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Related Experiment Video

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Management of multiple meningiomas.

Georgios Tsermoulas1, Mazda K Turel1, Jared T Wilcox1

  • 1Divisions of1Neurosurgery and.

Journal of Neurosurgery
|July 22, 2017
PubMed
Summary

Multiple meningiomas, often asymptomatic and small, require management tailored to individual cases. Surveillance is recommended for stable tumors, while symptomatic or growing lesions necessitate active treatment.

Keywords:
NF2 = neurofibromatosis Type 2SRS = stereotactic radiosurgeryasymptomatic meningiomacraniotomymultiple meningiomasoncologyradiation-induced meningiomasurveillance

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Area of Science:

  • Neurosurgery
  • Oncology
  • Neuropathology

Background:

  • Multiple meningiomas represent a challenging subset, accounting for 1%-10% of all meningiomas.
  • Their management requires careful consideration due to the presence of more than one tumor.
  • Epidemiological data and treatment outcomes for multiple meningiomas are less understood than for solitary tumors.

Purpose of the Study:

  • To describe the epidemiological characteristics of multiple meningiomas.
  • To evaluate management strategies and outcomes for patients with multiple meningiomas.
  • To differentiate between sporadic, radiation-induced, and familial forms of multiple meningiomas.

Main Methods:

  • A retrospective review of adult patients with two or more spatially separated meningiomas was conducted.
  • Exclusion criteria included patients with neurofibromatosis Type 2.
  • Data collected encompassed clinical, imaging, histological, and treatment details.

Main Results:

  • 133 patients with 395 synchronous and 53 metachronous meningiomas were analyzed over 25 years.
  • 67% of meningiomas were small (≤ 2 cm), and 11% were large (> 4 cm).
  • Two-thirds of patients required treatment, with surgery and radiotherapy being primary modalities; 1 in 4 surgically treated patients had high-grade (WHO Grade II/III) tumors.

Conclusions:

  • Multiple meningiomas are frequently asymptomatic, often small, and a significant proportion are radiation-induced.
  • While two-thirds of patients may require intervention, only one-third of all meningiomas necessitate active treatment.
  • Surveillance is advised for stable, asymptomatic lesions, whereas symptomatic or progressive tumors warrant therapeutic intervention.