[Recurrent Meningioma. Analysis of 43 Surgical Interventions in Meningioma of the Sphenoid Bone]

A total of 43 operations were carried out in 37 patients with a meningioma of the wing of the sphenoid bone or a Tuberculum sellae meningioma. In 18 cases the primary extirpation could be performed and in 18 patients the intervention only consisted of a resection. The removal of any meningioma tissue was classified as an extirpation. If a residual part of whatever size of the tumour was left, the intervention was declared to be a resection. Six patients died, 31 were submitted to a control examination. All 14 patients in whom an extirpation was carried out showed no signs of a renewed tumour growth within the observation period of 2 to 10 years after obtaining the computer-tomographical findings. In six of the 16 patients in whom only a resection was possible a second operation was carried out. An extirpation could be performed in four of these patients. Among the remaining ten patients (period of observation 2 to 6 years) five showed a further increase of the tumour size, in four patients no tendency of a growth could be proved, and one patient had died. In the postoperative assessment we distinguish between a residual tumour and a new tumour growth. A renewed tumour growth is present if the computer tomogram shows signs of meningioma tissue although earlier postoperative checks had not shown this. In the postoperative control examinations the residual tumours should be differentiated with respect to their importance as (a) a residual tumor with a growth tendency and (b) a residual tumour without a growth tendency.