Multiple skull base meningioma: Case report

BACKGROUND The incidence of multiple skull base meningiomas varies from 1 t o 3% in different series. Skull base meningiomas are rare. The pathogenetic role of low-dose radiation seems to be fairly well established in the onco genesis of meningiomas. Calvarial location and multiplicity seem to be amon g the distinctive features of radiation-induced meningiomas. Skull base loc ation is a very rare occurrence, mainly because the path of irradiation doe s not significantly involve this region. CASE REPORT We describe a rare case of simultaneous occurrence of two skull base meningiomas in a 66-year-old female. This patient underwent low-dose irradiation for tinea capitis when she was 8 years old. The patient complai ned of nuchal pain, paresthesias in both hands, and progressive weakness on her right side. She was admitted to the hospital in September 1994. An MRI showed two masses, one located at the level of the tuberculum sellae and t he other at the foramen magnum. These seemed very likely to be multiple men ingiomas. The latter lesion, which was more symptomatic and dangerous, was operated on first. Six months later, elective treatment of the suprasellar meningioma was performed with success. CONCLUSION The actual role of previous head irradiation in the oncogenesis of the present meningiomas remains somewhat unclear. Proper management and judicious use of skull base surgery techniques were key factors in the succ essful treatment of the patient. (C) 1999 by Elsevier Science Inc.