前床突起部髄膜腫の病態と治療
トルコ鞍近傍を発生母地とする髄膜腫の総称が傍鞍部髄膜腫であり, そのうち本稿では傍鞍部に発生する前床突起部髄膜腫について論じる. 前床突起部髄膜腫の最も多い症状は視機能障害で, 頭痛が次に続く. 治療には手術と定位放射線治療があり, 第一選択は摘出術である. 手術はpterional approachが基本で, 視神経の早期減圧が重要となる. 定位放射線照射にはガンマナイフ治療と寡分割照射があり, いずれも良好な腫瘍コントロール率となっている. 高悪性度髄膜腫に対する今後の治療として, ホウ素中性子捕捉療法に期待が寄せられている....
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| Published in | 脳神経外科ジャーナル Vol. 31; no. 11; pp. 711 - 716 |
|---|---|
| Main Authors | , , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人日本脳神経外科コングレス
2022
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0917-950X 2187-3100 |
| DOI | 10.7887/jcns.31.711 |
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| Abstract | トルコ鞍近傍を発生母地とする髄膜腫の総称が傍鞍部髄膜腫であり, そのうち本稿では傍鞍部に発生する前床突起部髄膜腫について論じる. 前床突起部髄膜腫の最も多い症状は視機能障害で, 頭痛が次に続く. 治療には手術と定位放射線治療があり, 第一選択は摘出術である. 手術はpterional approachが基本で, 視神経の早期減圧が重要となる. 定位放射線照射にはガンマナイフ治療と寡分割照射があり, いずれも良好な腫瘍コントロール率となっている. 高悪性度髄膜腫に対する今後の治療として, ホウ素中性子捕捉療法に期待が寄せられている. |
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| AbstractList | トルコ鞍近傍を発生母地とする髄膜腫の総称が傍鞍部髄膜腫であり, そのうち本稿では傍鞍部に発生する前床突起部髄膜腫について論じる. 前床突起部髄膜腫の最も多い症状は視機能障害で, 頭痛が次に続く. 治療には手術と定位放射線治療があり, 第一選択は摘出術である. 手術はpterional approachが基本で, 視神経の早期減圧が重要となる. 定位放射線照射にはガンマナイフ治療と寡分割照射があり, いずれも良好な腫瘍コントロール率となっている. 高悪性度髄膜腫に対する今後の治療として, ホウ素中性子捕捉療法に期待が寄せられている. |
| Author | 池田, 直廉 古瀬, 元雅 鰐渕, 昌彦 高見, 俊宏 矢木, 亮吉 川端, 信司 平松, 亮 宮武, 伸一 野々口, 直助 亀田, 雅博 |
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| Copyright | 2022 日本脳神経外科コングレス |
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| References | 4) Bassiouni H, Asgari S, Sandalcioglu IE, Seifert V, Stolke D, Marquardt G : Anterior clinoidal meningiomas : functional outcome after microsurgical resection in a consecutive series of 106 patients. Clinical article. J Neurosurg 111 : 1078-1090, 2009. 10) Fokas E, Henzel M, Surber G, Hamm K, Engenhart-Cabillic R : Stereotactic radiotherapy of benign meningioma in the elderly : clinical outcome and toxicity in 121 patients. Radiother Oncol 111 : 457-462, 2014. 25) Puzzilli F, Ruggeri A, Mastronardi L, Agrillo A, Ferrante L : Anterior clinoidal meningiomas : report of a series of 33 patients operated on through the pterional approach. Neuro Oncol 1 : 188-195, 1999. 18) Mariniello G, de Divitiis O, Bonavolonta G, Maiuri F : Surgical unroofing of the optic canal and visual outcome in basal meningiomas. Acta Neurochir (Wien) 155 : 77-84, 2013. 26) Romani R, Laakso A, Kangasniemi M, Lehecka M, Hernesniemi J : Lateral supraorbital approach applied to anterior clinoidal meningiomas : experience with 73 consecutive patients. Neurosurgery 68 : 1632-1647 ; discussion 1647, 2011. 17) MacCarty CS, Taylor WF : Intracranial meningiomas : experiences at the Mayo Clinic. Neurol Med Chir (Tokyo) 19 : 569-574, 1979. 6) Couldwell WT, MacDonald JD, Taussky P : Complete resection of the cavernous sinus―indications and technique. World Neurosurg 82 : 1264-1270, 2014. 1) Akyoldas G, Hergunsel OB, Yilmaz M, Sengoz M, Peker S : Gamma knife radiosurgery for anterior clinoid process meningiomas : a series of 61 consecutive patients. World Neurosurg 133 : e529-e534, 2020. 29) Santacroce A, Walier M, Régis J, Liščák R, Motti E, Lindquist C, Kemeny A, Kitz K, Lippitz B, Martínez Álvarez R, Pedersen PH, Yomo S, Lupidi F, Dominikus K, Blackburn P, Mindermann T, Bundschuh O, van Eck AT, Fimmers R, Horstmann GA : Long-term tumor control of benign intracranial meningiomas after radiosurgery in a series of 4565 patients. Neurosurgery 70 : 32-39 ; discussion 39, 2012. 2) Al-Mefty O : Clinoidal meningiomas. J Neurosurg 73 : 840-849, 1990. 22) Navarria P, Pessina F, Cozzi L, Clerici E, Villa E, Ascolese AM, De Rose F, Comito T, Franzese C, D'Agostino G, Lobefalo F, Fogliata A, Reggiori G, Fornari M, Tomatis S, Bello L, Scorsetti M : Hypofractionated stereotactic radiation therapy in skull base meningiomas. J Neurooncol 124 : 283-289, 2015. 14) Kaul D, Budach V, Wurm R, Gruen A, Graaf L, Habbel P, Badakhshi H : Linac-based stereotactic radiotherapy and radiosurgery in patients with meningioma. Radiat Oncol 9 : 78, 2014. 15) Komatsu F, Imai M, Shigematsu H, Aoki R, Oda S, Shimoda M, Matsumae M : Endoscopic extradural supraorbital approach to the temporal pole and adjacent area : technical note. J Neurosurg 128 : 1873-1879, 2018. 32) Wanibuchi M, Akiyama Y, Mikami T, Iihoshi S, Miyata K, Horita Y, Sugino T, Komatsu K, Suzuki K, Yamashita K, Mikuni N : Radical removal of recurrent malignant meningeal tumors of the cavernous sinus in combination with high-flow bypass. World Neurosurg 83 : 424-430, 2015. 11) Giammattei L, Starnoni D, Levivier M, Messerer M, Daniel RT : Surgery for clinoidal meningiomas : case series and meta-analysis of outcomes and complications. World Neurosurg 129 : e700-e717, 2019. 34) Zevgaridis D, Medele RJ, Muller A, Hischa AC, Steiger HJ : Meningiomas of the sellar region presenting with visual impairment : impact of various prognostic factors on surgical outcome in 62 patients. Acta Neurochir (Wien) 143 : 471-476, 2001. 20) Mathiesen T, Lindquist C, Kihlstrom L, Karlsson B : Recurrence of cranial base meningiomas. Neurosurgery 39 : 2-7 ; discussion 8-9, 1996. 23) Oya S, Matsui T : Ultra-early optic nerve decompression for the resection of anterior clinoidal meningioma. J Neurol Surg B Skull Base 79 (Suppl 2) : S231-S232, 2018. 21) Mirimanoff RO, Dosoretz DE, Linggood RM, Ojemann RG, Martuza RL : Meningioma : analysis of recurrence and progression following neurosurgical resection. J Neurosurg 62 : 18-24, 1985. 8) Demiral S, Dincoglan F, Sager O, Gamsiz H, Uysal B, Gundem E, Elcim Y, Dirican B, Beyzadeoglu M : Hypofractionated stereotactic radiotherapy (HFSRT) for who grade Ⅰ anterior clinoid meningiomas (ACM). Jpn J Radiol 34 : 730-737, 2016. 12) Goel A, Gupta S, Desai K : New grading system to predict resectability of anterior clinoid meningiomas. Neurol Med Chir (Tokyo) 40 : 610-616 ; discussion 616-617, 2000. 19) Martinez-Perez R, Albonette-Felicio T, Zachariah MA, Hardesty DA, Carrau RL, Prevedello DM : Quantitative anatomic study of the minipterional craniotomy in the paraclinoid region : benefits of extradural anterior clinoidectomy. World Neurosurg 135 : e221-e229, 2020. 27) Sade B, Lee JH : High incidence of optic canal involvement in clinoidal meningiomas : rationale for aggressive skull base approach. Acta Neurochir (Wien) 150 : 1127-1132 ; discussion 1132, 2008. 3) Attia M, Umansky F, Paldor I, Dotan S, Shoshan Y, Spektor S : Giant anterior clinoidal meningiomas : surgical technique and outcomes. J Neurosurg 117 : 654-665, 2012. 31) Uihlein A, Weyand RD : Meningiomas of anterior clinoid process as a cause of unilateral loss of vision ; surgical considerations. AMA Arch Ophthalmol 49 : 261-270, 1953. 33) Wong AK, Eddelman DB, Kramer DE, Munich SA, Byrne RW : Surgical resection of clinoidal meningiomas without routine use of clinoidectomy. World Neurosurg 146 : e467-e472, 2021. 13) Haghighi N, Seely A, Paul E, Dally M : Hypofractionated stereotactic radiotherapy for benign intracranial tumours of the cavernous sinus. J Clin Neurosci 22 : 1450-1455, 2015. 30) Takai S, Wanibuchi M, Kawabata S, Takeuchi K, Sakurai Y, Suzuki M, Ono K, Miyatake SI : Reactor-based boron neutron capture therapy for 44 cases of recurrent and refractory high-grade meningiomas with long-term follow-up. Neuro Oncol 24 : 90-98, 2022. 24) Pamir MN, Belirgen M, Ozduman K, Kilic T, Ozek M : Anterior clinoidal meningiomas : analysis of 43 consecutive surgically treated cases. Acta Neurochir (Wien) 150 : 625-635 ; discussion 635-626, 2008. 16) Krayenbuhl N, Pravdenkova S, Al-Mefty O : De novo versus transformed atypical and anaplastic meningiomas : comparisons of clinical course, cytogenetics, cytokinetics, and outcome. Neurosurgery 61 : 495-503 ; discussion 503-504, 2007. 28) Saenz A, Villalonga JF, Solari D, Baldoncini M, Mantese B, Lopez-Elizalde R, Campero A : Meningo-orbital band detachment : A key step for the extradural exposure of the cavernous sinus and anterior clinoid process. J Clin Neurosci 81 : 367-377, 2020. 7) Cui H, Wang Y, Yin YH, Fei ZM, Luo QZ, Jiang JY : Surgical management of anterior clinoidal meningiomas : a 26-case report. Surg Neurol 68 Suppl 2 : S6-S10 ; discussion S10, 2007. 5) Buttrick S, Morcos JJ, Elhammady MS, Wang AC : Extradural clinoidectomy for resection of clinoidal meningioma. Neurosurg Focus 43 (VideoSuppl 2) : V10, 2017. 9) Dossani RH, Kalakoti P, Guthikonda B : Supraorbital approach for resection of clinoidal meningioma. World Neurosurg 109 : 295, 2018. |
| References_xml | – reference: 12) Goel A, Gupta S, Desai K : New grading system to predict resectability of anterior clinoid meningiomas. Neurol Med Chir (Tokyo) 40 : 610-616 ; discussion 616-617, 2000. – reference: 6) Couldwell WT, MacDonald JD, Taussky P : Complete resection of the cavernous sinus―indications and technique. World Neurosurg 82 : 1264-1270, 2014. – reference: 15) Komatsu F, Imai M, Shigematsu H, Aoki R, Oda S, Shimoda M, Matsumae M : Endoscopic extradural supraorbital approach to the temporal pole and adjacent area : technical note. J Neurosurg 128 : 1873-1879, 2018. – reference: 30) Takai S, Wanibuchi M, Kawabata S, Takeuchi K, Sakurai Y, Suzuki M, Ono K, Miyatake SI : Reactor-based boron neutron capture therapy for 44 cases of recurrent and refractory high-grade meningiomas with long-term follow-up. Neuro Oncol 24 : 90-98, 2022. – reference: 16) Krayenbuhl N, Pravdenkova S, Al-Mefty O : De novo versus transformed atypical and anaplastic meningiomas : comparisons of clinical course, cytogenetics, cytokinetics, and outcome. Neurosurgery 61 : 495-503 ; discussion 503-504, 2007. – reference: 11) Giammattei L, Starnoni D, Levivier M, Messerer M, Daniel RT : Surgery for clinoidal meningiomas : case series and meta-analysis of outcomes and complications. World Neurosurg 129 : e700-e717, 2019. – reference: 2) Al-Mefty O : Clinoidal meningiomas. J Neurosurg 73 : 840-849, 1990. – reference: 3) Attia M, Umansky F, Paldor I, Dotan S, Shoshan Y, Spektor S : Giant anterior clinoidal meningiomas : surgical technique and outcomes. J Neurosurg 117 : 654-665, 2012. – reference: 21) Mirimanoff RO, Dosoretz DE, Linggood RM, Ojemann RG, Martuza RL : Meningioma : analysis of recurrence and progression following neurosurgical resection. J Neurosurg 62 : 18-24, 1985. – reference: 8) Demiral S, Dincoglan F, Sager O, Gamsiz H, Uysal B, Gundem E, Elcim Y, Dirican B, Beyzadeoglu M : Hypofractionated stereotactic radiotherapy (HFSRT) for who grade Ⅰ anterior clinoid meningiomas (ACM). Jpn J Radiol 34 : 730-737, 2016. – reference: 13) Haghighi N, Seely A, Paul E, Dally M : Hypofractionated stereotactic radiotherapy for benign intracranial tumours of the cavernous sinus. J Clin Neurosci 22 : 1450-1455, 2015. – reference: 5) Buttrick S, Morcos JJ, Elhammady MS, Wang AC : Extradural clinoidectomy for resection of clinoidal meningioma. Neurosurg Focus 43 (VideoSuppl 2) : V10, 2017. – reference: 20) Mathiesen T, Lindquist C, Kihlstrom L, Karlsson B : Recurrence of cranial base meningiomas. Neurosurgery 39 : 2-7 ; discussion 8-9, 1996. – reference: 25) Puzzilli F, Ruggeri A, Mastronardi L, Agrillo A, Ferrante L : Anterior clinoidal meningiomas : report of a series of 33 patients operated on through the pterional approach. Neuro Oncol 1 : 188-195, 1999. – reference: 18) Mariniello G, de Divitiis O, Bonavolonta G, Maiuri F : Surgical unroofing of the optic canal and visual outcome in basal meningiomas. Acta Neurochir (Wien) 155 : 77-84, 2013. – reference: 34) Zevgaridis D, Medele RJ, Muller A, Hischa AC, Steiger HJ : Meningiomas of the sellar region presenting with visual impairment : impact of various prognostic factors on surgical outcome in 62 patients. Acta Neurochir (Wien) 143 : 471-476, 2001. – reference: 14) Kaul D, Budach V, Wurm R, Gruen A, Graaf L, Habbel P, Badakhshi H : Linac-based stereotactic radiotherapy and radiosurgery in patients with meningioma. Radiat Oncol 9 : 78, 2014. – reference: 7) Cui H, Wang Y, Yin YH, Fei ZM, Luo QZ, Jiang JY : Surgical management of anterior clinoidal meningiomas : a 26-case report. Surg Neurol 68 Suppl 2 : S6-S10 ; discussion S10, 2007. – reference: 33) Wong AK, Eddelman DB, Kramer DE, Munich SA, Byrne RW : Surgical resection of clinoidal meningiomas without routine use of clinoidectomy. World Neurosurg 146 : e467-e472, 2021. – reference: 22) Navarria P, Pessina F, Cozzi L, Clerici E, Villa E, Ascolese AM, De Rose F, Comito T, Franzese C, D'Agostino G, Lobefalo F, Fogliata A, Reggiori G, Fornari M, Tomatis S, Bello L, Scorsetti M : Hypofractionated stereotactic radiation therapy in skull base meningiomas. J Neurooncol 124 : 283-289, 2015. – reference: 27) Sade B, Lee JH : High incidence of optic canal involvement in clinoidal meningiomas : rationale for aggressive skull base approach. Acta Neurochir (Wien) 150 : 1127-1132 ; discussion 1132, 2008. – reference: 1) Akyoldas G, Hergunsel OB, Yilmaz M, Sengoz M, Peker S : Gamma knife radiosurgery for anterior clinoid process meningiomas : a series of 61 consecutive patients. World Neurosurg 133 : e529-e534, 2020. – reference: 31) Uihlein A, Weyand RD : Meningiomas of anterior clinoid process as a cause of unilateral loss of vision ; surgical considerations. AMA Arch Ophthalmol 49 : 261-270, 1953. – reference: 29) Santacroce A, Walier M, Régis J, Liščák R, Motti E, Lindquist C, Kemeny A, Kitz K, Lippitz B, Martínez Álvarez R, Pedersen PH, Yomo S, Lupidi F, Dominikus K, Blackburn P, Mindermann T, Bundschuh O, van Eck AT, Fimmers R, Horstmann GA : Long-term tumor control of benign intracranial meningiomas after radiosurgery in a series of 4565 patients. Neurosurgery 70 : 32-39 ; discussion 39, 2012. – reference: 17) MacCarty CS, Taylor WF : Intracranial meningiomas : experiences at the Mayo Clinic. Neurol Med Chir (Tokyo) 19 : 569-574, 1979. – reference: 9) Dossani RH, Kalakoti P, Guthikonda B : Supraorbital approach for resection of clinoidal meningioma. World Neurosurg 109 : 295, 2018. – reference: 4) Bassiouni H, Asgari S, Sandalcioglu IE, Seifert V, Stolke D, Marquardt G : Anterior clinoidal meningiomas : functional outcome after microsurgical resection in a consecutive series of 106 patients. Clinical article. J Neurosurg 111 : 1078-1090, 2009. – reference: 32) Wanibuchi M, Akiyama Y, Mikami T, Iihoshi S, Miyata K, Horita Y, Sugino T, Komatsu K, Suzuki K, Yamashita K, Mikuni N : Radical removal of recurrent malignant meningeal tumors of the cavernous sinus in combination with high-flow bypass. World Neurosurg 83 : 424-430, 2015. – reference: 26) Romani R, Laakso A, Kangasniemi M, Lehecka M, Hernesniemi J : Lateral supraorbital approach applied to anterior clinoidal meningiomas : experience with 73 consecutive patients. Neurosurgery 68 : 1632-1647 ; discussion 1647, 2011. – reference: 10) Fokas E, Henzel M, Surber G, Hamm K, Engenhart-Cabillic R : Stereotactic radiotherapy of benign meningioma in the elderly : clinical outcome and toxicity in 121 patients. Radiother Oncol 111 : 457-462, 2014. – reference: 28) Saenz A, Villalonga JF, Solari D, Baldoncini M, Mantese B, Lopez-Elizalde R, Campero A : Meningo-orbital band detachment : A key step for the extradural exposure of the cavernous sinus and anterior clinoid process. J Clin Neurosci 81 : 367-377, 2020. – reference: 23) Oya S, Matsui T : Ultra-early optic nerve decompression for the resection of anterior clinoidal meningioma. J Neurol Surg B Skull Base 79 (Suppl 2) : S231-S232, 2018. – reference: 24) Pamir MN, Belirgen M, Ozduman K, Kilic T, Ozek M : Anterior clinoidal meningiomas : analysis of 43 consecutive surgically treated cases. Acta Neurochir (Wien) 150 : 625-635 ; discussion 635-626, 2008. – reference: 19) Martinez-Perez R, Albonette-Felicio T, Zachariah MA, Hardesty DA, Carrau RL, Prevedello DM : Quantitative anatomic study of the minipterional craniotomy in the paraclinoid region : benefits of extradural anterior clinoidectomy. World Neurosurg 135 : e221-e229, 2020. |
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| Title | 前床突起部髄膜腫の病態と治療 |
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| ispartofPNX | 脳神経外科ジャーナル, 2022, Vol.31(11), pp.711-716 |
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