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Doo-Sik Kong, Yong Hwy Kim, and Chang-Ki Hong

tumors according to the following 3 types based on the location of the tumor epicenter on the greater sphenoidal bone: the medial one-third, middle one-third, and lateral one-third of the greater sphenoidal wing ( Fig. 1 ). Further, depending on their growth pattern, the tumors were classified as en plaque type or globulous type. 8 , 9 The globulous type of meningioma was defined as globulous in shape, with a short dural tail and a growth pattern with less infiltration to the surrounding organ or tissues than the en plaque type. In contrast, the en plaque type of

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Natarajan Muthukumar, Venkatachalam Sureshkumar, and Vengalathur Ganesan Ramesh

that intradural spinal tuberculomas comprise only 2 to 5% of CNS tuberculomas. 24 Only 22 cases have been reported to date. 22 We report a rare case in which the patient had previously received therapy for tuberculous meningitis and in which the patient subsequently developed an extensive en plaque type of intradural extramedullary spinal tuberculoma concurrently with asymptomatic multiple intracranial tuberculomas. We emphasize the importance of considering the differential diagnosis of en plaque intradural extramedullary tuberculoma in a patient presenting with

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Harvey Jackson

to be found as a primary lesion in all groups. How and why is not so easy of explanation. Arising from arachnoidal villi it is more likely to relate itself to sites where larger venous sinuses abide. The orbitocranial meningiomas commonly associate themselves with a meningioma-en-plaque type of lesion, especially in the regions of the sphenoidal wing and of the floor of the anterior fossa. Sphenoidalwing meningioma not uncommonly gives rise to proptosis ( Fig. 19 ); in fact, it and arteriovenous fistulae produce the grossest degrees of proptosis to be seen

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Umesh S. Vengsarkar, Ramkrishna Prasad Pisipaty, Bharat Parekh, Venilal G. Panchal, and Manohar N. Shetty

enhancing and nonenhancing low-attenuation lesions. Enhancing lesions include 1) solid enhancing lesions, which can be: a) single or multiple; b) small or large; c) calcified or not; d) regular or irregular; or e) of a flat (en plaque) type; 2) ring enhancing lesions, which can be: a) single or multiple; b) small or large; c) regular or irregular; d) complete or incomplete; e) calcified or not; f) conglomerative; or g) of a “bull's eye” type; and 3) mixed or combination lesions. Such a broad classification acquaints a worker in this field with the spectrum of lesions he

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Doo-Sik Kong, Stephanie Ming Young, Chang-Ki Hong, Yoon-Duck Kim, Sang Duk Hong, Jung Won Choi, Ho Jun Seol, Jung-Il Lee, Hyung Jin Shin, Do-Hyun Nam, and Kyung In Woo

introduced for visualization within the limited space along the lateral wall of the orbit and a Silastic sheet is used to prevent the periorbita and orbit from iatrogenic injury ( G ). The lateral orbital wall is drilled to gain exposure to the tumor ( H ). In this case of an en plaque type of meningioma, the tumor is reduced and debulked using a high-speed diamond drill and Coblator ( I and J ). The middle cranial fossa is exposed after removal of the tumor ( K ). The dural defect is reconstructed with the double-button technique using autologous fascia lata ( L ). Figure

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Zhe Bao Wu, Chun Jiang Yu, and Shu Sen Guan

tumor morphologies: an expansive type (8 cases) and en plaque type (14 cases). Meningiomas with an en plaque growth pattern were more infiltrative and could invade neighboring structures or encircle them. It was more difficult to dissect this tumor completely from the neurovascular bundle. 10 All cases were resected via the retrosigmoid approach. Intraoperative fifth—seventh nerves monitoring was performed in 17 cases. Total resection was performed in 16 cases and subtotal resection in six. The rate of total resection was 73%. The rate of anatomical preservation of

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Liang Wu, Tao Yang, Xiaofeng Deng, Chenlong Yang, Lei Zhao, Ning Yao, Jingyi Fang, Guihuai Wang, Jun Yang, and Yulun Xu

are uncommon tumors, accounting for 3.3% to 21.4% of all spinal cord meningiomas. 24 , 31 , 36 En plaque types of extradural meningiomas are very rare. The surgical series presented in this study included 12 patients with intraoperatively and histologically proven extradural en plaque meningiomas. In our series, extradural en plaque meningiomas accounted for 3.5% of all spinal cord meningiomas (n = 346) treated at our institute during the same period. There were 7 female and 5 male patients with a mean age of 39.9 years. IDEM meningiomas affect women approximately

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K. Francis Lee, William H. Whiteley III, Norman J. Schatz, Jack Edeiken, Shu-ren Lin, and Fong-Young Tsai

sphenoid wing and orbital margin is certainly reactive in nature, but its pathogenesis is again uncertain. In both cases, absence of bone proliferation of the sphenoid wing would eliminate the possibility of meningioma. Discussion It is well known that meningioma is the most common cause of hyperostosis in the juxtasellar region. 4, 11, 14 “ En plaquetype meningioma usually causes a sheath-like, smooth, homogeneous ivory sclerosis in the sphenoid ridge. 4, 25 Midline subfrontal meningiomas generally produce irregular hyperostosis in the planum sphenoidale

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Tanmoy K. Maiti, Shyamal C. Bir, Devi Prasad Patra, Piyush Kalakoti, Bharat Guthikonda, and Anil Nanda

S pinal meningiomas are common, slow-growing tumors with a known association with neurofibromatosis Type 2 (NF2). They account for 25%–45% of all intradural spinal tumors and about 2% of all meningiomas. 33 However, they can be extradural, dumbbell shaped, or en plaque type. Safe, complete resection is possible in most cases, with a favorable outcome. Although few studies have discussed the factors predicting recurrence, composite studies of multiple clinicoradiological factors predicting the resection rate, recurrence, and functional outcome in a cohort