A minimally invasive supraorbital keyhole approach through superciliary arch for giant olfactory Groove angiopericytoma: case report

We sought to demonstrate a giant hemangiopericytoma within the olfactory groove resected by a minimally invasive supraorbital keyhole approach through superciliary arch, which is commonly used to remove relatively small meningioma, pituitary adenoma and craniopharyngioma.A 50-year-old female presented with a 1-year history of progressive headaches, anosmia, hyposmia, and visual deterioration.Anosmia and visual impairment were found by physical examination.The magnetic resonance imaging (MRI) scan demonstrated a large irregularly shaped intra-dural mass at bottom of right frontal lobe.A minimally invasive supraorbital keyhole approach through superciliary arch is performed for resecting this giant tumor.Surgical complications and degree of resection were recorded to evaluate the efficacy of this surgical method.Histological examination confirmed a diagnosis of hemangiopericytoma originating from the olfactory groove.Gross total resection of the intracranial hemangiopericytoma was possible with minimal brain retraction.Simpson grade I was achieved, and there were no presentation of new neurologic deficits, postoperative hematomas, and cerebrospinal fluid leakage in patient.We suggested that it is worthwhile a try to remove giant olfactory groove hemangiopericytoma by the minimally invasive supraorbital keyhole approach through superciliary arch, allowing for minimal damage of normal brain parenchyma, and improving prognosis.