Skip to main content
SpringerLink
Log in

Meningioma of the Sellar and Parasellar Region

  • Chapter
Atlas of Sellar and Parasellar Lesions

Abstract

Meningiomas are commonly occurring extra-axial lesions originating from the arachnoid cap cells of the dura.

They are typically benign, slow-growing lesions that present secondary to mass effect on surrounding structures.

Meningiomas in the sellar and parasellar region may arise from any point along the dural skull base, including the tuberculum sellae, planum sphenoidale, anterior or clinoid processes, sphenoid wing, cavernous sinuses, petroclival region, diaphragma sellae, or clivus.

Meningiomas typically comprise 1–3 % of sellar lesions resected in major transsphenoidal series. Purely intrasellar meningiomas are quite uncommon and may present with hypopituitarism, headache, and visual loss. Most purely intrasellar meningiomas arise from inferior leaves of the diaphragma sellae.

Meningiomas of the sellar region may present with headache, visual loss, hypopituitarism, cranial nerve paresis, proptosis, hydrocephalus, or any combination of these conditions.

Tuberculum sellae meningiomas frequently present with visual loss, causing a bilateral superior quadrantanopsia that gradually evolves into a full bitemporal hemianopsia.

Presentation of intrasellar meningioma mimicking pituitary apoplexy has been reported.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 199.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Fatemi N, Dusick JR, de Paiva Neto MA, Kelly DF. The endonasal microscopic approach for pituitary adenomas and other parasellar tumors: a 10-year experience. Neurosurgery. 2008;63:244–56; discussion 256.

    Article  PubMed  Google Scholar 

  2. Saeger W, Ludecke DK, Buchfelder M, Fahlbusch R, Quabbe HJ, Petersenn S. Pathohistological classification of pituitary tumors: 10 years of experience with the German Pituitary Tumor Registry. Eur J Endocrinol. 2007;156:203–16.

    Article  CAS  PubMed  Google Scholar 

  3. Nozaki K, Nagata I, Yoshida K, Kikuchi H. Intrasellar meningioma: case report and review of the literature. Surg Neurol. 1997;47:447–52; discussion 452–4.

    Article  CAS  PubMed  Google Scholar 

  4. Grisoli F, Vincentelli F, Raybaud C, Harter M, Guibout M, Baldini M. Intrasellar meningioma. Surg Neurol. 1983;20:36–41.

    Article  CAS  PubMed  Google Scholar 

  5. Taylor SL, Barakos JA, Harsh GR, Wilson CB. Magnetic resonance imaging of tuberculum sellae meningiomas: preventing preoperative misdiagnosis as pituitary macroadenoma. Neurosurgery. 1992;31:621–7; discussion 627.

    Article  CAS  PubMed  Google Scholar 

  6. Kinjo T, Al-Mefty O, Ciric I. Diaphragma sellae meningiomas. Neurosurgery. 1995;36:1082–92.

    Google Scholar 

  7. Orakdogeny M, Karadereler S, Berkman Z, Ersahin M, Ozdogan C, Aker F. Intra-suprasellar meningioma mimicking pituitary apoplexy. Acta Neurochir (Wien). 2004;146:511–5.

    Article  CAS  Google Scholar 

  8. Kudo H, Takaishi Y, Minami H, Takamoto T, Kitazawa S, Maeda S, Tamaki N. Intrasellar meningioma mimicking pituitary apoplexy: case report. Surg Neurol. 1997;48:374–81.

    Article  CAS  PubMed  Google Scholar 

  9. Michael AS, Paige ML. MR imaging of intrasellar meningiomas simulating pituitary adenomas. J Comput Assist Tomogr. 1988;12:944–6.

    Article  CAS  PubMed  Google Scholar 

  10. Abe T, Matsumoto K, Homma H, Kawamura N, Iwata T, Nemoto S. Dorsum sellae meningioma mimicking pituitary macroadenoma: case report. Surg Neurol. 1999;51:543–6; discussion 546–7.

    Article  CAS  PubMed  Google Scholar 

  11. Rhoton Jr AL. The sellar region. Neurosurgery. 2002;51:S335–74.

    PubMed  Google Scholar 

  12. Larson JJ, van Loveren HR, Balko MG, Tew Jr JM. Evidence of meningioma infiltration into cranial nerves: clinical implications for cavernous sinus meningiomas. J Neurosurg. 1995;83:596–9.

    Article  CAS  PubMed  Google Scholar 

  13. Sen C, Hague K. Meningiomas involving the cavernous sinus: histological factors affecting the degree of resection. J Neurosurg. 1997;87:535–43.

    Article  CAS  PubMed  Google Scholar 

  14. de Divitiis E, Esposito F, Cappabianca P, Cavallo LM, de Divitiis O. Tuberculum sellae meningiomas: high route or low route? A series of 51 consecutive cases. Neurosurgery. 2008;62:556–63.

    Article  PubMed  Google Scholar 

  15. Zada G, Du R, Laws Jr ER. Defining the “edge of the envelope”: patient selection in treating complex sellar-based neoplasms via transsphenoidal versus open craniotomy. J Neurosurg. 2011;114:286–300.

    Article  PubMed  Google Scholar 

  16. Mathiesen T, Kihlstrom L. Visual outcome of tuberculum sellae meningiomas after extradural optic nerve decompression. Neurosurgery. 2006;59:570–6.

    Article  PubMed  Google Scholar 

  17. Fahlbusch R, Schott W. Pterional surgery of meningiomas of the tuberculum sellae and planum sphenoidale: surgical results with special consideration of ophthalmological and endocrinological outcomes. J Neurosurg. 2002;96:235–43.

    Article  PubMed  Google Scholar 

  18. Couldwell WT, Weiss MH, Rabb C, Liu JK, Apfelbaum RI, Fukushima T. Variations on the standard transsphenoidal approach to the sellar region, with emphasis on the extended approaches and parasellar approaches: surgical experience in 105 cases. Neurosurgery. 2004;55:539–47; discussion 547–50.

    Article  PubMed  Google Scholar 

  19. Honegger J, Fahlbusch R, Buchfelder M, Huk WJ, Thierauf P. The role of transsphenoidal microsurgery in the management of sellar and parasellar meningioma. Surg Neurol. 1993;39:18–24.

    Article  CAS  PubMed  Google Scholar 

  20. Kitano M, Taneda M, Nakao Y. Postoperative improvement in visual function in patients with tuberculum sellae meningiomas: results of the extended transsphenoidal and transcranial approaches. J Neurosurg. 2007;107:337–46.

    Article  PubMed  Google Scholar 

  21. Kaptain GJ, Vincent DA, Sheehan JP, Laws Jr ER. Transsphenoidal approaches for the extracapsular resection of midline suprasellar and anterior cranial base lesions. Neurosurgery. 2001;49:94–100; discussion 100–1.

    CAS  PubMed  Google Scholar 

  22. Schwartz TH, Fraser JF, Brown S, Tabaee A, Kacker A, Anand VK. Endoscopic cranial base surgery: classification of operative approaches. Neurosurgery. 2008;62:991–1002; discussion 1002–5.

    Article  PubMed  Google Scholar 

  23. Gardner PA, Kassam AB, Thomas A, Snyderman CH, Carrau RL, Mintz AH, Prevedello DM. Endoscopic endonasal resection of anterior cranial base meningiomas. Neurosurgery. 2008;63:36–52; discussion 52–4.

    Article  PubMed  Google Scholar 

  24. de Divitiis E, Cavallo LM, Esposito F, Stella L, Messina A. Extended endoscopic transsphenoidal approach for tuberculum sellae meningiomas. Neurosurgery. 2008;62:1192–201.

    PubMed  Google Scholar 

  25. Borg A, Ekanayake J, Mair R, Smedley T, Brew S, Kitchen N, et al. Preoperative particle and glue embolization of meningiomas: indications, results and lessons learned from 117 consecutive patients. Neurosurgery. 2013;73:ons244–51; discussion ons252.

    Article  PubMed  Google Scholar 

  26. Hasegawa T, Kida Y, Yoshimoto M, Koike J, Iizuka H, Ishii D. Long-term outcomes of Gamma Knife surgery for cavernous sinus meningioma. J Neurosurg. 2007;107:745–51.

    Article  PubMed  Google Scholar 

  27. Kuo JS, Chen JC, Yu C, Zelman V, Giannotta SL, Petrovich Z, et al. Gamma knife radiosurgery for benign cavernous sinus tumors: quantitative analysis of treatment outcomes. Neurosurgery. 2004;54:1385–93; discussion 1393–4.

    Article  PubMed  Google Scholar 

  28. Zada G, Pagnini PG, Yu C, Erickson KT, Hirschbein J, Zelman V, Apuzzo ML. Long-term outcomes and patterns of tumor progression after gamma knife radiosurgery for benign meningiomas. Neurosurgery. 2010;67:322–8; discussion 328–9.

    Article  PubMed  Google Scholar 

  29. Pham CJ, Chang SD, Gibbs IC, Jones P, Heilbrun MP, Adler Jr JR. Preliminary visual field preservation after staged CyberKnife radiosurgery for perioptic lesions. Neurosurgery. 2004;54:799–810; discussion 810–2.

    Article  PubMed  Google Scholar 

  30. Chamberlain MC. The role of chemotherapy and targeted therapy in the treatment of intracranial meningioma. Curr Opin Oncol. 2012;24:666–71.

    Article  CAS  PubMed  Google Scholar 

  31. Chamberlain MC, Tsao-Wei DD, Groshen S. Temozolomide for treatment-resistant recurrent meningioma. Neurology. 2004;62:1210–2.

    Article  CAS  PubMed  Google Scholar 

  32. Muazzam A. Recent developments in chemotherapy for meningiomas: A Review. Neurosurg Focus 2013;35(6):E18.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurological Surgery, Keck School of Medicine, University of Southern California, 1200 N State Street, #3300, Los Angeles, CA, 90033, USA

    Gabriel Zada MD, MS

  2. Department of Pathology (Neuropathology), University of Virginia School of Medicine, 1215 Lee Street, Room 3060–HEP, Charlottesville, VA, 22908, USA

    M. Beatriz S. Lopes MD, PhD

  3. Department of Radiology, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA, 02115, USA

    Srinivasan Mukundan Jr. PhD, MD

  4. Department of Neurosurgery, Brigham and Women’s Hospital, 15 Francis Street, Boston, MA, 02115, USA

    Edward Laws Jr. MD

Authors
  1. Gabriel Zada MD, MS
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Beatriz S. Lopes MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Srinivasan Mukundan Jr. PhD, MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Edward Laws Jr. MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gabriel Zada MD, MS .

Editor information

Editors and Affiliations

  1. Department of Neurosurgery, University of Southern California, LOS ANGELES, California, USA

    Gabriel Zada

  2. Department of Pathology, University of Virginia, CHARLOTTESVILLE, Virginia, USA

    M. Beatriz S. Lopes

  3. Department of Radiology, Brigham and Women's Hospital, BOSTON, Massachusetts, USA

    Srinivasan Mukundan Jr.

  4. Department of Neurosurgery, Brigham and Women’s Hospital, BOSTON, Massachusetts, USA

    Edward R. Laws Jr.

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Zada, G., Lopes, M.B.S., Mukundan, S., Laws, E. (2016). Meningioma of the Sellar and Parasellar Region. In: Zada, G., Lopes, M., Mukundan Jr., S., Laws Jr., E. (eds) Atlas of Sellar and Parasellar Lesions. Springer, Cham. https://doi.org/10.1007/978-3-319-22855-6_28

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-22855-6_28

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-22854-9

  • Online ISBN: 978-3-319-22855-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation