Intracranial angiomatous meningiomas: A 15-year, multicenter study

Area of Science:

• Neurosurgery
• Oncology
• Radiology

Background:

• Angiomatous meningiomas (AMs) are a rare subtype of meningiomas, characterized by a prominent vascular component.
• They constitute less than 1% of intracranial tumors and approximately 2.1% of meningeal tumors.
• This study presents the largest series to date on intracranial AMs, detailing 58 cases from a Tunisian multicenter experience.

Purpose of the Study:

• To determine the clinical characteristics of angiomatous meningiomas.
• To identify the radiological features associated with AMs.
• To evaluate the prognosis and recurrence-free survival of patients with AMs.

Main Methods:

• Retrospective review of 58 patients with intracranial AMs treated between January 2001 and December 2015.
• Data collected included clinical presentation, radiographic features, and surgical treatment modality (Simpson I, II, or III resection).
• Recurrence-free survival (RFS) and overall survival (OS) were analyzed using Kaplan-Meier survival analysis.

Main Results:

• The median age of patients was 53 years, with a median symptom duration of six months.
• Common symptoms included increased intracranial pressure, seizures, and motor weakness. Radiologically, 81% had peritumoral edema and 86.2% showed vascular signal voids.
• Gross total resection (Simpson I/II) was achieved in 96.5% of cases. Recurrence occurred in 6 out of 56 patients in the Simpson I/II groups, with recurrence risk correlating with extent of resection and tumor location (P=0.001).

Conclusions:

• Angiomatous meningiomas are characterized by cystic components, significant peritumoral edema, and vascular signal voids.
• Gross total resection is the primary treatment, potentially enhanced by preoperative embolization.
• Long-term follow-up is crucial due to the potential for late recurrences, and routine adjuvant radiotherapy is not recommended for all cases.