How would you manage a very large diffuse skull base meningioma involving the olfactory groove, bilateral cavernous sinuses, and abutting optic chiasm that is not amenable to surgical resection?   

Skull base meningiomas are the ones that are commonly referred to Radiation Oncology departments as they are difficult to treat surgically, especially when they involve cranial nerves compartments as is the case in this patient. Given the number of OARs at risk for this patient, if the meningioma wa...

I echo @Baldassarre Stea's comment about the importance of determining a grade of meningioma in the context of symptomatic large skull base meningioma. However, when it comes to a recurrent high-grade meningioma, it is important to recognize that when dealing with gross disease in immediate pro...