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
Department of Neurosurgery, Philipps University of Marburg, Marburg, Germany
,
Blazej Zbytek
Department of Pathology and Laboratory Medicine, Center for Adult Cancer Research, University of Tennessee Health Science Center, Memphis, Tennessee, United States
Pathology Group of the MidSouth, Memphis, Tennessee, United States
,
Kenan I. Arnautović
Semmes Murphey Neurologic & Spine Institute, Memphis, Tennessee, United States
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.