Anterior Interhemispheric Approach for Aggressive Rhabdoid Tuberculum Sellae Meningioma: Report of a Rare Case and Literature Review

Tuberculum Sellae Meningioma (TSM) is one of the most challenging operations among neurosurgeons. Many approaches have been proposed in the attempt of total removal of the tumor. Rhabdoid meningioma is a rare subtype of meningiomas accounting for 2-3% of all intra-cranial meningiomas, an aggressive tumor classified as World Health Organization (WHO) grade III; it occurs mainly in the early childhood, but also rarely in teenagers and adults. It is an aggressive tumor and needs to be treated using both surgery and radiotherapy. We describe the case of a 16-year-old girl with bilateral progressive visual loss. Imaging studies show a tumor mass in the sellae region. Surgery using an anterior interhemispheric approach was performed, and gross total removal was achieved. Histopathological findings established a diagnosis of rhabdoid meningioma. The visual function was improved postoperatively within a week. Rhabdoid tuberculum sellae meningioma, a rare clinical entity in teenagers and adults, had been treated with excellent clinical outcome. This case report supports the suitability of the anterior interhemispheric approach for resection of rhabdoid TSM, followed by radiation therapy.