• Masahiko Wanibuchi, Yukinori Akiyama, Takeshi Mikami, Satoshi Iihoshi, Kei Miyata, Yoshifumi Horita, Toshiya Sugino, Katsuya Komatsu, Kengo Suzuki, Ken Yamashita, and Nobuhiro Mikuni.
• Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan. Electronic address: wanibuti@sapmed.ac.jp.
• World Neurosurg. 2015 Apr 1; 83 (4): 424-30.

BackgroundMeningiomas or solitary fibrous tumors arising from the cavernous sinus (CS) are usually treated with radiosurgery to control growth. Surgical removal of cavernous tumors is indicated only for tumors extending outside the CS. However, even after adequate treatment, the tumor may exhibit recurrence or malignant transformation. We report a treatment option for recurrent meningeal tumors of the CS.MethodsIn 4 patients with CS tumors that exhibited regrowth after multiple operations and radiosurgery, radical removal in combination with high-flow bypass was performed, and a vascularized muscle flap was used for reconstruction. One patient had a radiation-induced atypical meningioma, 2 patients had transformed atypical meningiomas, and 1 patient had a frequently recurring solitary fibrous tumor.ResultsNo local recurrence was observed in any patients during a follow-up period of 13-41 months. In all patients, a Karnofsky performance scale score of >80 on admission was maintained at >70 at the final follow-up evaluation.ConclusionsRadical removal in combination with high-flow bypass provides favorable results and maintains quality of life in patients with recurrent CS meningeal tumors.Copyright © 2015 Elsevier Inc. All rights reserved.

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