Pneumosinus Dilatans: A Case Report and Bone Analysis of a Rare Observation of its Relationship with Meningioma

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Published: Jul 9, 2026
DOI: https://doi.org/10.52600/2763-583X.bjcr.2026.6.1.bjcr209
Keywords:
Bone Remodeling, Meningioma, Pathogenesis, Pneumosinus Dilatans, Skull Base

Main Article Content

Gabriel de Assis Lopes
Hospital das Clínicas, School of Medicine, University of São Paulo
https://orcid.org/0009-0007-0488-0833
Letícia de Mello Silva
Hospital das Clínicas, School of Medicine, University of São Paulo
Alexandre Baldasserini Guimarães
Hospital das Clínicas, School of Medicine, University of São Paulo
https://orcid.org/0009-0005-4994-1797
Paulo Antônio de Freitas
Hospital das Clínicas, School of Medicine, University of São Paulo
https://orcid.org/0000-0002-9928-2110
Lívia Barreira Cavalcante
Center for Immunohistochemistry, Cytopathology and Anatomic Pathology, Hospital Alemão Oswaldo Cruz
https://orcid.org/0000-0003-3983-3184
Aldo Eden Cassol Stamm
São Paulo ENT Center
Eduardo de Arnaldo Silva Vellutini
Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, SP, Brazil.
https://orcid.org/0000-0003-1323-6488

Abstract

Pneumosinus dilatans (PD) is an abnormal expansion of the paranasal sinuses, frequently associated with anterior skull base meningiomas. Despite its potential clinical significance, the etiology remains unclear, with theories ranging from mechanical obstruction to biochemical stimulation. We report a case of a 30-year-old male with a tuberculum sellae meningioma who developed sphenoid PD after years of surveillance, concurrent with continuous tumor growth. The patient underwent successful endoscopic resection, with histopathology confirming a World Health Organization (WHO) grade I meningioma infiltrating bone. This temporal association supports the theory that PD arises from active, tumor-induced bone remodeling rather than obstructive mechanisms. PD should be recognized as a significant radiographic marker of underlying meningioma activity, warranting thorough investigation and influencing management decisions.

Article Details

How to Cite
Lopes, G. de A., Silva, L. de M., Guimarães, A. B., de Freitas, P. A., Cavalcante, L. B., Stamm, A. E. C., & Vellutini, E. de A. S. (2026). Pneumosinus Dilatans: A Case Report and Bone Analysis of a Rare Observation of its Relationship with Meningioma. Brazilian Journal of Case Reports, 6(1), bjcr209. https://doi.org/10.52600/2763-583X.bjcr.2026.6.1.bjcr209
Issue
Vol. 6 No. 1 (2026): January/December - 2026
Section
Clinical Case Reports
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Author Biographies

Gabriel de Assis Lopes, Hospital das Clínicas, School of Medicine, University of São Paulo

Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, SP, Brazil.

Letícia de Mello Silva, Hospital das Clínicas, School of Medicine, University of São Paulo

Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, SP, Brazil.

Alexandre Baldasserini Guimarães, Hospital das Clínicas, School of Medicine, University of São Paulo

Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, SP, Brazil.

Paulo Antônio de Freitas, Hospital das Clínicas, School of Medicine, University of São Paulo

Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, SP, Brazil.

Lívia Barreira Cavalcante, Center for Immunohistochemistry, Cytopathology and Anatomic Pathology, Hospital Alemão Oswaldo Cruz

Center for Immunohistochemistry, Cytopathology and Anatomic Pathology, Hospital Alemão Oswaldo Cruz, São Paulo, SP, Brazil.

Aldo Eden Cassol Stamm, São Paulo ENT Center

São Paulo ENT Center, São Paulo, SP, Brazil.

Eduardo de Arnaldo Silva Vellutini, Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, SP, Brazil.

Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, SP, Brazil.

DFV Neuro – Department of Neurology and Neurosurgery, Hospital Alemão Oswaldo Cruz, São Paulo, SP, Brazil.

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