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Clinico-Histomorphological and Mib-1 Analysis of Recurrent Meningiomas: A Retrospective Study
Sujata Sarangi1, Asha Shenoy1, Ashvini Kolhe1
1Department of Pathology, Seth G. S. Medical College and K. E. M. Hospital, Mumbai, Maharashtra, India.
Introduction:
Meningiomas are the most common primary brain tumors in adults, comprising 37.6% of central nervous system neoplasms. Though gross total resection is the treatment of choice, meningiomas recur even after complete resection. Additionally, meningiomas with a high Ki67/MIB-1 labeling index (LI) have a higher recurrence rate.
Aims:
This article analyzes the clinico-histomorphological features of recurrent meningiomas and compares the expression of MIB-1 LI of primary and recurrent tumors.
Materials And Methods:
This was a retrospective observational study of 50 recurrent meningiomas diagnosed between 2019 and 2023. Tumors were analyzed for site, radiological/histopathological features, and expression of MIB-1 LI in both primary and recurrent tumors.
Results:
Thirty-four percent of the recurrent cases were between 41 and 50 years of age, 58% of the recurrent cases were males. Recurrence was most commonly seen in the frontal region (26%; n = 13) and 52% cases recurred between 1 and 10 years after primary resection. Of the primary tumors, 30 cases (60%) were grade 1, 16 cases (32%) were grade 2, and 4 cases (8%) were grade 3. Mean MIB-1 of primary meningiomas was 4.25% overall and 1.8% for grade 1. Progression in grade was noted in 15 cases with 5 cases showing brain invasion on recurrence while 17/30 grade 1, 14/16 grade 2, and 4/4 grade 3 tumors recurred with no change in grade. Overall mean MIB-1 LI of recurrent tumors was 5.4%.
Conclusion:
Although MIB-1 LI is not an independent criterion for tumor grading, it can be used as an additional tool to identify at-risk patients and recommend close follow-up.
Insights
Recurrent meningiomas, common in adults, show increased MIB-1 labeling index (LI). This marker aids in identifying high-risk patients for closer monitoring after primary brain tumor resection.
Area of Science:
- Neurosurgery
- Oncology
- Pathology
Background:
- Meningiomas are the most common primary brain tumors in adults.
- Complete resection is the standard treatment, but recurrence is possible.
- High MIB-1 labeling index (LI) correlates with increased recurrence rates.
Purpose of the Study:
- To analyze clinico-histomorphological features of recurrent meningiomas.
- To compare MIB-1 LI expression in primary versus recurrent meningiomas.
Main Methods:
- Retrospective observational study of 50 recurrent meningiomas (2019-2023).
- Analysis of tumor site, radiological/histopathological features.
- Comparison of MIB-1 LI in primary and recurrent tumors.
Main Results:
- Recurrence most common in the frontal region; 52% recurred 1-10 years post-surgery.
- Primary tumor grades: 60% Grade 1, 32% Grade 2, 8% Grade 3.
- Mean MIB-1 LI increased from 4.25% in primary to 5.4% in recurrent tumors; grade progression observed in 15 cases.
Conclusions:
- MIB-1 LI is not a sole grading criterion but a valuable tool.
- Elevated MIB-1 LI can identify patients at higher risk for recurrence.
- Close follow-up is recommended for patients with high MIB-1 LI.
