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Incidence and clinicopathological features of meningioma
M Rohringer1, G R Sutherland, D F Louw
1Department of Surgery, University of Manitoba, Winnipeg, Canada.
Abstract:
The incidence of intracranial meningioma in Manitoba, Canada, was reviewed from 1980 through 1987. During that time, 193 tumors were diagnosed, with a male:female ratio of 1:2. This occurrence corresponded to crude incidence rates of 2.3/100,000 for all meningiomas and 0.17/100,000 for malignant meningiomas. Among malignant meningiomas, the male:female ratio was 1:1. The age-specific annual incidence rate increased with age up to the eighth decade where it peaked at 8.4/100,000. The distribution of histopathological subtypes was: 74 meningotheliomatous (38%), 64 transitional (33%), 14 malignant (7%), 14 fibroblastic (7%), seven psammomatous (4%), four angioblastic (2%), and 16 unknown (8%). The diagnosis of malignant meningioma was based on the World Health Organization criteria, with only Grade III and IV tumors included in this subtype. Clinical features did not allow for differentiation of benign from malignant neoplasms. Individuals with malignant tumors were, however, more likely to suffer paresis (50%) and less likely to be without deficit (14%) than their benign counterparts. The radiographic appearance of "mushrooming" was observed only in patients with malignant meningioma. All malignant tumors showed evidence of peritumoral edema; however, none exhibited calcification. During the 8-year study interval, the tumor recurred in 10 (71%) of the 14 patients with malignant meningioma. Tumor recurrence was accompanied by dedifferentiation from a more benign histology in four patients (2% of the total material).
Insights
This study reviewed intracranial meningioma incidence in Manitoba, Canada (1980-1987). Malignant meningiomas showed higher recurrence and distinct radiographic signs like "mushrooming" and peritumoral edema.
Area of Science:
- Neuro-oncology
- Epidemiology
- Pathology
Background:
- Intracranial meningiomas are common primary brain tumors.
- Understanding their incidence and characteristics is crucial for diagnosis and treatment.
Purpose of the Study:
- To determine the incidence and epidemiological features of intracranial meningiomas in Manitoba, Canada.
- To analyze histopathological subtypes, clinical presentations, and outcomes, particularly for malignant meningiomas.
Main Methods:
- Retrospective review of 193 intracranial meningioma cases diagnosed between 1980 and 1987 in Manitoba.
- Analysis of incidence rates, male:female ratios, age-specific incidence, histopathological subtypes, clinical features, radiographic findings, and recurrence rates.
Main Results:
- Crude incidence rates were 2.3/100,000 for all meningiomas and 0.17/100,000 for malignant meningiomas.
- Malignant meningiomas (WHO Grade III/IV) had a 1:1 male:female ratio and a 71% recurrence rate.
- Clinical features like paresis and radiographic signs such as "mushrooming" and peritumoral edema were associated with malignant tumors.
Conclusions:
- Malignant meningiomas exhibit distinct epidemiological and clinical characteristics.
- Early detection and aggressive management may be warranted for malignant meningiomas due to high recurrence rates.