CT findings in malignant meningiomas

Area of Science:

• Neurosurgery
• Oncology
• Radiology

Background:

• Recurrent meningiomas are often linked to incomplete tumor resection, particularly in challenging locations like the skull base.
• Meningiomas of the convexity rarely recur after complete resection.
• Histological alterations in recurrent meningiomas, including increased mitotic activity, necrosis, and brain invasion, suggest aggressive behavior and potential malignancy.

Purpose of the Study:

• To correlate computed tomography (CT) findings with microscopic features in cases of malignant meningioma.
• To investigate the imaging characteristics of aggressive meningioma recurrence.

Main Methods:

• Retrospective analysis of five cases of malignant meningioma.
• Correlation of CT scan findings with histopathological examination of tumor samples.

Main Results:

• CT findings in malignant meningiomas reflect their microscopic appearance.
• Tumoral necrosis on CT corresponds to heterogeneous enhancement.
• Brain parenchymal invasion by the tumor is indicated by an irregular tumor outline and sometimes a lack of a surrounding low-attenuation area.

Conclusions:

• CT imaging can reveal signs of malignancy in recurrent meningiomas, such as heterogeneous enhancement and irregular borders due to necrosis and brain invasion.
• Understanding these CT-histopathology correlations is crucial for diagnosing and managing aggressive meningioma recurrence.