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Published on: January 17, 2018
Clinical and histological features of multiple meningiomas compared with solitary meningiomas
Hongguang Huang1, Ralf Buhl, Heinz Hermann Hugo
1Department of Neurosurgery, First Affiliated Hospital of Zhejiang University, Hangzhou, China.
Abstract:
Between 1991 and 2002, 456 patients with an intracranial meningioma were treated. Thirty-nine of these had more than one meningioma (8.6%). The mean age was 58 years (27-85 years). Sex distribution was 8.8:1 (35 female, four male). There was no associated spinal meningioma. No patient had neurofibromatosis. In 19 patients all meningiomas were removed. Twelve showed the same histology, seven had different histological features. In the remaining 20 patients only the symptomatic meningioma was removed. Recurrences occurred in 11 patients (28.2%). Six patients died during follow-up. Multiple meningiomas have their own clinical features. Besides a high female preponderance, PR expression was stronger in multiple meningiomas than in solitary meningiomas while p53 status and MIB-1 LI were similar between the two groups. Progesterone receptor, p53 status and MIB-1 LI were valuable markers for predicting a patient's outcome in multiple meningiomas. The number of meningiomas is growing in patients with recurrent meningiomas.
Insights
Multiple meningiomas, often occurring in older females, present unique clinical features. Progesterone receptor (PR) expression and other markers can predict patient outcomes in these cases.
Area of Science:
- Neurosurgery
- Oncology
- Pathology
Background:
- Intracranial meningiomas are common primary brain tumors.
- Multiple meningiomas are rare, accounting for 8.6% of cases in this study.
- No association with neurofibromatosis or spinal meningiomas was observed.
Purpose of the Study:
- To investigate the clinical features and outcomes of patients with multiple intracranial meningiomas.
- To identify prognostic markers for multiple meningiomas.
- To compare the characteristics of multiple meningiomas with solitary ones.
Main Methods:
- Retrospective analysis of 456 intracranial meningioma patients treated between 1991 and 2002.
- Review of patient demographics, tumor histology, and treatment outcomes.
- Analysis of progesterone receptor (PR) expression, p53 status, and MIB-1 labeling index (LI).
Main Results:
- 39 patients (8.6%) had multiple meningiomas, with a mean age of 58 years and a female predominance (8.8:1).
- Complete removal was achieved in 19 patients; 11 (28.2%) experienced recurrences.
- Stronger PR expression was noted in multiple meningiomas compared to solitary ones; p53 and MIB-1 LI were similar.
- PR, p53, and MIB-1 LI were valuable prognostic markers.
Conclusions:
- Multiple meningiomas exhibit distinct clinical characteristics, including a strong female predilection.
- Prognostic markers like PR expression are crucial for predicting outcomes in patients with multiple meningiomas.
- The incidence of multiple meningiomas appears to be increasing in patients with recurrent disease.
