Intracranial Angiomatous Meningioma: A Clinicopathological Study of 23 Cases

Abstract

Background: Intracranial angiomatous meningioma (AM) is a rare subtype of meningioma. Here, we investigated the clinical and pathological features of AMs. Materials and Methods: We performed a retrospective study of 23 intracranial AMs verified by postoperative pathology at Huashan Hospital North between 2013 and 2018. Clinical data, radiological and pathological findings, and information on treatment and outcomes were collected and analyzed. Additionally, the literature on intracranial AMs was reviewed. Results: The sample comprised 13 men and 10 women with AMs. The mean age was 54.2 years, and the mean duration of symptoms was 14.9 months. Headache and epilepsy were the most common symptoms. The most common AMs locations were the cerebral convexity and parasagittal/falx region. The rates of vascular signs, homogeneous enhancement, and peritumoral brain edema (PTBE) on magnetic resonance images were high. Histologically, besides typical meningioma cells, AMs had an abundant vascular component and low Ki-67 index. The extent of PTBE was related to microvessel density (MVD) of tumors, but not to the expression of MMP9 or VEGF. Simpson grade I resection was achieved in 15 cases, and grade II resection was achieved in 7 cases. Twenty-one cases were followed up, and they all had favorable outcomes without recurrence. Conclusion: AM is a type of meningioma with a rich blood supply and distinct clinical and pathological features. It showed a slight male predominance and was common at the cerebral convexity or parasagittal/falx region. Histologically, it showed benign biological characteristics despite frequent and severe PTBE, and the extent of PTBE was related to MVD of tumors. Simpson I resection is the best treatment, and the prognosis is usually good after total tumor removal, while gamma knife is recommended for small residual tumor.

Calvarial angiomatous meningioma developed in the diploe

“…[1][2][3][4][5][6][7][11][12][13][14][15][16][17][18][19][20][21][22][23][24]26] Furthermore, cerebral angiomatous meningioma is known to be a rare subtype of low-grade meningioma. [9,25] In the present patient, the intradiploic tumor showed a lobular structure on MRI, with intense enhancement of the surrounding dura mater. In addition, the inner table and dura underlying the tumor appeared intact.…”

“…[1,2,[4][5][6][7]10,12,[16][17][18]20,21,26] Angiomatous meningioma is a rare subtype of the World Health Organization Grade I meningioma, characterized by tumor cells consistent with low-grade meningioma and prominent microvessels of varying sizes. [9,25] To the best of our knowledge, there have been no reports documenting intradiploic angiomatous meningiomas.…”

Non-Invasive Preoperative Imaging Differential Diagnosis of Intracranial Hemangiopericytoma and Angiomatous Meningioma: A Novel Developed and Validated Multiparametric MRI-Based Clini-Radiomic Model

“…Angiomatous meningioma is a rare WHO grade I meningioma type with a total incidence rate of 2.1–2.59% of all meningiomas ( 29 ). The blood supply of angiomatous meningioma is very rich ( 30 ), and according to Hasselblatt et al., meningiomas with >50% vascular components can be diagnosed as angiomatous meningioma ( 14 ).…”

“…In the preoperative radiological examination, compared with other meningiomas, angiomatous meningioma showed more obvious enhancement and vascular signs, and fewer meningeal tail signs, which made it difficult to distinguish angiomatous meningioma from hemangiopericytoma on conventional imaging ( 30 ). The imaging characteristics of intracranial hemangiopericytoma and angiomatous meningiomas are similar, but their treatment and prognosis are very different.…”

“…However, angiomatous meningioma is benign and its clinical presentation, surgical management, and prognosis are almost similar to the classical meningioma ( 2 ). The surgical resection of angiomatous meningioma is more difficult than other types of meningioma, with more intraoperative bleeding and more serious complications such as neurological impairment ( 30 ). Therefore, accurate preoperative diagnosis of intracranial hemangiopericytoma and angiomatous meningioma is of great clinical significance for the planning of operation and the evaluation of prognosis.…”