Diagnosis
Mass lesions of the anterior, middle, and posterior cranial fossae. Status post-resection of the right temporal lobe segment and partial tumor debulking. Chiari I malformation.
Patient:
Female, 29 years old, Kazakhstan
Physician:
Prof. Dr. med. Martin Scholz, Head of the Neurosurgery Department, Sana Hospital Duisburg
Patient’s Complaints:
Headaches and visual impairment.
Expert Opinion by Prof. Martin Scholz:
Upon reviewing the provided brain MRI scans, I must emphasize that this represents a highly complex medical case requiring long-term, staged treatment.
The indication for the prior resection of the right temporal lobe remains unclear to me, though it was likely performed to address a localized lesion in that region. The clinical picture is further complicated by the presence of multiple meningiomas. Most critically, a frontobasal tumor extends along the midline of the sella turcica, spanning from the tuberculum sellae to the dorsum sellae. This mass exerts direct compression on the optic chiasm; if tumor progression continues, the patient faces a significant risk of irreversible blindness.
Surgical resection of the frontobasal mass should be performed via a right-sided pterional craniotomy under continuous intraoperative visual evoked potentials (VEP) monitoring to safeguard optic nerve function. Furthermore, imaging reveals a petroclival lesion on the right side and a mass in the left cerebellopontine angle. The petroclival tumor should be targeted in a secondary surgical stage following the frontobasal resection, whereas the lesion in the left cerebellopontine angle can be managed via stereotactic radiosurgery.
Our neurosurgical department is fully prepared to admit the patient and proceed with the necessary multidisciplinary treatment.