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CC BY-NC-ND 4.0 · J Neurol Surg Rep 2023; 84(03): e92-e102
DOI: 10.1055/s-0043-1772201
Original Report

Surgical Management of Meningiomas Involving the Torcula, Transverse Sinus, and Jugular Bulb: A Technical Note and Review of the Literature

Robert G. Power
1   Division of Neurosurgery, DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
,
Fred C. Lam
1   Division of Neurosurgery, DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
,
Anthony C. Whitton
2   Department of Radiation Oncology, Juravinski Cancer Centre, Hamilton, Ontario, Canada
3   Juravinski Cancer Centre, Hamilton Health Sciences Corporation, Hamilton, Ontario, Canada
,
Sunjay Sharma
1   Division of Neurosurgery, DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
,
Ekkehard M. Kasper 
1   Division of Neurosurgery, DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
3   Juravinski Cancer Centre, Hamilton Health Sciences Corporation, Hamilton, Ontario, Canada
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Abstract

Meningiomas that invade the confluens sinuum are rare and require extensive preoperative planning. Here, we describe the surgical and radio-oncological management of an aggressive large occipital meningioma invading the superior sagittal sinus, torcula, right and left transverse sinus down to the level of the jugular bulb in a 21-year-old female patient. Details of the surgical approach are presented to highlight the planned staged resection of this tumor at the level of the torcula to initially debulk the lesion while preserving venous outflow through the patent's sinus. Once the tumor fully occluded the confluens, a second-stage en bloc resection ensued. Postsurgical adjuvant radiation therapy was delivered via fractionated external beam therapy which has provided local control of the tumor since. This case is being discussed in the context of the pertinent literature to demonstrate the highly complex interdisciplinary and staged management of partially intravascular meningiomas involving the major venous sinuses.

Keywords

meningioma - torcula - intravascular meningioma - venous sinus - tumor


Publikationsverlauf

Eingereicht: 21. Februar 2021

Angenommen: 26. Januar 2023

Artikel online veröffentlicht:
25. August 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Brotchi J. Brussels. World Neurosurg 2013; 82: 325
    PubMedGoogle Scholar
  • 2 Riemenschneider MJ, Perry A, Reifenberger G. Histological classification and molecular genetics of meningiomas. Lancet Neurol 2006; 5 (12) 1045-1054
    CrossrefPubMedGoogle Scholar
  • 3 Ostrom QT, Cioffi G, Gittleman H. et al. CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2012-2016. Neuro-oncol 2019; 21 (Suppl. 05) v1-v100
    CrossrefPubMedGoogle Scholar
  • 4 Harsh IV GR, Wilson CB. Meningiomas of the peritorcular region. In: Al-Mefty O. ed. Meningiomas. New York: Raven Press; 1991: 363-369
    Google Scholar
  • 5 Pathmanaban ON, Sadler KV, Kamaly-Asl ID. et al. Association of genetic predisposition with solitary schwannoma or meningioma in children and young adults. JAMA Neurol 2017; 74 (09) 1123-1129
    CrossrefPubMedGoogle Scholar
  • 6 Evans DG. Neurofibromatosis 2 [bilateral acoustic neurofibromatosis, central neurofibromatosis, NF2, neurofibromatosis type II]. Genet Med 2009; 11 (09) 599-610
    CrossrefPubMedGoogle Scholar
  • 7 Kerr K, Qualmann K, Esquenazi Y, Hagan J, Kim DH. Familial syndromes involving meningiomas provide mechanistic insight into sporadic disease. Neurosurgery 2018; 83 (06) 1107-1118
    CrossrefPubMedGoogle Scholar
  • 8 Hatch EE, Linet MS, Zhang J. et al. Reproductive and hormonal factors and risk of brain tumors in adult females. Int J Cancer 2005; 114 (05) 797-805
    CrossrefPubMedGoogle Scholar
  • 9 Louis DN, Perry A, Reifenberger G. et al. The 2016 World Health Organization classification of tumors of the central nervous system: a summary. Acta Neuropathol 2016; 131 (06) 803-820
    CrossrefPubMedGoogle Scholar
  • 10 Simpson D. The recurrence of intracranial meningiomas after surgical treatment. J Neurol Neurosurg Psychiatry 1957; 20 (01) 22-39
    CrossrefPubMedGoogle Scholar
  • 11 Buerki RA, Horbinski CM, Kruser T, Horowitz PM, James CD, Lukas RV. An overview of meningiomas. Future Oncol 2018; 14 (21) 2161-2177
    CrossrefPubMedGoogle Scholar
  • 12 Gousias K, Schramm J, Simon M. The Simpson grading revisited: aggressive surgery and its place in modern meningioma management. J Neurosurg 2016; 125 (03) 551-560
    CrossrefPubMedGoogle Scholar
  • 13 Ehresman JS, Garzon-Muvdi T, Rogers D. et al. The relevance of Simpson grade resections in modern neurosurgical treatment of World Health Organization grade I, II, and III meningiomas. World Neurosurg 2018; 109: e588-e593
    CrossrefPubMedGoogle Scholar
  • 14 Fogh SE, Johnson DR, Barker II FG. et al. Case-Based Review: meningioma. Neurooncol Pract 2016; 3 (02) 120-134
    PubMedGoogle Scholar
  • 15 Mazur MD, Neil JA, Agarwal C, Jensen RL, Couldwell WT. Surgical management of a transosseous meningioma with invasion of torcula, superior sagittal sinus, transverse sinus, calvaria, and scalp. Surg Neurol Int 2015; 6 (01) 40
    CrossrefPubMedGoogle Scholar
  • 16 Alvernia JE, Sindou MP. Torcular, transverse, and sigmoid sinus meningiomas. In: Lee JH. ed. Meningiomas. London: Springer; 2009
    CrossrefGoogle Scholar
  • 17 Cushing H, Eisenhardt L. Meningiomas: Their Classification, Regional Behaviour, Life History and Surgical Results. Springfield, IL: Charles C Thomas; 1938
    Google Scholar
  • 18 Mantovani A, Di Maio S, Ferreira MJ, Sekhar LN. Management of meningiomas invading the major dural venous sinuses: operative technique, results, and potential benefit for higher grade tumors. World Neurosurg 2014; 82 (3-4): 455-467
    CrossrefPubMedGoogle Scholar
  • 19 Sindou M. Meningiomas involving major dural sinuses: should we attempt at radical removal and venous repair?. World Neurosurg 2014; 81 (01) 46-47
    CrossrefPubMedGoogle Scholar
  • 20 Di Maio S, Ramanathan D, Garcia-Lopez R. et al. Evolution and future of skull base surgery: the paradigm of skull base meningiomas. World Neurosurg 2012; 78 (3-4): 260-275
    CrossrefPubMedGoogle Scholar
  • 21 Sindou M, Hallacq P. Venous reconstruction in surgery of meningiomas invading the sagittal and transverse sinuses. Skull Base Surg 1998; 8 (02) 57-64
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 22 Mathiesen T, Lindquist C, Kihlström L, Karlsson B. Recurrence of cranial base meningiomas. Neurosurgery 1996; 39 (01) 2-9
    CrossrefPubMedGoogle Scholar
  • 23 Sindou MP, Alvernia JE. Results of attempted radical tumor removal and venous repair in 100 consecutive meningiomas involving the major dural sinuses. J Neurosurg 2006; 105 (04) 514-525
    CrossrefPubMedGoogle Scholar
  • 24 Sindou M, Hallacq P, Ojemann RG, Laws ER. Aggressive vs. conservative treatment of parasagittal meningiomas involving the superior sagittal sinus. In: Al Mefty Origitano TC, Harkey HL. eds. Controversies in Neurosurgery. New York: Thieme; 1996: 80-89
    Google Scholar
  • 25 Hwang SK, Gwak HS, Paek SH, Kim DG, Jung HW. Guidelines for the ligation of the sigmoid or transverse sinus during large petroclival meningioma surgery. Skull Base 2004; 14 (01) 21-28 , discussion 29
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 26 Oka K, Go Y, Kimura H, Tomonaga M. Obstruction of the superior sagittal sinus caused by parasagittal meningiomas: the role of collateral venous pathways. J Neurosurg 1994; 81 (04) 520-524
    CrossrefPubMedGoogle Scholar
  • 27 Caroli E, Orlando ER, Mastronardi L, Ferrante L. Meningiomas infiltrating the superior sagittal sinus: surgical considerations of 328 cases. Neurosurg Rev 2006; 29 (03) 236-241
    CrossrefPubMedGoogle Scholar
  • 28 Debernardi A, Quilici L, La Camera A, Boccardi E, Cenzato M. Torcular meningioma with multi-venous sinus invasion: compensatory drainage veins and surgical strategy. World Neurosurg 2018; 109: 451-454
    CrossrefPubMedGoogle Scholar
  • 29 Sindou MP, Alvernia JE. Results of attempted radical tumor removal and venous repair in 100 consecutive meningiomas involving the major dural sinuses. J Neurosurg 2006; 105 (04) 514-525
    CrossrefPubMedGoogle Scholar
  • 30 Al-Mefty O, Yamamoto Y. Neurovascular reconstruction during and after skull base surgery. Contemp Neurosurg 1993; 15: 1-6
    CrossrefPubMedGoogle Scholar
  • 31 Hakuba A. Reconstruction of dural sinus involved in meningiomas. In: Al Mefty O. ed. Meningiomas. New York: Raven Press; 1991: 371-382
    Google Scholar
  • 32 Bauman GS, Wong E. Re: new radiotherapy technologies for meningiomas: 3D conformal radiotherapy? Radiosurgery? Sterotactic radiotherapy? Intensity modulated radiotherapy? Proton beam radiotherapy? Spot scanning proton radiation therapy? Or nothing at all? [Radiother Oncol 2004;71(3):247-249]. Radiother Oncol 2004; 73 (02) 251-252
    CrossrefPubMedGoogle Scholar
  • 33 Chin LS, Szerlip NJ, Regine WF. Stereotactic radiosurgery for meningiomas. Neurosurg Focus 2003; 14 (05) e6
    PubMedGoogle Scholar
  • 34 Kondziolka D, Nathoo N, Flickinger JC, Niranjan A, Maitz AH, Lunsford LD. Long-term results after radiosurgery for benign intracranial tumors. Neurosurgery 2003; 53 (04) 815-821
    CrossrefPubMedGoogle Scholar
  • 35 NCCN Guidelines. Central Nervous System Cancers. Version 1.2017, Accessed 9 June 2020 at: http://nccn.org/
    PubMedGoogle Scholar
  • 36 Walcott BP, Nahed BV, Brastianos PK, Loeffler JS. Radiation treatment for WHO Grade II and III meningiomas. Front Oncol 2013; 3: 227
    CrossrefPubMedGoogle Scholar
  • 37 Weber DC, Ares C, Villa S. et al. Adjuvant postoperative high-dose radiotherapy for atypical and malignant meningioma: a phase-II parallel non-randomized and observation study (EORTC 22042-26042). Radiother Oncol 2018; 128 (02) 260-265
    CrossrefPubMedGoogle Scholar
  • 38 Rogers CL, Won M, Vogelbaum MA. et al. High-risk meningioma: initial outcomes from NRG oncology/RTOG 0539. Int J Radiat Oncol Biol Phys 2020; 106 (04) 790-799
    CrossrefPubMedGoogle Scholar
  • 39 Kondziolka D, Mathieu D, Lunsford LD. et al. Radiosurgery as definitive management of intracranial meningiomas. Neurosurgery 2008; 62 (01) 53-58 , discussion 58–60
    CrossrefPubMedGoogle Scholar
  • 40 Singh VP, Kansai S, Vaishya S, Julka PK, Mehta VS. Early complications following gamma knife radiosurgery for intracranial meningiomas. J Neurosurg 2000; 93 (Suppl. 03) 57-61
    CrossrefPubMedGoogle Scholar
  • 41 Barua KK, Tamaki N, Ehara K, Nagashima T, Suzuki H. Spontaneous peritumoral haemorrhage associated with sinus confluence meningioma: case report. Surg Neurol 2000; 54 (03) 254-259
    CrossrefPubMedGoogle Scholar
  • 42 Feng R, Che X, Hu J, Pan L, Cui D, Yang L. Surgical treatment of recurrent torcular meningiomas: case report and review of the literature. J Neurol Surg A Cent Eur Neurosurg 2013; 74 (Suppl. 1) e266-e270
    PubMedGoogle Scholar
  • 43 Li X, He X, Niu J, Du C, Wang J. Microsurgical Treatment of Meningiomas in the Torcular Herophili Region. J Craniofac Surg 2016; 27 (02) e211-e215
    CrossrefPubMedGoogle Scholar
  • 44 Raza SM, Gallia GL, Brem H, Weingart JD, Long DM, Olivi A. Perioperative and long-term outcomes from the management of parasagittal meningiomas invading the superior sagittal sinus. Neurosurgery 2010; 67 (04) 885-893
    CrossrefPubMedGoogle Scholar
  • 45 Talacchi A, Biroli A, Hasanbelliu A, Locatelli F. Surgical Management of Medial Tentorial Meningioma: Falcotentorial and Torcular. World Neurosurg 2018; 115: e437-e447
    CrossrefPubMedGoogle Scholar
  • 46 Zeeshan Q, Patel A, Cheng CY, Zhao NH, Barber J, Ghodke BV, Sekhar LN. Resection of Meningiomas Involving Major Dural Venous Sinuses: Classification, Technique, and Long-Term Results. World Neurosurg 2019; 125: e521-e536
    CrossrefPubMedGoogle Scholar