Background: Spheno-orbital enplaque meningioma (SOEMs) are complex lesions that primarily originate in the sphenoid wing with extensive hyperostosis and may involve the orbit and cavernous sinus, making a gross total resection difficult and posing a high risk of postsurgical morbidity and recurrence.
Method: a series of 13 consecutive patients with SOEM presented by proptosis and hyperostosis who underwent surgical excision by frontotemporal craniotomy, clinical, radiological, surgical technique and follow up was reviewed and analyzed.
Result: In this series of 13 consecutive patients, 11 were women and 2 were men. The age range was from 35-63 years with a mean of 46.3 years. Tumors were located on the right side in 9 patients (69%) and the left side in 4 patients (31%). Cavernous sinus (CS) and superior orbital fissure (SOF) invasion in 4 cases (31%). Gross total excision grades I and II were obtained in 6 cases (46%), near total excision grades III in 3 cases (23%), and partial excision grade IV in 4 cases (31%). 11 cases (85%) show improvement of proptosis (7 patients, 54% have a complete resolution of proptosis and 4 cases, 31% have partial resolution of proptosis) and 2 cases show no improvement of proptosis after a long follow-up period.
Conclusion: The decision for each case of Spheno-orbital enplaque meningioma should be individualized depending on the extension of the lesion to the surrounding structures. Extension to the CS and SOF should be considered the surgical limit for excision.