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Intracranial Angiomatous Meningioma: A Clinicopathological Study of 23 Cases
Liusong Yang1, Guoqiang Ren2, Jianmin Tang2
1Department of Neurosurgery, Huashan Hospital North, Fudan University, Shanghai 201907, People's Republic of China.
Background:
Intracranial angiomatous meningioma (AM) is a rare subtype of meningioma. Here, we investigated the clinical and pathological features of AMs.
Materials And Methods:
We performed a retrospective study of 23 intracranial AMs verified by postoperative pathology at Huashan Hospital North between 2013 and 2018. Clinical data, radiological and pathological findings, and information on treatment and outcomes were collected and analyzed. Additionally, the literature on intracranial AMs was reviewed.
Results:
The sample comprised 13 men and 10 women with AMs. The mean age was 54.2 years, and the mean duration of symptoms was 14.9 months. Headache and epilepsy were the most common symptoms. The most common AMs locations were the cerebral convexity and parasagittal/falx region. The rates of vascular signs, homogeneous enhancement, and peritumoral brain edema (PTBE) on magnetic resonance images were high. Histologically, besides typical meningioma cells, AMs had an abundant vascular component and low Ki-67 index. The extent of PTBE was related to microvessel density (MVD) of tumors, but not to the expression of MMP9 or VEGF. Simpson grade I resection was achieved in 15 cases, and grade II resection was achieved in 7 cases. Twenty-one cases were followed up, and they all had favorable outcomes without recurrence.
Conclusion:
AM is a type of meningioma with a rich blood supply and distinct clinical and pathological features. It showed a slight male predominance and was common at the cerebral convexity or parasagittal/falx region. Histologically, it showed benign biological characteristics despite frequent and severe PTBE, and the extent of PTBE was related to MVD of tumors. Simpson I resection is the best treatment, and the prognosis is usually good after total tumor removal, while gamma knife is recommended for small residual tumor.
Insights
Intracranial angiomatous meningiomas (AMs) are rare tumors with distinct features. Complete surgical removal offers a good prognosis, with gamma knife treatment for residual tumors.
Area of Science:
- Neurosurgery
- Neuropathology
- Oncology
Background:
- Intracranial angiomatous meningioma (AM) is a rare meningioma subtype.
- Investigating clinical and pathological features of AMs is crucial for understanding this rare tumor.
Purpose of the Study:
- To investigate the clinical, radiological, and pathological features of intracranial angiomatous meningiomas.
- To analyze treatment outcomes and prognostic factors for intracranial AMs.
Main Methods:
- Retrospective study of 23 intracranial AMs diagnosed between 2013-2018.
- Collected and analyzed clinical, radiological, pathological, treatment, and outcome data.
- Reviewed existing literature on intracranial AMs.
Main Results:
- AMs showed a slight male predominance, with a mean age of 54.2 years.
- Common symptoms included headache and epilepsy; common locations were cerebral convexity and parasagittal/falx regions.
- High rates of vascular signs, homogeneous enhancement, and peritumoral brain edema (PTBE) were observed. Histologically, AMs had abundant vasculature and low Ki-67 index. PTBE extent correlated with microvessel density (MVD).
- Simpson grade I or II resection was achieved in 22/23 cases. All 21 followed-up cases had favorable outcomes without recurrence.
Conclusions:
- Intracranial AMs possess a rich blood supply and distinct clinical/pathological characteristics.
- Despite frequent and severe PTBE, AMs exhibit benign biological behavior. PTBE extent is linked to tumor MVD.
- Simpson I resection is optimal; prognosis is favorable after complete tumor removal. Gamma knife radiosurgery is recommended for residual tumors.
