Case Detail

History: A 64 year old women presented with mild headache and numbness on the right side of her face. Neurological exam are otherwise normal.in imaging there is a mass in the right cavernous sinus.

Question: 1-what is your diagnosis? 2- what is the best treatment plan? 3-if you consider radiotherapy, what is the best dose and technique?

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Name	Date	Opinion	Result
Mostafa	6/21/2021	Sub frontal approach	Surgery
Dr Arjmandi	6/21/2021	I recommend biopsy for this case	Surgery
Dr Sotoudeh	6/21/2021	50-54Gy	Radiotherapy
Mostafa Farzin	6/21/2021	Most probable diagnosis: meningioma Due to pressure on brainstem and also in order to have a pathologic diagnosis, I do recommend surgical intervention. Complete resection is not expected. So, adjuvant radiotherapy seems to be necessary. Based on post-op MRI, hypofractionated stereotactic RT, may be possible (eg. 35Gy in 5 Fr.). But applying fractionated RT using IMRT (54-55.8Gy in 30-31Fr) will be my first choice.	Surgery and Adjuvant treatment
Sara	6/21/2021	54 Gy	Radiotherapy
Dr Gomar	6/21/2021	there are multiple differential diagnoses by hyperintense mass in CS such as schwanommas,neurofibroma,chordoma,lymphoma,meningioma.... I think that the first step is biopsy of this lesion and decision making by it's result.	Surgery
Dr Javadinia	6/21/2021	I would suggest stereotactic biopsy first.	Surgery and Adjuvant treatment
Mousareza Anbarlouei	6/21/2021	Dx: 1-schwannoma 2-meningioma	Surgery
Sara Soltanzadeh	6/22/2021		Surgery and Adjuvant treatment
Keyvan Tayebi Meybodi	6/22/2021	Ddx include: meningioma, hemangioma, schwannoma Attempt for total surgical resection may be appropriate. Otherwise, subtotal resection plus radiation therapy, if indicated clinically for tumor regrowth, seems optimal.	Surgery and Adjuvant treatment
	6/23/2021	one of the best management for pathologies of cavernous sinus meningioma which is the most probable scenario, in this case, is radiosurgery. however other diagnoses such as inflammation and infections should be sought and ruled out.	Radiotherapy
Mohamad Namvar	6/23/2021	Maximal safe resection by surgery is preferable. Based on post-op MRI Radiotherapy using 54GY would be helpful.	Surgery and Adjuvant treatment
Dr.Amin hessam	6/23/2021	Cavernous meningioma.	Radiotherapy
	6/23/2021	Cavernous meningioma	Radiotherapy
Dr amini	6/23/2021		Surgery and Adjuvant treatment
A.R Mohsenian Sisakht	6/25/2021	1-what is your diagnosis? Cavernus sinus meningioma 2- what is the best treatment plan? Surgery and aadjuvant treatment 3-if you consider radiotherapy, what is the best dose and technique?	Surgery and Adjuvant treatment
	7/2/2021	Close follow up is recommended	Follow-up