title: Radical removal of recurrent malignant meningeal tumors of the cavernous sinus in combination with high-flow bypass.
abstract: BACKGROUND
  Meningiomas 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.
  
  
  METHODS
  In 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.
  
  
  RESULTS
  No 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.
  
  
  CONCLUSIONS
  Radical removal in combination with high-flow bypass provides favorable results and maintains quality of life in patients with recurrent CS meningeal tumors.
authors: Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan. Electronic address: wanibuti@sapmed.ac.jp.
authors: Masahiko
authors: M
authors: Wanibuchi
authors: Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan.
authors: Yukinori
authors: Y
authors: Akiyama
authors: Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan.
authors: Takeshi
authors: T
authors: Mikami
authors: Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan.
authors: Satoshi
authors: S
authors: Iihoshi
authors: Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan.
authors: Kei
authors: K
authors: Miyata
authors: Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan.
authors: Yoshifumi
authors: Y
authors: Horita
authors: Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan.
authors: Toshiya
authors: T
authors: Sugino
authors: Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan.
authors: Katsuya
authors: K
authors: Komatsu
authors: Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan.
authors: Kengo
authors: K
authors: Suzuki
authors: Department of Plastic and Reconstructive Surgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan.
authors: Ken
authors: K
authors: Yamashita
authors: Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan.
authors: Nobuhiro
authors: N
authors: Mikuni
mesh_terms: D000328:Adult; D002426:Cavernous Sinus / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D008579:Meningioma / Q000532:radiotherapy / Q000601:surgery*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D019651:Plastic Surgery Procedures; D019292:Skull Base Neoplasms / Q000601:surgery; D013524:Surgical Flaps
keywords: Cavernous sinus; High-flow bypass; Meningioma; Radical removal; Skull base