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Published on: July 5, 2021
Long term clinical outcomes of malignant meningiomas
Yu Seok Lim1, Min Ki Kim1, Bong Jin Park1
1Department of Neurosurgery, College of Medicine, Kyung Hee University, Seoul, Korea.
Objective:
Malignant meningiomas are rare and have worse prognosis than benign meningiomas. We report our experience of a malignant meningioma and review relevant literature in an attempt to investigate the clinical features, treatment, and prognosis of these tumors.
Methods:
Fifteen patients underwent surgical treatment for intracranial malignant meningiomas between year 1990 and 2012 in our institution. Anaplastic meningiomas were diagnosed in thirteen cases and papillary meningiomas in two. Fourteen patients (93.3%) received radiotherapy after surgical resection. All patients were followed regularly including clinical-neurological follow-up as well as magnetic resonance imaging. Progression was determined radiographically when there was more than 10% of mass volume increase or when there were onset or worsening of neurological symptoms not attributable to other causes.
Results:
Six patients were male and nine were women, and their mean age was 56.9 years (range 36-78). The median follow-up was 54 months (range 3-246). According to our study result, the 5-year progression free survival rate of malignant meningiomas was 53.6%. There were 2 cases (13.3%) of postoperative complications. Recurrences were confirmed in 4 patients (26.7%) during follow-up, the median recurrence time was 35 months (range 12-61), and further procedures were performed. Two of the recurred patients were treated with radiosurgery after secondary tumor resection, and other two patients were treated with radiosurgery alone. There was no more recurred disease patients in the follow-up period after then.
Conclusion:
We report the outcomes of the aggressive surgery with radiation of malignant meningiomas. Although the data is limited, we found that radiosurgery treatment had favorable tumor control on recurred patients from our experience.
Insights
Malignant meningiomas are rare brain tumors. Aggressive surgery with radiation showed a 5-year progression-free survival of 53.6%, with radiosurgery effective for recurrences.
Area of Science:
- Neurosurgery
- Oncology
- Neuropathology
Background:
- Malignant meningiomas are rare, aggressive tumors with a poorer prognosis than benign types.
- Understanding their clinical features, treatment, and prognosis is crucial for improving patient outcomes.
Purpose of the Study:
- To investigate the clinical features, treatment strategies, and prognosis of intracranial malignant meningiomas.
- To report institutional experience and review relevant literature on these rare tumors.
Main Methods:
- Retrospective analysis of 15 patients with intracranial malignant meningiomas treated between 1990 and 2012.
- Diagnosis included anaplastic (13 cases) and papillary (2 cases) meningiomas; 93.3% received radiotherapy post-surgery.
- Regular follow-up included clinical assessment and MRI to monitor progression.
Main Results:
- The 5-year progression-free survival rate was 53.6%.
- Recurrence occurred in 26.7% of patients, with a median recurrence time of 35 months.
- Radiosurgery, alone or after secondary resection, demonstrated favorable tumor control in recurrent cases.
Conclusions:
- Aggressive surgical and radiation approaches are utilized for malignant meningiomas.
- Radiosurgery appears to be an effective treatment for controlling tumor recurrence in this patient population.
