DUMBBELL TUMOR OF THE ANTERIOR SKULL BASE - MENINGIOMA - NO, ADENOID CYSTIC CARCINOMA

BACKGROUND Adenoid cystic carcinoma (ACC) is a rare neoplasm of the ex ocrine glands. Because of its tendency for skull base involvement and intracranial spread, ACC should be diagnosed promptly by the neurosurg eon, although discrimination from meningioma is often difficult. Radic al resection of such tumors requires familiarity with complex craniofa cial approaches. CASE DESCRIPTION An unusual case of dumbbell-shaped A CC centered over the planum sphenoidale is presented. Regular margins and neuroimaging features suggested a preoperative diagnosis of mening ioma. The lesion was gross, totally resected in a two-staged procedure through frontobasal and transfacial approaches, with good functional and aesthetic result. CONCLUSION The epidemiologic, histologic, and cl inical features of ACC are reviewed. ACC is rarely encountered by the neurosurgeon; however it should always be considered in the differenti al diagnosis of skull base tumors. Interdisciplinary surgical approach es represent the major advance in the treatment of these complex neopl asms. (C) 1998 by Elsevier Science Inc.