Jugular Foramen Meningioma with Transverse and Sigmoid Sinuses Invasion and Jugular Vein Extension

Abstract

We present the case of a jugular foramen meningioma with predominantly intraluminal invasion of the transverse, sigmoid sinuses, jugular bulb, and internal jugular vein with venous occlusion in a 45-year-old woman. Magnetic resonance imaging (MRI) of the brain and conventional angiography were performed preoperatively and revealed a right-sided extra-axial dural-based mass in the jugular foramen. The surgical approach was a high cervical approach with exposure of the internal carotid artery, jugular vein, and cranial nerves IX to XII as well as a combined posterior temporo-basal and retrosigmoid craniotomy with mastoidectomy and posterior retrolabyrinthine petrosectomy. The transverse, sigmoid sinuses, jugular bulb, and superior internal jugular vein were removed en bloc, and the exophytic intradural tumor extension around cranial nerves IX, X, XI, and XII was resected subtotally. Postoperatively, the patient presented a transient right facial weakness (House-Brackmann II). MRI showed partial resection. This is the first case report of a jugular foramen meningioma with transverse and sigmoid sinuses invasion and jugular vein extension in the adult population.

Keywords

jugular foramen - meningioma - dural venous sinus invasion - skull base tumor

• References

• 1 Al-Mefty O, Teixeira A. Complex tumors of the glomus jugulare: criteria, treatment, and outcome. J Neurosurg 2002; 97 (06) 1356-1366
• 2 Bakar B. Jugular foramen meningiomas: review of the major surgical series. Neurol Med Chir (Tokyo) 2010; 50 (02) 89-96 , 96–97
• 3 Vachhrajani S, Jea A, Rutka JA, Blaser S, Cusimano M, Rutka JT. Meningioma with dural venous sinus invasion and jugular vein extension. J Neurosurg Pediatr 2008; 2 (06) 391-396
• 4 Gilbert ME, Shelton C, McDonald A. , et al. Meningioma of the jugular foramen: glomus jugulare mimic and surgical challenge. Laryngoscope 2004; 114 (01) 25-32
• 5 Arnautović KI, Al-Mefty O. Primary meningiomas of the jugular fossa. J Neurosurg 2002; 97 (01) 12-20
• 6 Molony TB, Brackmann DE, Lo WW. Meningiomas of the jugular foramen. Otolaryngol Head Neck Surg 1992; 106 (02) 128-136
• 7 Prabhu SS, DeMonte F. Complete resection of a complex glomus jugulare tumor with extensive venous involvement. Case report. Neurosurg Focus 2004; 17 (02) E12
• 8 Ramina R, Neto MC, Fernandes YB, Aguiar PH, de Meneses MS, Torres LF. Meningiomas of the jugular foramen. Neurosurg Rev 2006; 29 (01) 55-60
• 9 Rohringer M, Sutherland GR, Louw DF, Sima AA. Incidence and clinicopathological features of meningioma. J Neurosurg 1989; 71 (5 Pt 1): 665-672
• 10 Sindou MP, Alvernia JE. Results of attempted radical tumor removal and venous repair in 100 consecutive meningiomas involving the major dural sinuses. J Neurosurg 2006; 105 (04) 514-525
• 11 Maiuri F, Di Martino G, Vergara P, Mariniello G. Meningiomas of the transverse—sigmoid sinus junction area. Br J Neurosurg 2011; 25 (04) 492-496
• 12 Michael II LM, Robertson JH. Glomus jugulare tumors: historical overview of the management of this disease. Neurosurg Focus 2004; 17 (02) E1
• 13 Sanna M, Bacciu A, Falcioni M, Taibah A, Piazza P. Surgical management of jugular foramen meningiomas: a series of 13 cases and review of the literature. Laryngoscope 2007; 117 (10) 1710-1719
• 14 Sindou M. Meningiomas invading the sagittal or transverse sinuses, resection with venous reconstruction. J Clin Neurosci 2001; 8 (Suppl. 01) 8-11
• 15 Morita A, Coffey RJ, Foote RL, Schiff D, Gorman D. Risk of injury to cranial nerves after gamma knife radiosurgery for skull base meningiomas: experience in 88 patients. J Neurosurg 1999; 90 (01) 42-49