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Histological subtypes and prognostic problems in meningiomas.

K Jellinger, F Slowik

    Journal of Neurology
    |January 1, 1975
    PubMed
    Summary
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    This study analyzed 1238 meningioma cases, finding that while most subtypes have similar recurrence rates, hemangiopericytomas and atypical meningiomas recur more frequently and sooner. Histological factors like cellularity and mitotic rate influence recurrence in non-angiomatous meningiomas.

    Area of Science:

    • Neurosurgery
    • Oncology
    • Pathology

    Background:

    • Meningiomas are tumors arising from the meninges, with diverse histological subtypes.
    • Understanding the incidence and recurrence patterns of these subtypes is crucial for patient management.
    • Previous classifications of "angioblastic" meningiomas have varied, necessitating clearer segregation.

    Purpose of the Study:

    • To analyze the incidence of various meningioma histological subtypes in surgically treated patients.
    • To investigate recurrence rates and intervals based on histological subtype and extent of surgical removal.
    • To identify prognostic histological criteria for recurrent meningiomas.

    Main Methods:

    • Retrospective analysis of 1238 surgically treated meningioma cases.

    Related Experiment Videos

  • Histological classification based on Courville (1950) and Rubinstein (1972), with specific segregation of "angioblastic" subtypes.
  • Evaluation of recurrence in patients surviving at least 5 years post-surgery, correlating with histological features and mitotic activity.

    • Main Results:

    • Endotheliomatous and transitional subtypes were most common (85%).
    • Recurrence rates were 13% overall, higher after partial removal, with no significant difference among most subtypes.
    • Hemangiopericytomas and atypical meningiomas showed significantly higher recurrence frequency and shorter recurrence intervals.
    • In recurrent non-angiomatous meningiomas, higher cellularity and mitotic rate were associated with poorer prognosis, unlike nuclear pleomorphism or necrosis.
    • A small percentage of recurrences showed altered growth rates, and rare cases transformed into sarcomas.

    Conclusions:

    • Histological subtype is a critical factor in meningioma recurrence, particularly for hemangiopericytomas and atypical meningiomas.
    • Cellularity and mitotic rate are important prognostic indicators for non-angiomatous meningioma recurrence.
    • Careful histological assessment and consideration of subtype are essential for predicting meningioma behavior and patient outcomes.