Neuro-oncology


Radiosurgery for Sphenoid Wing Meningioma

 

Meningiomas were first identified by the Swiss physician and anatomist Felix Plater in 1614. Although simple lesions, meningiomas were considered unresectable due to their location in the anterior skull base.

 

"Sphenoid wing meningiomas occur in the confined space immediately adjacent to the sella turcica, the lateral portion dividing the anterior from the medial cranial fossa," says Thomas Weisenburger, MD, FACR, radiation oncologist and medical director of the Cancer Center of Santa Barbara. "Advances in anesthesia, microsurgery and neuroradiology have made possible safer surgical treatment. However, for those symptomatic meningiomas that can only be partially

resected and for certain deep seated tumors in medically fragile individuals, radiosurgery may become the treatment of choice."

 

Diagnosis and Treatment

Not all meningiomas require treatment. Those in the medial sphenoid wing area that do will typically cause patients to present with symptoms of cavernous sinus invasion (i.e., diplopia, anisocoria, orbital pain, facial numbness, carotid distribution ischemia) and in the lateral sphenoid wing area

with headaches and seizures.

 

Thomas Weisenburger, MD, FACR
Radiation oncologist

 

 

By The Numbers

75 %    Meningiomas occurring in Caucasian women
50   Average age of onset of meningioma
< 20 %    Meningioma occurrence in all brain tumors

 

"Surgery is the treatment of choice for locations that allow effective resection," says Dr. Weisenburger. "In circumstances where meningiomas are located too close to critical structures and cannot be excised, radiation therapy using stereotactic radiosurgery would be indicated."

 

Sagittal view of the plan shows the tightly conformal radiation dose distribution
around the lesion.

Axial view of a computer-generated treatment plan shows the radiotherapeutic dose distribution for radiosurgical treatment of a patient with sphenoid wing meningioma.

 

Unique Local Solution
The Cancer Center of Santa Barbara is home to the Novalis Tx™ radiosurgery system-the only one of its kind in the Tri-County area.

 

"We can perform frameless radiosurgery, a single treatment for tumors such as meningioma in sensitive areas, to stop the encroachment on critical structures," says Dr. Weisenburger. "More efficient and comfortable for the patient, radiosurgery using the Novalis Tx can provide exact positioning for those who require 28 treatments given during a five-and-a-half-week period."

 

 

For more information about services at Cancer Center of Santa Barbara, visit www.ccsb.org. To refer a patient, call (805) 682-7300.

 

Managing Meningiomas

Magnetic resonance imaging (MRI) is used in the diagnosis of meningiomas and to calculate the treatment plan for those requiring intervention. Computed tomography (CT) imaging offers physicians the density of patient anatomy in 3D also needed to calculate the dose.

 

"We perform a CT scan with the patient in the brain lab, wearing an immobilization mask," says Thomas Weisenburger, MD, FACR, radiation oncologist and medical director of the Cancer Center of Santa Barbara. "We transfer the image to the software and fuse that image with the diagnostic MRI, allowing us to accurately draw on the CT images the volume that needs to be treated."

 


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