Abstract
Objectives Complete removal of infiltrated bone is required to achieve a Simpson Grade 1 meningioma
resection. Reconstruction of the resulting bone defect is typically achieved with
a nonnative implant that can result in poor cosmesis, foreign body reaction, or infection.
Extracorporeal irradiation and reimplantation of tumorous bone has been used for limb-sparing
surgery with excellent results, but this treatment option is not routinely considered
in meningioma surgery. We present a case of anterior fossa meningioma with tumorous
overlying calvarium that was successfully managed with intraoperative extracorporeal
irradiation and reimplantation.
Design, Setting, and Participant A 37-year-old woman with persistent chronic headaches was found to have an anterior
skull base meningioma with extension into the forehead frontal bone. Concurrently
with mass resection, the bone flap was irradiated intraoperatively with 120 Gy. After
resection of the tumor, the bone flap was replaced in its native position.
Main Outcome Measures and Results Twenty-nine months postoperatively, the patient had an excellent cosmetic outcome
with no radiographic evidence of tumor recurrence or significant bone flap resorption.
Conclusion Intraoperative extracorporeal irradiation of tumorous calvaria during meningioma
surgery is an effective, logistically feasible treatment option to achieve local tumor
control and excellent cosmetic outcome.
Keywords
extracorporeal irradiation - meningioma - tumorous calvarium - skull reconstruction
