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Superficial meningioma with bone involvement: surgical strategies and clinical outcomes
Gang Li1, Qilong Tian1, Shoujie Wang1
1Department of Neurosurgery, Tangdu hospital, Air Force Medical University, Xi'an, Shaanxi, China.
Introduction:
Meningiomas with bone involvement account for 4.5-17% of all intracranial meningiomas. Little is known about whether these meningiomas (WHO grade I) behave differently than meningiomas without bone involvement. We sought to study the relatively uncommon imaging manifestations of meningioma and to evaluate their clinical significance.
Methods:
A single-institution retrospective cohort study of surgically treated superficial meningioma patients between 2011 and 2022 was conducted. Age, sex, preoperative imaging, operative data, and surgical outcomes were reviewed. Imaging variables and outcomes were reported for patients with bone-invading meningiomas and compared with those with nonbone-invading meningiomas. Univariate analyses were also conducted.
Results:
Of 577 total superficial meningiomas treated surgically, 47 (8.1%) exhibited bone invasion. Most bone-invading meningiomas were parasagittal (n = 29, 61.7%). A total of 12.7% (n = 6) of patients with bone-invading meningioma had recurrence, whereas 9.1% (n = 48) of patients with non-bone-invading meningioma had recurrence (p = 0.426). No significant difference in the median time to recurrence was observed between patients with bone-invading meningiomas and patients with nonbone-invading meningiomas (69.8 months, Q1:53.1; Q3:81.4 months vs. 69.7 months, Q1:47.5; Q3:96.7; p = 0.638).
Conclusions:
Superficial meningioma with bone involvement had similar outcomes compared to those of superficial meningioma without bone involvement. Hyperostosis in meningioma (WHO grade I) may not be a surrogate for aggressive meningioma behavior.
Insights
Superficial meningiomas invading bone show similar recurrence rates and timing as those without bone involvement. Bone invasion in these WHO grade I tumors does not appear to indicate more aggressive behavior.
Area of Science:
- Neurosurgery
- Oncology
- Radiology
Background:
- Meningiomas with bone involvement represent 4.5-17% of intracranial meningiomas.
- The behavior of WHO grade I meningiomas with and without bone involvement is not well understood.
- This study investigates the clinical significance of uncommon imaging manifestations in meningioma.
Purpose of the Study:
- To analyze the imaging characteristics of superficial meningiomas.
- To compare the clinical outcomes of meningiomas with and without bone invasion.
- To determine if bone involvement signifies more aggressive tumor behavior.
Main Methods:
- Retrospective cohort study of surgically treated superficial meningioma patients (2011-2022).
- Review of age, sex, preoperative imaging, operative data, and surgical outcomes.
- Comparison of outcomes between bone-invading and non-bone-invading meningiomas using univariate analyses.
Main Results:
- Of 577 superficial meningiomas, 47 (8.1%) invaded bone, predominantly parasagittal.
- Recurrence rates were 12.7% for bone-invading and 9.1% for non-bone-invading meningiomas (p=0.426).
- No significant difference in median time to recurrence was observed between the two groups (p=0.638).
Conclusions:
- Superficial meningiomas with bone involvement exhibit similar outcomes to those without bone involvement.
- Hyperostosis in WHO grade I meningiomas may not predict aggressive behavior.
- Bone invasion is not a reliable indicator of increased tumor aggressiveness in superficial meningiomas.
