CC-BY-NC-ND 4.0 · J Neurol Surg Rep 2018; 79(02): e55-e62
DOI: 10.1055/s-0038-1655773
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Anterior Clinoid Metastasis Removed Extradurally: First Case Report

Mirza Pojskić
1  Department of Neurosurgery, Philipps University of Marburg, Marburg, Germany
,
Blazej Zbytek
2  Department of Pathology and Laboratory Medicine, Center for Adult Cancer Research, University of Tennessee Health Science Center, Memphis, Tennessee, United States
3  Pathology Group of the MidSouth, Memphis, Tennessee, United States
,
Kenan I. Arnautović
4  Semmes Murphey Neurologic & Spine Institute, Memphis, Tennessee, United States
5  Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, United States
› Author Affiliations
Further Information

Publication History

06 September 2017

10 April 2018

Publication Date:
31 May 2018 (online)

Abstract

Background We report a case of isolated metastasis on the anterior clinoid process (ACP) mimicking meningioma.

Clinical Presentation A 58-year-old male presented with headaches, right-sided visual disturbances, and blurred and double vision. The cause of double vision was partial weakness of the right III nerve, resulting from compression of the nerve by “hypertrophied” tumor-involved right anterior clinoid. Medical history revealed two primary malignant tumors—male breast cancer and prostate cancer (diagnosed 6 and 18 months prior, respectively). The patient was treated with chemotherapy and showed no signs of active disease, recurrence, or metastasis. Postcontrast head magnetic resonance imaging (MRI) showed extra-axial well-bordered enhancing mass measuring 1.6 × 1.1 × 1 × 1 cm (anteroposterior, transverse, and craniocaudal dimensions) on the ACP, resembling a clinoidal meningioma. Extradural clinoidectomy with tumor resection was performed via right orbitozygomatic pretemporal skull base approach. Visual symptoms improved. Follow-up MRI showed no signs of tumor residual or recurrence.

Conclusion This is the first case report of a metastasis of any kind on ACP. Metastasis should be included as a part of the differential diagnosis of lesions of the anterior clinoid. Extradural clinoidectomy is a safe and effective method in the treatment of these tumors.