Peritumoral brain edema in intracranial meningiomas

Pereira-Filho, Nelson; Soares, Fabiano Pasqualotto; Chemale, Ivan de Mello; Coutinho, Lígia Maria Barbosa

doi:10.1590/s0004-282x2010000300003

Cited by 13 publications

(7 citation statements)

References 9 publications

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“…PTBE is a well-known negative prognostic factor as it can exacerbate preoperative neurological deficits, increase the risk of intra-operative complications, and prolong hospitalization time; however, its pathophysiology is yet unclear. Factors like tumor size and histological type, location, and gender have been proposed to relate with PTBE, even in cases of small, peripheral, low malignancy meningiomas (Lee et al 2008 ; Pereira-Filho 2010 ). The implication of E-cadherin, beta catenin (Rutkowski et al 2018 ), and hypoxia inducible factor-1 (HIF-1) (Reszec et al 2013 ) along with the vascular endothelial growth factor A (VEGF-A) pathway activation and increased vascular supply (Nassehi et al 2011 ; Nassehi et al 2013 ; Sakuma et al 2008 ; Schmid et al 2010 ) support the theory that PTBE in meningiomas is vasogenic, e.g., a growing meningioma, results in a further increase of intratumoral venous pressure leading to tumor congestion and accumulation of angiogenic substances, increased permeability of cerebral-pial capillaries and expansion of the PTBE (Hou et al 2013 ; Nassehi 2013 ).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of AQP4/TRPV4 Channel Co-expression, Microvessel Density, and its Association with Peritumoral Brain Edema in Intracranial Meningiomas

et al. 2021

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Apart from VEGF-A pathway activation, the existence of peritumoral edema (PTBE) in meningiomas has been correlated with the expression levels of water transporter aquaporin 4 (AQP4). A novel cooperation of AQP4 with the transient receptor potential isoform 4 (TRPV4), a polymodal swelling-sensitive cation channel, has been proposed for regulating cell volume in glial cells. We investigated AQP4/TRPV4 channel co-expression in meningiomas along with the neovascularization of tumors and associate with PTBE. Immunohistochemical staining for AQP4 and TRPV4 expression was quantitatively analyzed in semi-serial sections of archival tissue from 174 patients. Microvessel density was expressed as microvessel count (MVC). PTBE was measured and edema index (EI) was assessed in 23 patients, based on magnetic resonance images (MRI) whereas mRNA levels of AQP4 and TRPV4 were evaluated in these patients using quantitative real-time PCR. High AQP4 was associated with lower–tumor grade (p < 0.05). AQP4 and TRPV4 were correlated in benign (WHO, grade I) (p < 0.0001) but not in high-grade (WHO, grades II and III) meningiomas (p > 0.05). AQP4/TRPV4 levels were independent of EI and MVC (p > 0.05). In contrast, EI was correlated to MVC (p = 0.02). AQP4/TRPV4 co-expression was detected in both edematous and non-edematous meningiomas. However, most of tumors with larger edema (EI ≥ 2) demonstrated increased levels of AQP4 and TRPV4. Importantly, peri-meningioma tissue of edematous meningiomas demonstrated significantly increased expression for AQP4 (p = 0.007) but not for TRPV4 (p > 0.05) compared with the main tumor. AQP4 and TRPV4 expression is rather associated with a response to vasogenic edema of meningiomas than with edema formation.

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Section: Introductionmentioning

confidence: 99%

Evaluation of AQP4/TRPV4 Channel Co-expression, Microvessel Density, and its Association with Peritumoral Brain Edema in Intracranial Meningiomas

et al. 2021

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“…Pathogenesis of PTBE in meningiomas is highly variable and multifactorial 20,21 . The mechanisms operating in edema genesis have not been completely elucidated 22‐25 . The expression of vascular permeability factor/vascular endothelial growth factor (VPF/VEGF) and its endothelial receptor “flt‐1” has been studied in MM by Christov et al, who reported that the density of vessels positive for VPF/VEGF/flt‐1 expression was much higher with MM than in other solid meningiomas, possibly ascribing it as a key role as a driver for microcyst formation.…”

Section: Discussionmentioning

confidence: 99%

Microcystic Meningiomas: MRI‐Pathologic Correlation

Kulanthaivelu

Lanka

Chandran

et al. 2020

Journal of Neuroimaging

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Microcystic meningiomas (MM) are a distinctive, rare subtype of Grade I meningiomas with limited radiological descriptions. We intend to identify unique imaging phenotypes and seek radiopathological correlations. Methods: Retrospective analysis of histopathologically proven MM was undertaken. Clinicodemographic profiles, imaging, and histopathological characteristics were recorded. Spearman rank correlations among radiological and pathological attributes were performed. Results: Twenty-eight cases were analyzed (mean age = 45.5 years; M:F = 1:1.54; mean volume = 50.1 mL; supratentorial n = 27). Most lesions were markedly T2 hyperintense (higher than peritumoral brain edema-a unique finding) (89.3%) and showed invariable diffusion restriction, severe peritumoral brain edema (edema index >2 in 64.3%), a "storiform" pattern on T2-weighted images (T2WI) (75%), reticular pattern on postcontrast T1 (78.6%)/diffusion-weighted images (DWI) (65.4%), hyperperfusion, T1 hypointensity (84.6%), and absence of blooming on susceptibility-weighted image (80.9%). Storiform/reticular morphology correlated with large cysts on histopathology (ρ = .56; P = .005753). Lesion dimension positively correlated with reticular morphology on imaging (ρ = .59; P = .001173), higher flow voids (ρ = .65; P = .00027), and greater microcystic changes on histopathology (ρ = .51; P = .006778). Peritumoral brain edema was higher for lesions demonstrating greater angiomatous component (ρ = .46; P = .014451). Conclusions: We have elucidated varied neuroimaging features and highlighted pathological substrates of crucial imaging findings of MM. MM ought to be considered as an imaging possibility in an extra-axial lesion with a marked hypodensity on noncontrast computed tomography, markedly T2-hyperintense/T1-hypointense signal, and a storiform/reticular pattern on T2W/GdT1w//DWI.

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“…In our study, the mean tumor volume was 27.81 cm 3 without significant differences between males and females. Some studies found no statistically significant correlation between tumor volume and PTBE ( 10 , 11 ), but some papers report on strong correlation between tumor volume and PTBE ( 6 , 8 ). Some tumors caused significant venous compression and ischemic stroke and significant brain edema ( 12 ).…”

Section: Discussionmentioning

confidence: 99%

Correlation of Peritumoral Brain Edema with Morphological Characteristics and Ki67 Proliferative Index in Resected Intracranial Meningiomas

Bečulić

Skomorac

Jusić

et al. 2019

ACC

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SUMMARY The aim of the study was to analyze correlation between morphological characteristics of intracranial meningiomas and Ki67 labeling index (Ki67 LI), and their influence on peritumoral brain edema (PTBE). There were 41 consecutive patients with intracranial meningiomas surgically treated at the Department of Neurosurgery, Zenica Cantonal Hospital, Zenica, Bosnia and Herzegovina, during the period from January 2010 to December 2015. We reviewed clinical data including patient age, gender, magnetic resonance imaging (MRI) characteristics of the tumor and peritumoral edema, tumor margins, intraoperative characteristics, histopathologic grade and Ki67 LI. In all cases, follow up MRI was obtained at about three months after resection and PTBE was analyzed. Our research showed the tumor volume, tumor margins, and intraoperative signs of arachnoidal and pial invasion to be associated with PTBE in intracranial meningiomas. Ki67 LI expression correlated with PTBE. This study showed the resolution of PTBE to depend on invasive behavior of meningioma and KI67 LI. PTBE, pial/cortical and arachnoidal invasion significantly influence the extent of surgical resection.

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Peritumoral brain edema in intracranial meningiomas

Cited by 13 publications

References 9 publications

Evaluation of AQP4/TRPV4 Channel Co-expression, Microvessel Density, and its Association with Peritumoral Brain Edema in Intracranial Meningiomas

Evaluation of AQP4/TRPV4 Channel Co-expression, Microvessel Density, and its Association with Peritumoral Brain Edema in Intracranial Meningiomas

Microcystic Meningiomas: MRI‐Pathologic Correlation

Correlation of Peritumoral Brain Edema with Morphological Characteristics and Ki67 Proliferative Index in Resected Intracranial Meningiomas

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