Management of Skull-Base Meningiomas With Extracranial Extensions: Clinical Features, Radiological Findings, Surgical...

Area of Science:

• Neurosurgery
• Oncology
• Radiology

Background:

• Skull-base meningiomas with extracranial extensions are uncommon neoplasms.
• Understanding their clinical and prognostic features is crucial for effective management.

Purpose of the Study:

• To summarize the clinical and prognostic features of skull-base meningiomas with extracranial extensions.
• To enhance the management strategies for these specific meningiomas.

Main Methods:

• Retrospective analysis of medical records and follow-up data from 53 patients.
• Surgical interventions included routine craniotomy and endoscopic endonasal approaches.
• Data collected from 2009 to 2020 at West China Hospital.

Main Results:

• Incidence was 0.74%; average age at diagnosis was 45.9 years (1:3.1 male to female ratio).
• 84.9% were WHO grade I; typical imaging showed heterogeneous enhancement and bone invasion.
• Gross total resection achieved in 62.3% with 20.8% complications; 34.9% recurrence rate.
• Extent of resection and histological grade significantly impacted prognosis (p<0.01).
• Adjuvant radiotherapy benefited subtotal resection and high-grade cases (p<0.05).

Conclusions:

• Skull-base meningiomas with extracranial extensions are sporadic.
• Surgical approach (craniotomy or endoscopic endonasal) should be tailored to tumor location and extension.
• Maximized resection, adjuvant radiotherapy, and low histological grade correlate with better prognosis.