[Atypical and malignant intracranial meningiomas]
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M Gelabert-González1, J M Fernández-Villa, M Iglesias-Pais
1Instituto Universitario de Ciencias Neurológicas Pedro Barrié de la Maza, Universidad de Santiago de Compostela, España. cimigego@usc.es
Introduction:
Meningiomas are one of the most common tumours of the central nervous system, with an incidence of 15% to 20% of all primary brain tumours. Meningiomas are generally slowly growing, benign tumours attached to the dura-mater and composed of neoplastic meningothelial cells. Most of meningiomas are benign and can be graded into WHO grade I. However certain histological subtypes are associated with a poor clinical outcome and correspond to WHO grades II and III.
Objective:
To review the epidemiology, clinical, surgical, and histological aspects of multiple intracranial meningiomas.
Patients And Methods:
The authors report 12 cases of malignant intracranial meningioma, consecutively operated on at our hospital between 1985-2002. All the patients were studied with CT and the last 9 with MRI. All patients showed no manifestations of von Recklinghausen disease.
Results:
The age at diagnosis ranged from 39 to 87 (mean 64.3 years). There were 6 males and 6 females. The predominant site for the meningioma was the parasagittal region (5 cases), followed by the cerebral convexity (3 cases). All meningiomas were treated with surgical extirpation and in 8 cases the treatment was radiotherapy. The more common histological subtype was atypical meningiomas (5 cases). The median time survival was 48 months (range 16-168).
Conclusions:
Malignant meningiomas constitute 1% to 10% of all meningiomas. They affect men and women almost equally, in contrast, benign meningiomas are more commonly found in women. Complete surgical resection and administration of adjuvant irradiation following initial resection is crucial to long term control.
Insights
Malignant meningiomas, though rare, require aggressive treatment. Complete surgical resection and adjuvant radiotherapy are crucial for long-term control in these aggressive brain tumors.
Area of Science:
- Neuro-oncology
- Neurosurgery
- Pathology
Context:
- Meningiomas are common central nervous system tumors, typically benign (WHO grade I).
- However, certain histological subtypes (WHO grades II and III) are aggressive and associated with poor outcomes.
- Malignant meningiomas represent 1-10% of all meningiomas.
Purpose:
- To review the epidemiology, clinical presentation, surgical management, and histological characteristics of multiple intracranial meningiomas.
- To analyze outcomes for patients with malignant intracranial meningiomas.
Summary:
- This study reviewed 12 cases of malignant intracranial meningiomas treated between 1985-2002.
- Atypical meningiomas were the most common subtype (5 cases). Median survival was 48 months.
- Complete surgical resection combined with adjuvant radiotherapy is essential for managing malignant meningiomas.
Impact:
- Highlights the importance of multimodal treatment for aggressive meningiomas.
- Informs clinical decision-making for neurosurgeons and oncologists.
- Contributes to understanding the prognosis of malignant meningiomas.
