Intracranial meningiomas and neurofibromatosis type 2

LETTER TO THE EDITOR - BRAIN TUMORS Intracranial meningiomas and neurofibromatosis type 2 Gokcen Gokce & Osman Melih Ceylan & Fatih Mehmet Mutlu & Halil Ibrahim Altinsoy Received: 4 March 2014 /Accepted: 7 March 2014 /Published online: 21 March 2014 # Springer-Verlag Wien 2014 Dear Editor, We read with great interest the study by Aboukais et al. [1] describing the characteristics of intracranial meningiomas and neurofibromatosis type 2 (NF 2). On the basis of our experi- ence, there is another important point that should be mentioned. Meningiomas are slow-growing tumors, and they are most- ly asymptomatic for a patient’ s entire life. Meningiomas occur in about half of NF 2 patients, and they are often multiple [4]. Barrett et al. [2] and Prasad et al. [5] reported that recurrent third nerve palsy could be the presenting feature of NF 2. We reported a similar case of a 57-year-old man with recurrent alternating oculomotor nerve palsy secondary to a parasagittal meningioma [ 3]. It is possible that these high-grade meningiomas related to NF 2 can cause a form of neuromyotonia or meningioma-associated mediators may trigger an inflammatory reaction combined with vascu- lopathy leading to oculomotor neuropathy. We recommend that all NF2 patients should be investigated to diagnose a possible oculomotor nerve disorder secondary to meningioma in the follow-up period. Conflicts of interest None. References 1. Aboukais R, Zairi F, Baroncini M, Bonne NX, Schapira S, Vincent C, Lejeune JP (2013) Intracranial meningiomas and neurofibromatosis type 2. Acta Neurochir (Wien) 155:997–1001 2. Barrett VJ, Tan MH, Elston JS (2012) Recurrent third nerve palsy as the presenting feature of neurofibromatosis 2. J Neuroophthalmol 32: 329–331 3. Gokce G, Ceylan OM, Altinsoy HI (2013) Recurrent alternating oculomotor nerve palsy: an unusual presentation of parasagittal meningioma. Neuro-Ophthalmology 37:82–85 4. Goutagny S, Kalamarides M (2010) Meningiomas and neurofibromatosis. J Neurooncol 99:341–347 5. Prasad M, Choi J, Baxter P (2014) Recurrent third nerve palsy as the presenting feature of neurofibromatosis 2. J Neuroophthalmol 34:102– 103 G. Gokce (*) Department of Ophthalmology, Sarikamis Military Hospital, Kars, Turkey e-mail: [email protected] O. M. Ceylan Department of Ophthalmology, Ardahan Military Hospital, Ardahan, Turkey F. M. Mutlu Department of Pediatric Ophthalmology and Strabismus, Gulhane Military Medical Academy, Ankara, Turkey H. I. Altinsoy Department of Pediatric Ophthalmology and Strabismus, World Eye Hospital, Ankara, Turkey Acta Neurochir (2014) 156:1103 DOI 10.1007/s00701-014-2069-x

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Transcript of Intracranial meningiomas and neurofibromatosis type 2

LETTER TO THE EDITOR - BRAIN TUMORS

Intracranial meningiomas and neurofibromatosis type 2

Gokcen Gokce & Osman Melih Ceylan &

Fatih Mehmet Mutlu & Halil Ibrahim Altinsoy

Received: 4 March 2014 /Accepted: 7 March 2014 /Published online: 21 March 2014# Springer-Verlag Wien 2014

Dear Editor,We read with great interest the study by Aboukais et al. [1]describing the characteristics of intracranial meningiomas andneurofibromatosis type 2 (NF 2). On the basis of our experi-ence, there is another important point that should bementioned.

Meningiomas are slow-growing tumors, and they are most-ly asymptomatic for a patient’s entire life. Meningiomas occurin about half of NF 2 patients, and they are often multiple [4].Barrett et al. [2] and Prasad et al. [5] reported that recurrentthird nerve palsy could be the presenting feature of NF 2. Wereported a similar case of a 57-year-old man with recurrentalternating oculomotor nerve palsy secondary to a parasagittalmeningioma [3]. It is possible that these high-grademeningiomas related to NF 2 can cause a form ofneuromyotonia or meningioma-associated mediatorsmay trigger an inflammatory reaction combined with vascu-lopathy leading to oculomotor neuropathy. We recommendthat all NF2 patients should be investigated to diagnose a

possible oculomotor nerve disorder secondary to meningiomain the follow-up period.

Conflicts of interest None.

References

1. Aboukais R, Zairi F, Baroncini M, Bonne NX, Schapira S, Vincent C,Lejeune JP (2013) Intracranial meningiomas and neurofibromatosistype 2. Acta Neurochir (Wien) 155:997–1001

2. Barrett VJ, Tan MH, Elston JS (2012) Recurrent third nerve palsy asthe presenting feature of neurofibromatosis 2. J Neuroophthalmol 32:329–331

3. Gokce G, Ceylan OM, Altinsoy HI (2013) Recurrent alternatingoculomotor nerve palsy: an unusual presentation of parasagittal me-ningioma. Neuro-Ophthalmology 37:82–85

4. Goutagny S, Kalamarides M (2010) Meningiomas and neurofibroma-tosis. J Neurooncol 99:341–347

5. Prasad M, Choi J, Baxter P (2014) Recurrent third nerve palsy as thepresenting feature of neurofibromatosis 2. J Neuroophthalmol 34:102–103

G. Gokce (*)Department of Ophthalmology, Sarikamis Military Hospital,Kars, Turkeye-mail: [email protected]

O. M. CeylanDepartment of Ophthalmology, Ardahan Military Hospital,Ardahan, Turkey

F. M. MutluDepartment of Pediatric Ophthalmology and Strabismus, GulhaneMilitary Medical Academy, Ankara, Turkey

H. I. AltinsoyDepartment of Pediatric Ophthalmology and Strabismus, World EyeHospital, Ankara, Turkey

Acta Neurochir (2014) 156:1103DOI 10.1007/s00701-014-2069-x