Walsh & Hoyt: Tumors Involving the Frontal Lobe

Inspection of the external surface of the frontal lobe reveals three important natural borders: the central (rolandic) sulcus, the sylvian fissure, and the corpus callosum. Since the frontal lobes represent about 30% of the volume of the cerebral hemispheres, it is not surprising that they harbor a large proportion of supratentorial tumors. In Hubers series, frontal lobe tumors made up 24% of all tumors and 51% of all supratentorial tumors. Both intrinsic and extrinsic tumors may infiltrate or compress the frontal lobe. Extrinsic tumors, such as meningiomas, dermoids, teratomas, and chordomas, may be located subfrontally or in the falx, where they compress the mesial aspect of the lobes and produce bilateral damage. They may also have a more lateral origin and compress the dorsolateral aspect of one frontal lobe only. Intrinsic tumors, such as gliomas or metastatic lesions, may also produce unilateral or bilateral signs. Syndromes of frontal lobe damage from tumors vary with location, depth, rate of tumor growth, tumor histology, and age of the patient.