Multiple intracranial meningiomas: diagnosis, biological behavior and treatment

Abstract

-Multiple intracranial meningiomas (MIM) are a rare pathology when not associated with neurofibromatosis. The prevalence rate of those tumors varied from 2.3 to 8.9% of all intracranial meningiomas.Objective: To present, analyze and discuss the cases of seven patients diagnosed with multiple intracranial meningiomas, describing their clinical and histological characteristics, as well as their biological behavior. Method: The patients records, surgical descriptions, imaging studies and the histopathological exams were retrospectively reviewed. This is the largest series of MIM publisted in Brazil. Results: This sample consists of five women and two men. The age varied from 42 to 84 (average 53.8). Twenty-two meningiomas were identified and varied from 1.5 to 192 cm 3 , with an 62.8 cm 3 average volume. The number of procedures varied from 1 to 5 per patient. No surgical death occurred in this series. Conclusion: Despite the multiplicity of tumors, number of recurrences, the new tumors, repeated operations and re-operations, radiotherapy and a number of postoperative complications, the patients experienced a long survival in conjunction with a fairly good quality of life.Key WorDs: brain tumors, meningiomas, multiple intracranial meningiomas, microneurological surgery. Meningiomas intracranianos múltiplos: diagnóstico, comportamento biológico e tratamentoResumo -os meningiomas intracranianos múltiplos são tumores raros quando não associados a neurofibromatose, correspondem de 2,3 a 8,9% de todos os meningiomas intracranianos. Objetivo: Apresentar, analisar e discutir 7 pacientes com diagnóstico de meningioma intracraniano múltiplo, descrevendo as características clínicas, histológicas e o comportamento biológico desses tumores. Método: Trata-se de revisão retrospectiva incluindo a análise dos prontuários, das descrições cirúrgicas, dos estudos de imagem e do material histopatológico. esta série é a maior série de meningiomas intracranianos múltiplos publicada no Brasil. Meningiomas are tumors originated from arachnoidal cells present in the villi, in the granulations, in the stroma of the perivascular spaces and in the choroid plexus; corresponding to 13 to 20% of all intracranial tumors [1][2][3] . Multiple intracranial meningiomas (MIM), when not associated with neurofibromatosis, are a rare event, which corresponding to 2.3 to 8.9% of all intracranial meningiomas [4][5][6][7][8][9][10][11] . The multiple intracranial meningiomas terminology should be used only when two or more meningiomas occur either simultaneously or sequentially in different locations. It is important to establish the difference between this pathology and tumor recurrence or diffuse meningiomatosis 1,3,4,[7][8][9][10] . our study aims presenting, analyzing and discussing 7 patients diagnosed with multiple intracranial meningiomas, describing their clinical, radiological, and histological characteristics, as well as their biological behavior. It also highlights the fact that, although the patients underwent a number of surgeries and ...

Intracranial Inflammatory Pseudotumors Associated with Immunoglobulin G4-Related Disease Mimicking Multiple Meningiomas: A Case Report and Review of the Literature

“…The cerebral convexity, parasagittal-falx region, and sphenoid ridge are common sites of occurrence of multiple meningiomas (3,12,17,21) and these sites are different from the locations of the mass lesions in our case. Because of the growing number of reports of such multiple pseudotumors associated with IgG4-related disease, we think that special attention to this disease entity is needed in the differential diagnosis when multiple dural-based tumors are observed.…”

Méningiome intracranien multiple: expérience du service de neurochirurgie CHU Avicenne Rabat - Salé, à propos de 4 cas et revue de la littérature

“…Série : Les méningiomes multiples ont été décrit pour la première fois par Anfirmow et Blumenna [ 5 ], il est important de faire la différence entre les méningiomatoses liées à la neurofibromatose (NF) et méningiomes multiples en absence de cas familial [ 1 , 2 , 5 ]. La plus grande série retrouvé jusqu'ici comporte 7 patients, c'est une étude multicentrique sur une période de 10 ans (1996 - 2006) incluant deux hôpitaux brésiliens de référence; L’âge moyen des patients de cette série était de 53,8 ans avec une prédominance féminine [ 3 ]. La prévalence des méningiomes multiples dans notre série était de 2,3% comparable à ce qui a été rapporté par différent auteurs [ 3 , 4 , 6 – 8 ].…”

“…Localisation : La localisation la plus fréquente est en sus tentorielle, cependant il existe des cas de méningiomatose de la fosse cérébrale postérieure [ 3 ].…”

Meningiomas Múltiplos

“…Simis A, Aguiar PHP, Silva CC -Meningiomas Múltiplos: Relato de caso e revisão da literatura no quadro clínico e prognóstico, quando comparado aos pacientes portadores de meningiomas únicos 8,12,15,29 . De forma semelhante, uma revisão histológica destes tumores não revelou diferenças entre os meningiomas múltiplos e únicos, não sendo reveladas características malignas destas lesões 3,19,27 .…”