Olfactory groove meningioma – upfront radiosurgery





















SKULL BASE REGION Olfactory Groove
HISTOPATHOLOGY Meningioma
PRIOR SURGICAL RESECTION No
PERTINENT LABORATORY FINDINGS N/A


Case description


The patient is a 65-year-old man who was found to have an olfactory groove meningioma during workup for nasal polyps ( Figure 2.7.1 ). Serial neuroimaging showed a progressive increase in size with minimal surrounding edema. He had no significant symptoms, and olfaction was intact. Given the size, age, and medical comorbidities, the patient opted for radiosurgery. He underwent radiosurgery with 8 isocenters to cover a tumor volume of 6100 cc (margin dose 16 Gy; maximum dose 35.6 Gy; treated at 45% isodose line) ( Figure 2.7.2 ).














Radiosurgery Machine Gamma Knife – Perfexion
Radiosurgery Dose (Gy) 16, at 45% isodose line
Number of Fractions 1



Figure 2.7.1.


Initial MRI demonstrating olfactory groove meningioma.



Figure 2.7.2.


Imaging of the treatment plan.
















Critical Structure Dose Tolerance
Optic nerve/chiasm


  • 10 Gy maximum point dose



  • <0.2 cc >8 Gy, goal <6 Gy

Pituitary gland Stalk-to-gland radiation dose <0.8



















Side Effects/Complications Frequency
Visual dysfunction <1% with limited dose
Olfactory dysfunction 34% change in smell with >5.1 Gy
Symptomatic edema 5%–43%



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Apr 6, 2024 | Posted by in GENERAL RADIOLOGY | Comments Off on Olfactory groove meningioma – upfront radiosurgery

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