Опухоли передней черепной ямки: клинический случай крупной менингиомы обонятельной борозды с бифронтальной компрессией и перифокальным отёком

Olfactory groove meningiomas are anterior cranial fossa tumors characterized by an indolent clinical course and may therefore reach a considerable size before diagnosis, producing frontal lobe compression and peritumoral vasogenic edema. Clinical manifestations may include olfactory dysfunction, headache, visual impairment, emotional and behavioral abnormalities, cognitive dysfunction, and signs of intracranial hypertension. We report the case of a 59-year-old woman with a large extra-axial anterior cranial fossa mass located in the olfactory groove region, causing bilateral frontobasal compression, vasogenic edema, hyposmia, cerebral symptoms, and frontal behavioral dysfunction. Contrast-enhanced magnetic resonance imaging demonstrated a lesion with a maximum dimension of approximately 42 mm. Due to the symptomatic course, marked mass effect, and frontal lobe compression, microsurgical treatment was undertaken. A right frontolateral craniotomy was performed, achieving total tumor removal corresponding to Simpson grade II. Postoperatively, cerebral and frontal behavioral symptoms regressed, Karnofsky performance status improved from 70 to 80, no new motor deficit developed, and the surgical wound healed primarily. This case emphasizes the diagnostic significance of subtle olfactory and neurobehavioral manifestations, individualized selection of the surgical corridor, and the principle of maximal safe resection in anterior cranial fossa tumors.

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