MIB-1 staining index and peritumoral brain edema of meningiomas

Ide, Mitsunobu; Jimbo, Michio; Yamamoto, Masaaki; Umebara, Yutaka; Hagiwara, Shinji; Kubo, Osami

doi:10.1002/(sici)1097-0142(19960701)78:1<133::aid-cncr19>3.0.co;2-0

Cited by 62 publications

(47 citation statements)

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“…Peritumoral edema of meningioma may be correlated with tumor aggressiveness as determined by MIB-1 LI. 4) In our case, severe peritumoral edema and high MIB-1 LI (12.8%) were also observed. We performed gross total resection (Simpson grade 1), but rapid growth, severe peritumoral edema, and high MIB-1 LI prohibited a long recurrence-free period.…”

Section: Discussionsupporting

confidence: 61%

“…MIB-1 LI, 3,4,9,12) estrogen and progesterone receptors, 13) proliferating cell nuclear antigen, 8) VEGF, 18) insulin-like growth factor, 10) and matrix metalloproteinases 11) are all strongly related to the rapid growth and/or recurrence of meningioma. Incidental meningioma should be followed up carefully, especially in young patients and patients with large tumors.…”

Section: Discussionmentioning

confidence: 99%

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Rapidly Growing Microcystic Meningioma o f the Middle Fossa Floor-Case Report-

Honda

Baba

Kaminogo

et al. 2005

Neurol. Med. Chir.(Tokyo)

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A 74-year-old woman presented with a microcystic meningioma which manifested as mental disturbance. A rapidly growing tumor in the left middle fossa had not been detected by examination 10 months before. The tumor was remarkably enhanced by contrast medium on both computed tomography and magnetic resonance imaging and was associated with massive perifocal edema. Cerebral angiography revealed that the tumor was mainly fed by the left middle meningeal artery, which was embolized preoperatively. The tumor was completely removed and no postoperative adjuvant therapy was administered. The histological diagnosis was microcystic meningioma with many mitotic figures and a MIB-1 labeling index of 12.8%. Four months later, the tumor recurred and invaded the paranasal sinus. Focal irradiation successfully controlled further regrowth. This case suggests that microcystic meningioma may have aggressive features, and close observation is necessary even after gross total removal.

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Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Rapidly Growing Microcystic Meningioma o f the Middle Fossa Floor-Case Report-

Honda

Baba

Kaminogo

et al. 2005

Neurol. Med. Chir.(Tokyo)

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“…[22] Multiple attempts to correlate the occurrence and degree of peritumoral edema with various factors, including patient gender, tumor location, tumor size, vascularity, cellularity, mitotic activity, steroid receptors, secretory activity, blood supply by intracranial vessels, histological subtype (excepting malignant varieties), and occlusion of veins by the tumor, have failed to establish convincing relationships. [1,3,10,12,13,17,20,[24][25][26]28,30,34] Peritumoral edema has been successfully correlated with the flow cytometric proliferative index in a study of 20 tumors by Crone and coworkers [11] and in a study by Ide, et al, [19] of 57 tumors in which MIB-1 staining was used. Meningiomas with edema contained significantly higher levels of vascular endothelial growth factor messenger RNA than those without edema in 16 tumors analyzed by Kalkanis and associates [22] and in 18 tumors analyzed by Provias and colleagues.…”

Section: Discussionmentioning

confidence: 99%

Predicting the probability of meningioma recurrence based on the quantity of peritumoral brain edema on computerized tomography scanning

Mantle¹,

Lach²,

Delgado³

et al. 1999

FOC

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Object The goal of this study was to determine whether the quantity of peritumoral brain edema displayed on computerized tomography (CT) scanning could be correlated with brain invasion and subsequent recurrence of meningiomas. Methods One hundred thirty-five patients who underwent resection of intracranial meningiomas at the Ottawa Civic Hospital were followed during the period 1980 to 1998. A complete resection was defined as one in which tumor, invaded bone, and involved dura were removed. Tumors were examined microscopically for evidence of brain invasion. The mean follow-up period was 9 years (± 4 years, standard deviation [SD]) and the mean time to recurrence was 5 years (± 4 years, SD). The authors used a simple grading system based on the average thickness (in centimeters) of edema seen on an axial CT slice showing the most tumor. Edema grade was linearly related to edema volume determined by digitizing the scans (r = 0.96; 29 cases). The chance of brain invasion increased by 20% for each centimeter of edema (rs = 1, p < 0.0001; 124 cases). The presence of brain invasion was predictive of recurrence after complete resection with an accuracy of 83%, a sensitivity of 89%, and a specificity of 82%. The chance of recurrence within 10 years after complete resection was given by the equation: percentage chance of recurrence = (centimeter of edema)3 X 0.7, which can be used to predict the chance of recurrence based on findings on CT scans (rs = 1.00, p < 0.0001; 86 patients). Statistical significance was confirmed using Kaplan-Meier and univariate and multivariate analyses. Completeness of resection was the most powerful predictor of recurrence (p < 0.00001, r = 0.6), followed by edema grade and brain invasion (both p = 0.02, r = 0.1). Patient age and gender and tumor location, size, and histological subtype were nonsignificant factors. Conclusions Brain invasion causes peritumoral edema. Invaded brain tissue is also the source of residual cells in cases of tumor recurrence after gross-total resection.

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“…We conducted the MIB-1 immunostaining and calculated the MIB-1 labeling index by a method reported elsewhere. 4,5) The MIB-1 labeling index was 11%. The diagnosis was CCM.…”

Section: Case Reportmentioning

confidence: 97%

Rapid Regrowth of Intracranial Clear Cell Meningioma After Craniotomy and Gamma Knife Radiosurgery-Case Report-

Ide

Yamamoto

Hagiwara

et al. 2004

Neurol. Med. Chir.(Tokyo)

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A 24-year-old woman underwent craniotomy for falx meningioma (5 cm in diameter) on October 24, 1995. The deepest part of the tumor was located in the anterior horn of the lateral ventricle, which was not resected. The histology was clear cell meningioma (CCM), aggressive in nature. The MIB-1 labeling index was high (11%). She underwent gamma knife (GK) radiosurgery for the residual tumor with an irradiation dose of 16 Gy at the tumor periphery on May 24, 1996. The postradiosurgical course was uneventful. The residual intraventricular tumor gradually decreased in size, but the peripheral portion gradually grew into the diencephalic region. The patient remained in good condition for 5 years until September 2001, when she exhibited memory disturbance and lethargy. Magnetic resonance imaging demonstrated a large tumor (4.5 cm in diameter) in the diencephalon, compressing the optic nerves and fornix. The calculated tumor doubling time was 120 days. A second craniotomy was performed on October 9, 2001. The tumor was totally resected through the anterior transcallosal approach. The histology and the MIB-1 labeling index of the tissue from the second operation did not differ markedly from those of the first operation. Neither tumor recurrence nor metastasis has been observed to date. GK radiosurgery contributed to control of the residual intraventricular tumor, but the peripheral portion of the tumor, which received a relatively low radiation dose (16 Gy), grew rapidly. This suggests that a marginal dose of 16 Gy may not be sufficient for control of CCM.

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MIB-1 staining index and peritumoral brain edema of meningiomas

Abstract: BACKGROUND.Growth rates and tumor aggressiveness of meningiomas are thought

Cited by 62 publications

References 46 publications

Rapidly Growing Microcystic Meningioma o f the Middle Fossa Floor-Case Report-

Rapidly Growing Microcystic Meningioma o f the Middle Fossa Floor-Case Report-

Predicting the probability of meningioma recurrence based on the quantity of peritumoral brain edema on computerized tomography scanning

Rapid Regrowth of Intracranial Clear Cell Meningioma After Craniotomy and Gamma Knife Radiosurgery-Case Report-

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