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Clinical outcomes after microsurgical resection of giant lateral ventricular meningiomas
1Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.
Abstract:
Giant lateral ventricular meningiomas (LVMs), with the largest diameter of at least 5 cm, form a distinct subset. The incidence of giant LVMs is considered to be relatively low. Here, we evaluated clinical characteristics, and clinical outcomes after microsurgical resection, especially functional outcomes and morbidity of giant LVMs. We retrospectively reviewed 49 patients with LVMs, including 18 giant LVMs from 2012 to 2020. And we analyzed clinical, histopathological, surgical, and outcome data at our institution. Giant LVMs were most commonly present in the fourth decade of patients with the male-to-female ratio of 1:2. The most common subtypes were transitional and fibrous. Most lesions were resected via the temporal or parieto-occipital approach in our series. The median volume of blood loss was higher in the giant group (900 vs. 600 ml, p = 0.02). Meanwhile, the median length of hospital stay was prolonged for giant LVMs (20.5 vs. 16.0 days, p < 0.01). The proportion of discharged functional deterioration was higher in giant LVMs (38.9% vs. 6.5%, p = 0.02). However, there was no statistical significance between functional deterioration and tumor size at long-term follow-up (p = 0.28). Giant LVMs patients suffered from neurological and regional complications more commonly, particularly from a postoperative hematoma (4/18 vs. 1/31), and hydrocephalus (2/18 vs. 0/31). Patients with giant LVMs had a high incidence of immediate functional deterioration after microsurgery, and there was no difference in functional deterioration between the giant and non-giant LVMS during long-term follow-up. Microsurgery entails a higher complication rate in giant LVMs. We need to pay special attention to preventing postoperative hematoma and hydrocephalus.
Insights
Giant lateral ventricular meningiomas (LVMs) pose higher surgical risks, including increased blood loss and longer hospital stays. While immediate outcomes may show functional decline, long-term results are comparable to smaller LVMs, emphasizing complication prevention.
Area of Science:
- Neurosurgery
- Oncology
- Neurology
Background:
- Giant lateral ventricular meningiomas (LVMs), defined as >5 cm, are rare tumors.
- Microsurgical resection is a primary treatment for LVMs, but outcomes for giant subtypes require specific evaluation.
Purpose of the Study:
- To evaluate clinical characteristics and outcomes after microsurgical resection of giant LVMs.
- To assess functional outcomes, morbidity, and complications associated with giant LVMs compared to smaller ones.
Main Methods:
- Retrospective review of 49 LVM patients (18 giant) from 2012-2020.
- Analysis of clinical, histopathological, surgical, and outcome data, including functional status and complications.
Main Results:
- Giant LVMs occurred in the fourth decade, predominantly in females (2:1 ratio), with transitional and fibrous subtypes most common.
- Microsurgery for giant LVMs involved higher blood loss (900 vs. 600 ml) and longer hospital stays (20.5 vs. 16.0 days).
- Immediate functional deterioration was higher in giant LVMs (38.9% vs. 6.5%), with increased risks of postoperative hematoma and hydrocephalus, though long-term functional outcomes did not significantly differ by tumor size.
Conclusions:
- Giant LVMs present unique surgical challenges, including increased intraoperative complications and immediate postoperative functional decline.
- Despite higher initial morbidity, long-term functional outcomes for giant LVMs are comparable to smaller ones.
- Special attention to preventing postoperative hematoma and hydrocephalus is crucial in managing giant LVMs.
