Meningioma recurrence

Abstract

<jats:title>Abstract</jats:title><jats:p>Meningioma accounts for more than 30% of all intracranial tumours. It affects mainly the elderly above the age of 60, at a female:male ratio of 3:2. The prognosis is variable: it is usually favourable with no progression in tumour grade and no recurrence in WHO grade 1 tumours. However, a minority of tumours represent atypical (grade 2) or anaplastic (grade 3) meningiomas; this heterogeneity is also reflected in histopathological appearances. Irrespective of the grade, the size of the tumour and the localisation may have severe, sometimes lethal consequences. Following neurosurgical interventions to remove the tumour, recurrence and progression in WHO grade may occur. Our knowledge on predisposing histomorphological and molecular factors of recurrence is rather limited. These can be classified as I) demographic II) environmental, III) genetic and epigenetic IV) imaging, V) neuropathological, and VI) neurosurgical. In view of the complex background of tumour recurrence, the recognition of often subtle signs of increased risk of recurrence requires close collaboration of experts from several medical specialties. This multidisciplinary approach results in better therapy and fewer complications related to tumour recurrence.</jats:p>

Factors Related to the Post-operative Recurrence of Atypical Meningiomas

“…Studies have investigated the predictors of post-operative recurrence of meningiomas. The extent of resection, tumor pathological features, tumor location and size, tumor invasion, peritumoral edema, age, and gender have been found to be associated with the post-operative recurrence of meningiomas (20). However, little is known about the factors related to the post-operative recurrence of AM in Chinese population.…”

Epidemiología y caracterización general de los tumores cerebrales primarios en el adulto

“…El tratamiento de elección es la cirugía, buscando siempre resección Simpson I (resección macroscópica de dura y hueso); sin embargo, en caso de no garantizarse este grado de resección y de acuerdo con la patología del meningioma, se debe dar manejo complementario con radioterapia o quimioterapia, que lleva a una tasa de recurrencia en resección tumoral Simpson I, II, III, IV, V de 9%, 19%, 29%, 44% y 100%, respectivamente (20,21).…”

“…En el manejo complementario, los objetivos de la radioterapia son la prolongación de la supervivencia libre de progresión con preservación de la función neurológica; sus indicaciones dependen del tamaño del tumor, el estadio de la enfermedad y el grado WHO (20,21). Está indicada en el manejo de meningiomas residuales o no resecables en el momento del primer diagnóstico, meningiomas recurrentes o progresivos no resecables, meningiomas WHO II y III, y como una alternativa a la cirugía en adultos mayores con alto riesgo quirúrgico (figura 2) (20,21).…”

“…Histológicamente, corresponden a los meningiomas coroideo, de células claras y atípico (11). La exposición a la radiación ionizante se ha relacionado firmemente con un mayor riesgo de aparición de meningiomas, y estos son más propensos a ser atípicos o malignos, además de ser predominantemente multifocales; y en menor medida de aparición esporádica (es decir, aquellos que no son atribuibles a un factor causal particular) (10, 21,23,24,25,26). La recurrencia o progresión a 5 años se aproxima a un 30% después de la resección total, y un 40%, posterior a la resección subtotal.…”

Fifty shades of meningioma: challenges and perspectives of different PET molecular probes

“…These tumors need aggressive treatment and the conundrum for clinicians and surgeons is whether treating these patients with surgery and/or radiotherapy. Furthermore, the possibility of metastatic extra-cranial spread must be taken into account [1] and in the further course of the disease the possibility of local relapse [2] which represents a challenge to nuclear medicine physicians and radiologists. In routine clinical practice, meningiomas may represent diagnostic pitfalls occurring during single photon emission computed tomography (SPECT) or positron emission tomography (PET) scans, performed for somatic tumors.…”