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Assessing the Malignancy Risk of a Meningioma by Its Location
Luis A Rodríguez-Hernández1, Rodrigo Uribe-Pacheco1, Michel Mondragon-Soto2
1Neurosurgery Department, Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suárez", Mexico City, MEX.
Background:
Meningiomas represent 30% of primary intracranial tumors. The current incidence is up to 4.5 cases per 100,000 habitants worldwide. Although there is no prognostic difference among benign histopathological subtypes, atypical meningiomas and malignant meningiomas (WHO grade II and III respectively) may extend to the adjacent brain parenchyma, dura mater, and osseous tissue with a recurrence score (21-49%). This manuscript analyzes the malignancy risk according to neoplastic localization through a logistic retrospective analysis from a total sample of 452 patients with grade I, II, and III (WHO) meningiomas.
Methods:
Detailed data collection through a three-year retrospective analysis (January 2008 to December 2011) was applied at Mexico's National Neurology and Neurosurgery Institute including patients with intracranial or spinal-cord meningioma, preoperative imaging study availability and post-surgical histopathological diagnosis. Formal written consent was not required with a waiver by the appropriate national research ethics committee in accordance with the provisions of the regulations of the general health law of Mexico.
Results:
Convexity lesions displayed an increased risk of malignancy turning for non-benign meningiomas with an odds ratio of 3.1 (95% CI 1.6 to 5.7, p=0.0002) meanwhile skull-base meningiomas present an inverse risk with an odds ratio of 0.4 (95% CI 0.2 to 0.9, p=0.02), as well as spinal-cord meningiomas with an odds ratio of 0.3 (95% CI 0.1 to 0.9).
Conclusion:
Skull base and spinal cord meningiomas usually have benign behavior, meanwhile grade II or III meningiomas within this location are rare. The present work provides an additional criterion for decision making, according to the meningioma's location.
Insights
Meningioma location impacts malignancy risk. Convexity meningiomas show higher malignancy risk, while skull base and spinal cord tumors are typically benign.
Area of Science:
- Neurosurgery
- Oncology
- Pathology
Background:
- Meningiomas are the most common primary intracranial tumors, accounting for 30% of cases.
- While most meningiomas are benign (WHO grade I), atypical (WHO grade II) and malignant (WHO grade III) subtypes can recur and invade surrounding tissues.
- Understanding factors influencing meningioma malignancy is crucial for treatment planning.
Purpose of the Study:
- To analyze the risk of meningioma malignancy based on tumor location.
- To identify specific anatomical sites associated with increased or decreased risk of non-benign meningiomas.
Main Methods:
- A retrospective analysis of 452 patients with WHO grade I, II, and III meningiomas was conducted.
- Data included tumor location, preoperative imaging, and post-surgical histopathological diagnosis.
- The study spanned three years (January 2008 to December 2011) at a national neurology institute.
Main Results:
- Convexity meningiomas demonstrated a significantly increased risk of malignancy (OR 3.1, p=0.0002).
- Skull base meningiomas showed a reduced risk of malignancy (OR 0.4, p=0.02).
- Spinal cord meningiomas also presented an inverse risk of malignancy (OR 0.3, p=0.02).
Conclusions:
- Meningiomas at the skull base and spinal cord generally exhibit benign behavior, with rare occurrences of WHO grade II or III tumors.
- Tumor location is a significant factor in assessing meningioma malignancy risk.
- Findings offer an additional criterion for clinical decision-making in meningioma management.
