Tuberculum sellae meningiomas

ABSTRACT

This study was done to evaluate the importance of the size of the lesion and early identification of thesymptoms and their effect on the outcome in patients with tuberculum sellae meningiomas. Between 1999 and 2004, at the Department ofNeurosurgery, Alexandria University and other hospitals, 21patients with histopathologically identified tuberculum sellae meningiomas received surgical tumour removal. In thisstudy, the records and clinical data of these patients are retrospectively analyzed. All patients had preoperative plainX-ray, CTscan and MRI of the brain. Different surgical procedures were done. Unilateral subfrontal was done in 16patients. Bifrontal approach was used in one patient and pterional approach was done in 4 cases. Tuberculum sellae meningioma was most frequent in the fifth decade, with a clear predominance in women.Neurological and endocrine deficits were minimal, whereas ophthalmologic signs were always present. The duration ofsymptoms ranged from 3 months to 15 years, averaging 3.25 years. Tumor size ranged from 1.6 cm to 4.4 cm,averaging 3.4 cm. Sellae turcica was not enlarged in all cases. Computed tomography and MRI were the most reliablediagnostic tools. All patient underwent craniotomy using the operating microscope. Prognosis was evaluated accordingto the tumour size and duration of symptoms. Results showed the prognosis was favorably affected by a tumor size of 3cm or less and symptom duration of one year or less. In this series, patients with a tumor size of 3 cm or less and patients with a duration of symptoms for oneyear or less had a better visual outcome, higher total removal rates and lower recurrence rates