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Cystic meningiomas: Radiological and pathological correlation with surgical implications.
Rodrigo Carrasco Moro1, Herbert D Jiménez Zapata1, Héctor Pian Arias2
1Servicio de Neurocirugía, H. U. Ramón y Cajal, Madrid, España.
Neurocirugia (English Edition)
|September 30, 2018
Summary
Cystic meningiomas (CM) present diagnostic challenges. Surgical removal is effective, with no recurrences observed in a 15-year study of 11 patients, highlighting the importance of biopsy and irrigation for complex cystic types.
Area of Science:
- Neurosurgery
- Oncology
- Pathology
Background:
- Cystic meningiomas (CM) pose diagnostic and surgical challenges.
- Prominent cystic changes can obscure preoperative diagnosis.
- Management of peripheral, thin-walled cysts (types 2 and 3) is particularly complex.
Purpose of the Study:
- To present institutional experience in diagnosing and managing cystic meningiomas.
- To analyze clinical, radiological, and pathological findings in CM cases.
- To evaluate surgical outcomes and recurrence rates for CM.
Main Methods:
- Retrospective review of patient database over 15 years.
- Analysis of clinical data, radiological findings, and pathological reports.
- Classification of cystic changes using Nauta et al. scheme.
Main Results:
- 11 cystic meningiomas identified (1.8% of operated meningiomas).
- Predominantly affected adult females; epilepsy was a common symptom.
- Radiological diagnosis was equivocal in half the cases; no recurrences after surgery (mean follow-up 52.8 months).
Conclusions:
- Cystic meningiomas require careful preoperative assessment due to diagnostic ambiguity.
- Surgical management, especially for types 2 and 3 CMs, necessitates thorough biopsy and irrigation.
- Complete surgical excision appears to yield favorable long-term outcomes.
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