Tuberculum sellae meningioma (TSM)


Neurosurgery Department, University General Hospital of Alicante, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Alicante, Spain

Suprasellar meningioma usually arises from the tuberculum sellae or the sulcus chiasmatis. Due to the close proximity to the optic apparatus, the same may be involved even when the lesions are small.

Tuberculum sellae meningiomas originate in the middle fossa (unlike planum sphenoidale meningiomas which are in the anterior fossa).

They are in a deep and sensitive location, proximity to critical neurovascular elements, hypothalamus with often dense and fibrous nature.

Characteristically lie in a suprasellar subchiasmal midline position, displacing the optic chiasm posteriorly and slightly superiorly, and the optic nerves laterally 1).

Although tuberculum sellae (TS) and diaphragma sellae meningiomas have different anatomical origins, they are frequently discussed as a single entity.

They comprise approximately 3%–10% of all intracranial meningiomas 2).

The coexistence of a pituitary macroadenoma and a tuberculum sellae meningioma is very rare 3).

Tuberculum Sellae Meningioma Classification.

Tuberculum sellae meningioma clinical features.

Ophthalmological examination include visual acuity, fundoscopy, and visual field.

From 4)

All patients needs evaluation by CT scanning and MR imaging, with intravenous administration of a contrast agent. The radiological parameters include tumor size, brain–tumor interface, peritumoral edema, arterial encasement, optic canal extension, hyperostosis, etc.

Gadolinium-enhanced sagittal and coronal T1 weighted image demonstrating a tuberculum sellae meningioma with suprasellar and sellar involvement.

Angiographic embolization of tuberculum sellae meningiomas is not routinely performed. The vascular supply tends to derive from small perforating branches from the posterior ethmoidal artery, ophthalmic artery, superior hypophyseal artery, and A1/A2 artery segments. Preoperative angiography can help demonstrate distorted vascular anatomy secondary to tumor mass effect, which usually reveals posterior displacement of the A1 and A2 segments of the ACA in 80% of patients and encasement of the A1 segment in 24%

see Tuberculum sellae meningioma treatment.

Tuberculum Sellae Meningioma Outcome.

see Tuberculum sellae meningioma case series.

Tuberculum Sellae Meningioma Videos.

Tuberculum Sellae Meningioma Case Reports.

1) , 2)
Chi JH, McDermott MW. Tuberculum sellae meningiomas. Neurosurg Focus. 2003;14:e6.
Mahvash M, Igressa A, Pechlivanis I, Weber F, Charalampaki P. Endoscopic endonasal transsphenoidal approach for resection of a coexistent pituitary macroadenoma and a tuberculum sellae meningioma. Asian J Neurosurg. 2014 Oct-Dec;9(4):236. doi: 10.4103/1793-5482.146629. PubMed PMID: 25685225; PubMed Central PMCID: PMC4323972.
  • tuberculum_sellae_meningioma.txt
  • Last modified: 2022/04/13 08:48
  • by administrador