Imaging characteristics and surgical treatment of invasive meningioma

Hou, Weina; Ma, Yuechao; Xing, Hongshun; Yin, Yue-Hui

doi:10.3892/ol.2017.5833

Cited by 12 publications

(9 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…2 , 11–21 However, no imaging finding was found to predict reliably the histological grade for meningioma. 5 , 6 , 19 To our knowledge, this is the largest case series examining imaging findings of brain-invasive meningiomas, which included 60 such cases. Two previous studies which examined meningioma brain invasion found a positive association with peritumoral oedema, similar to our result.…”

Section: Discussionmentioning

confidence: 99%

“…4 The identification of atypical meningiomas would be useful for determining prognosis, surgical planning and post-treatment follow-up. Although previous studies have discussed magnetic resonance imaging (MRI) techniques to differentiate typical from atypical meningiomas, most of them referred to the former 2007 WHO classification for histological diagnosis, 5 , 6 which did not include brain invasion as a histological criterion. Only a few studies specifically assessed imaging findings of brain-invasive and non-invasive meningiomas.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

MRI predictors for brain invasion in meningiomas

et al. 2020

View full text Add to dashboard Cite

Background and purpose In the 2016 revision of the World Health Organization classification of central nervous system tumours, brain invasion was added as an independent histological criterion for the diagnosis of a World Health Organization grade II atypical meningioma. The aim of this study was to assess whether magnetic resonance imaging characteristics can predict brain invasion for meningiomas. Materials and methods We conducted a retrospective review of all meningiomas resected at our institution between 2005 and 2016 which had preoperative magnetic resonance imaging and included brain tissue within the pathology specimen. One hundred meningiomas were included in the study, 60 of which had histopathological brain invasion, 40 of which did not. Magnetic resonance imaging characteristics of tumours were evaluated for potential predictors of brain invasion. Tumour location, size, perilesional oedema, contour, cerebrospinal fluid cleft, peritumoral cyst, dural venous sinus invasion, bone invasion, hyperostosis and the presence of enlarged pial arteries and veins were evaluated. Data were analysed using conventional chi-square, Fisher’s exact test and logistic regression. Results The volume of peritumoral oedema was significantly higher in the brain-invasive meningioma group compared to the non-brain-invasive group. The presence of a complete cleft was a rare finding that was only found in non-brain-invasive meningiomas. The presence of enlarged pial feeding arteries was a rare finding that was only found in brain-invasive meningiomas. Conclusions An increased volume of perilesional oedema is associated with the likelihood of brain invasion for meningiomas.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

MRI predictors for brain invasion in meningiomas

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Heterogeneous enhancement could be due to the existence of necrosis and cystic degeneration. On account of the rapid proliferation rate, the central area of the tumor often has insufficient blood circulation, resulting in ischemic necrosis or cystic degeneration ( 25 ). The necrotic area is usually larger in more invasive tumors ( 25 ).…”

Section: Discussionmentioning

confidence: 99%

“…On account of the rapid proliferation rate, the central area of the tumor often has insufficient blood circulation, resulting in ischemic necrosis or cystic degeneration ( 25 ). The necrotic area is usually larger in more invasive tumors ( 25 ). In the study, bone destructive absorption accounts for 36.4% of the bone changes in the skull base, which is much higher than that reported in the literature ( 6 , 8 ).…”

Section: Discussionmentioning

confidence: 99%

Clinial Features, Individualized Treatment and Long-Term Surgical Outcomes of Skull Base Meningiomas With Extracranial Extensions

Liu

Qian

et al. 2020

Front. Oncol.

View full text Add to dashboard Cite

Object: Skull base meningiomas with extracranial extensions are rarely described. This study describes the clinical features, surgical management and clinical outcomes of these rare tumors and investigates risk factors associated with progression-free survival (PFS). Methods: The clinical data of 34 consecutive patients who underwent surgery for skull base meningiomas with extracranial extensions from 2007 to 2018 were retrospectively collected and analyzed. Results: The mean patient age was 47.9 ± 13.9 years; 50.0% were male. The most common symptoms on admission were ophthalmic. All patients underwent a multidisciplinary consultation before surgery, and received individualized surgical management. The gross total resection (GTR) rate was 55.9% (19/34). Twelve patients received post-operative adjuvant radiotherapy (RT). Twelve patients experienced tumor recurrence during the follow-up period. The median PFS duration was 54 months. The mean overall survival (OS) duration was 111 months. By univariate analysis, a higher histological grade (WHO grade II and III), Ki-67 LI ≥ 5 and the extent of resection (EOR) were significantly associated with tumor recurrence. Multivariate analysis revealed Ki-67 LI ≥ 5, the EOR and adjuvant RT as prognostic factor of PFS. Conclusions: These relatively rare meningiomas are difficult to resect and have a poor prognosis; they are more common in males and have a higher histological grade than intracranial meningiomas. Multidisciplinary collaboration and individualized surgical strategies are crucial for surgically managing these complex tumors. Total removal of the tumor remains challenging. Subtotal resection (STR) or partial resection (PR) followed by RT is a reasonable strategy when radical resection is infeasible. Adjuvant RT should be recommended especially for tumors with histopathological risk factors (Ki-67 LI ≥ 5 or high histological grade).

show abstract

“…The surgical aim is symptom remission and if it is the case to leave the smallest cortical layer of tumour to prevent neurological alteration, even though this means subtotal resection -Simpson IV [12,19]. On the one hand this approach is preferable because of the slow growth pattern of the lesion and because gross resection is associated with increased morbidity for the infiltrative borders type, on the other hand some studies found that Simpson resection grade is a predictor factor for recurrence.…”

Section: Discussionmentioning

confidence: 99%

Surgical management of Rolandic area meningioma in the era of intraoperative neurophysiological monitoring

Coșman¹,

Panţiru²,

Cucu³

et al. 2020

roneuro

View full text Add to dashboard Cite

Introduction: The advantages and the necessity of intraoperative neurophysiological monitoring (IOM) in the surgery of motor area infiltrative tumours is well known. The use of this technique for Rolandic meningioma is still debatable. The absence or the loss of the cleavage plan and an infiltrative border make the dissection exceedingly difficult and increase the risk of new postoperative motor disfunction. Materials and methods: We evaluated the impact of IOM, especially direct cortical stimulation on the degree of resection, new postoperative deficits, symptom remission and clinical-imagistic aspects at one-year follow up of 19 cases of Rolandic meningioma admitted in Third Department of Neurosurgery,” Prof. Dr N. Oblu” Emergency Clinical Hospital, Yassi, Romania, between January 2014 and July 2018. Results: More than half of the cases (57,88%) had epileptic manifestations as the main clinical symptom with the Jacksonian seizures being on the first place (31,57%), followed by progressive paresis (26,31%) and other nonspecific symptoms. Intraparenchymal preoperative oedema was observed in 36,84% of patients. The intensity of direct cortical stimulation was between 6-13 mA (median = 9mA; mode = 12mA). Simpson degree of resection was dominated by S3– 47,36% and S4 was obtained in 15,78% of cases. Postoperative the outcome was favourable for 73,68% patients with 5,26% motor aggravation and 10,52% new deficits. At one-year follow up no imagistic recurrence was observed and the permanent motor deficit was maintained in one of the three cases (5,26%). Conclusion: Even though meningiomas are extranevraxial lesions and those located on the convexity have a low risk of complication, the absence of a clear dissection plan between the tumour and the adjacent motor cortex is associated with a high risk for new postoperative neurological deficits. Therefore, it is important to perform cortical mapping for Rolandic meningioma, to determine the location of the primary motor area and to protect it from mechanical and vascular trauma, during tumour resection.

show abstract

Imaging characteristics and surgical treatment of invasive meningioma

Cited by 12 publications

References 21 publications

MRI predictors for brain invasion in meningiomas

MRI predictors for brain invasion in meningiomas

Clinial Features, Individualized Treatment and Long-Term Surgical Outcomes of Skull Base Meningiomas With Extracranial Extensions

Surgical management of Rolandic area meningioma in the era of intraoperative neurophysiological monitoring

Contact Info

Product

Resources

About