The Meckel cave: computed tomographic study. Part I: Normal anatomy; Part II: Pathology.

Kapila, Ashwani; Chakeres, Donald W.; Blanco, E. Herrero

doi:10.1148/radiology.152.2.6739810

Cited by 46 publications

(9 citation statements)

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“…Neurinoma also occurs frequently in this location and has a dumbbell shape; it extends from the middle to the posterior cranial fossa and is reported to be found in approximately 20% of all trigeminal neurinomas. 6,9,12,17 A Meckel's cave meningioma must also be considered in the differential diagnosis, although its incidence is less frequent than that of the trigeminal neurinoma. Approximately one-eighth of Meckel's cave meningiomas are reported to show a dumbbell shape.…”

Section: Discussionmentioning

confidence: 99%

Solitary metastatic breast carcinoma in a trigeminal nerve mimicking a trigeminal neurinoma

Nakano

Iwasaki²,

Kondo³

1996

Journal of Neurosurgery

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An unusual case of a metastatic adenocarcinoma located entirely within the trigeminal nerve is reported. The patient, with a history of breast cancer, presented with a pure trigeminal mononeuropathy. The neurological and neuroradiological findings in this patient were quite similar to those of a patient with trigeminal neurinoma. Surgery revealed that the tumor was located within the trigeminal nerve and its appearance was similar to that of a neurinoma. However, histopathological studies proved the tumor to be an adenocarcinoma that was related to the breast cancer treated earlier. A solitary metastatic tumor arising solely in a trigeminal nerve is quite rare; this is the first report of such a case metastasized from breast cancer.

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Section: Discussionmentioning

confidence: 99%

Solitary metastatic breast carcinoma in a trigeminal nerve mimicking a trigeminal neurinoma

Nakano

Iwasaki²,

Kondo³

1996

Journal of Neurosurgery

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“…Meningiomas of the Meckel cave typically originate from the dura mater, compress the trigeminal ganglion, and can extend toward the middle cranial fossa or through the porus trigeminus into the posterior fossa in a dumbbell-shaped configuration. 2 Meningiomas generally derive from dural-based arachnoid cap cells; however, intracranial meningiomas without dural attachment occur in the ventricles, Sylvian fissure, pineal region, and even in the brain parenchyma. 7 The average age at diagnosis of patients affected by meningiomas without dural attachment is 26.5 years, approximately 20 years younger than the average age at diagnosis of meningiomas in general, with a male-to-female ratio of meningiomas without dural attachment of 1.39:1.…”

Section: Discussionmentioning

confidence: 99%

Atypical Cystic Meningioma of the Trigeminal Nerve in a Pediatric Patient

Obeng¹,

Rumboldt²,

Tuite³

et al. 2008

American Journal of Neuroradiology

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SUMMARY:We report an unusual case of atypical cystic meningioma of the trigeminal nerve proved by histology in a 15-year-old white girl. A review of the literature showed that this is only the second reported case of a meningioma of the trigeminal nerve without dural attachment and the first occurrence in a pediatric patient. P rimary tumors of the trigeminal nerve and Meckel cave represent less than 0.5% of intracranial tumors.1 We report the case of a dumbbell-shaped atypical meningioma of the trigeminal nerve without dural attachment, involving the Meckel cave and the posterior fossa in an adolescent. Case ReportA 15-year-old white girl presented with a 2-month history of leftsided facial numbness and loss of sensation of the left hemitongue. Physical examination showed hypoesthesia in the left V1, V2, and V3 dermatome distribution and absent left corneal reflex. She had no family history of neurofibromatosis, and physical examination revealed no evidence of café au lait spots or freckling in the axillary or inguinal area. Aside from the absence of a left corneal reflex, the findings of the ophthalmologic examination were unremarkable, with no evidence of lens abnormalities. A brain MR imaging revealed an extra-axial dumbbell-shaped cystic mass, without obvious "dural tail" or dural attachment, demonstrating peripheral rim enhancement (Fig 1), with a cystic component in the posterior fossa at the root entry zone of the left trigeminal nerve, and a second cystic lesion with a fluid-fluid level at the level of the left Meckel cave. The mass was thought to be consistent with a cystic schwannoma of the left trigeminal nerve. There were no masses along the course of the 8 cranial nerves.A 1-stage surgical excision of the middle and posterior fossa components of the mass was planned. The patient underwent a left-sided skull base craniotomy, with a left temporal craniotomy and zygomatic osteotomy, by using an extradural approach. At surgery, it was noted that the mass arose from the left trigeminal nerve, did not have a dural attachment, and was heavily intermixed with the surrounding trigeminal nerve. Surgical resection of the mass was thought to be complete.The resected gross specimen consisted of multiple fragments of brown-red variegated tissue. Histology (Fig 2) showed concentric structures typical of meningioma, hypercellularity, mitotically active foci, and focal necrosis, making it atypical. Embedded nerve fascicles of the excised trigeminal nerve appeared infiltrated by tumor. Reticulin stain showed chiefly perivascular staining in the tumor, highlighting its vascularity. A final diagnosis of atypical meningioma was made.Given the histology and the location of the neoplasm, we planned to treat residual or recurrent tumor with stereotactic radiosurgery. Since surgery, a postoperative MR imaging and subsequent follow-up MR imaging performed every 2 months in the last 4 months did not demonstrate evidence of macroscopic residual or recurrent tumor.Findings of an MR imaging of the cervical spine performed 2 mon...

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“…It is centered anteromedial to IAC. 53 Schwannomas from IX, X and XI cranial nerves within the posterior fossa should be considered in the differential diagnosis of acoustic schwannomas. Foraminal widening, if evident, aids in making the diagnosis.…”

Section: Schwannomas From Other Cranial Nervesmentioning

confidence: 99%

MRI of Lateral Skull Base Lesions

Patkar¹,

Yanamandala²,

Pardhi³

et al. 2011

An International Journal of Otorhinolaryngology Clinics

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This article reviews the role of magnetic resonance imaging (MRI) in the evaluation of lateral skull base lesions. Due to superior soft tissue resolution and multiplanar capability, MRI provides accurate information and exquisite anatomical detail. Thus, it guides the surgeon in proper preoperative planning regarding the approach of a lesion. MRI is also useful in post-treatment follow-up to assess the therapeutic response and to identify potential complications. We discuss the relevant anatomy, indications of MRI and MR pulse sequences used in the diagnosis of lesions of lateral skull base. Characteristic MRI findings of various lesions which help to arrive at a specific diagnosis as well as pitfalls of MRI which may confound the diagnosis are described. Newer MR pulse sequences enable image-guided surgery, which assist the surgeon intraoperatively, are briefly discussed. In summary, this article emphasizes the role of MRI in providing a specific answer to a clinical problem and its ability to guide the clinician for better management of patients.

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The Meckel cave: computed tomographic study. Part I: Normal anatomy; Part II: Pathology.

Cited by 46 publications

References 0 publications

Solitary metastatic breast carcinoma in a trigeminal nerve mimicking a trigeminal neurinoma

Solitary metastatic breast carcinoma in a trigeminal nerve mimicking a trigeminal neurinoma

Atypical Cystic Meningioma of the Trigeminal Nerve in a Pediatric Patient

MRI of Lateral Skull Base Lesions

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