Peritumoural brain oedema in intracranial meningiomas: Influence of tumour size, location and histology

Abstract

Peritumoural brain oedema was examined retrospectively in 175 patients with 179 intracranial meningiomas. The influence of tumour size, location and histology were investigated. Tumour volume and localization, and the presence of peritumoural brain oedema (PTBOe) were determined by computed tomography (CT). The oedema-tumour volume ratio was defined as Oedema Index (Oel). All patients underwent microsurgical removal of the tumour. Surgically resected meningiomas were classified histopathologically based on criteria of the new World Health Organization (WHO) classification. A close relationship was found between the tumour size and the incidence of peritumoural oedema: with increasing size of the tumour the incidence of oedema also rises, the oedema index, however decreases. Frontobasal and temporobasal meningiomas showed a significant increase in the oedema incidence and the mean oedema index. If major parts of the surface of meningiomas were adjacent to subarachnoid cisterns only a slight tendency for the development of oedema was observed. WHO-III-meningiomas showed a significantly higher oedema incidence (61.1% vs. 94.4%; p < 0.004) and mean oedema index (Oel = 2.7 vs. 3.7; p < 0.0009) than WHO-I-meningiomas. Brain tissue was affected in 59 cases. 19 meningiomas with infiltration into adjacent brain parenchyma revealed a statistically significant increase in oedema incidence (94.7% vs. 51.7%; p < 0.0003) and mean oedema index (Oel = 3.9 vs. Oel = 2.2; p < 0.0001) when compared to tumours without any brain tissue involvement in the histopathological specimens. Tumours with large volume, fronto-temporo-basal location and anaplastic histology were not only associated with the highest incidence of oedema formation but also presented with an overproportionate infiltrative growth. Thus, a disruption of the arachnoid or a true brain infiltration may be an essential factor for the development of a PTBOe.

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

“…Furthermore, we show that the presence of brain invasion is predictive of recurrence (accuracy 83%). Our results with respect to edema and brain invasion are consistent with a previous study by Bitzer and colleagues [5] of 179 meningiomas examined retrospectively, in which a significant increase in the incidence of edema when infiltration was present was demonstrated.…”

“…and the recent work of Bitzer, et al, [5] support an association between brain invasion by meningiomas and peritumoral edema observed on computerized tomography (CT) scans. Our objective in the present study was to determine whether the quantity of peritumoral edema could be correlated with both brain invasion by tumor and subsequent tumor recurrence.…”

Lymphoplasmacyte-Rich Meningioma With Atypical Invasive Nature-Case Report-

“…17) Brain infiltration may be essential for the development of peritumoral brain edema. 2) However, prominent edema around the tumor was not observed in this case despite its invasive nature. The diagnosis of LPR meningioma would be hard to establish preoperatively because peritumoral edema is not so rare in other types of meningiomas.…”

Ekstraaksiyel Beyin Tumorleri

“…Elektron mikroskop incelemelerde ve difüzyon ağırlıklı görüntülerde beyin öde-minin vazojenik olduğu tespit edilmiştir. Bu bulgu da ödemin kaynağının beyin dokusundan çok menenjiom dokusundan kaynaklandı-ğını akla getirmektedir [20][21][22]. Ödem oluşu- munda tümörün salgıladığı vasküler endotelyal growth faktörün (VEGF) önemli rol oynadığı düşünülmektedir [23].…”