakpor PO, Mori K. Sylvian cleft meningioma: surgical approach and postoperative morbidity. Niger J Med 2006; 15 (4) 437-440
• 23 Miyahara K, Ichikawa T, Yagishita S , et al. Deep sylvian meningioma without dural attachment: a case report [in Japanese]. No Shinkei Geka 2011; 39 (11) 1067-1072
• 24 Fukushima S, Narita Y, Yonezawa M , et al. Short communication: sclerosing meningioma in the deep sylvian fissure. Brain Tumor Pathol 2014; 31 (4) 289-292