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Falx meningiomas: surgical results and lessons learned from 68 cases
Sang-Bong Chung1, Chae-Yong Kim, Chul-Kee Park
1Department of Neurosurgery, Seoul National University, College of Medicine, Seoul, Korea.
Objective:
The purpose of this study was to review the characteristics of falcine meningioma retrospectively and to identify the parameters associated with tumor recurrence.
Methods:
The analysis included; age, sex, extent of resection, and radiologic and pathologic findings. Falcine meningiomas were classified by location as anterior, middle, or posterior as described for parasagittal meningiomas.
Results:
Of the 795 meningioma patients treated between 1990 and 2004 at the authors' institution, 68 patients with meningiomas arising from the falx underwent craniotomies. There were 22 male and 46 female patients (1 : 2.1). Mean age was 55 years and ranged from 14 to 77 years. Locations of falcine meningioma were; the anterior third in 33 cases, middle in 20, and posterior in 15. Mean tumor volume was 42 cc and ranged from 4 to 140 cc. In 58 of the 68 patients tumors were totally removed. Additional surgery for recurrence was performed in 6 patients over 15 years. Of these 6 patients, only two patients underwent gross total tumor resection at first operation; the other four underwent subtotal tumor resection. Based on pathologic reports, the largest tumor subtype was transitional. There were four patients with a high grade tumor-three atypical and one anaplastic meningioma. Of the 68 patients, 59 achieved a good outcome (no neurological deficit or recurrence), six had temporary complications, two suffered new permanent postoperative deficits, and the remaining one died due to severe brain swelling despite postoperative intensive care. Extent of surgical resection was found to be significantly related to tumor recurrence.
Conclusion:
Falcine meningioma accounted for 8.5% of intracranial meningiomas and the transitional meningioma was the most common subtype of falcine meningioma. Gross total resection of tumor was the single most important predictor of an improved surgical outcome.
Insights
Gross total resection of falcine meningiomas is key to preventing tumor recurrence. This retrospective study analyzed 68 cases, finding extent of surgical resection significantly impacts outcomes.
Area of Science:
- Neurosurgery
- Oncology
- Pathology
Background:
- Falcine meningiomas are tumors arising from the dura mater along the superior sagittal sinus.
- Understanding their characteristics is crucial for effective treatment and predicting recurrence.
Purpose of the Study:
- To retrospectively review falcine meningioma characteristics.
- To identify factors associated with tumor recurrence.
Main Methods:
- Retrospective analysis of 68 patients with falcine meningiomas treated between 1990-2004.
- Evaluation of age, sex, extent of resection, and radiologic/pathologic findings.
- Classification of tumor location (anterior, middle, posterior falx).
Main Results:
- Falcine meningiomas constituted 8.5% of intracranial meningiomas.
- Transitional subtype was most common; 4 high-grade tumors identified.
- Gross total resection achieved in 58/68 patients; 6 required further surgery for recurrence.
- Extent of surgical resection significantly correlated with tumor recurrence.
Conclusions:
- Falcine meningiomas, particularly the transitional subtype, represent a significant portion of intracranial meningiomas.
- Achieving gross total resection is the most critical factor for favorable surgical outcomes and reduced recurrence.
