The Recurrence of Intracranial Meningiomas After Surgical Treatment

Simpson, Donald

doi:10.1136/jnnp.20.1.22

Cited by 2,126 publications

(1,138 citation statements)

References 19 publications

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“…Complete surgical extirpation of the tumor was defined as Simpson grade I or II, corresponding to a macroscopically determined complete tumor resection with bipolar coagulation of the dural insertion [15].…”

Section: Clinical Variablesmentioning

confidence: 99%

Hyperdiploidy defines a distinct cytogenetic entity of meningiomas

et al. 2007

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Background The most common chromosomal aberration found in meningiomas is monosomy 22. Progression and recurrence of meningiomas are usually associated with additional chromosome losses. Rarely, however, meningiomas have strongly hyperdiploid karyotypes with over 50 chromosomes; the objective of this study was to explore the cytogenetic and histopathologic patterns as well as the clinical significance of hyperdiploidy in meningiomas. Methods Within a series of 677 consecutive meningiomas, we identified a subgroup comprising 16 cases that display a strikingly uniform pattern of hyperdiploidy mostly without structural chromosome rearrangements, as shown by banding techniques and, in the single structurally aberrant case, spectral karyotyping. Results These meningiomas each have between 50 and 56 chromosomes, with trisomy 12 (14/16 cases), trisomy 20 (13/16 cases), trisomy 5 (12/16 cases), and trisomy 17 (10/16 cases). Histomorphologically, hyperdiploid meningiomas feature a heterogeneous phenotype. However, they are associated with a higher histological grade, and decreased expression of alkaline phosphatase as compared to meningiomas with typical karyotype. In two patients, recurrences were documented and three patients died of disease during the period of observation, indicating a worse prognosis of hyperdiploid than of cytogenetically typical meningiomas. Conclusion We conclude that hyperdiploidy constitutes a small but clinically relevant entity of biologically aggressive meningiomas, which are cytogenetically distinguishable from the majority of commontype meningiomas.

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Section: Clinical Variablesmentioning

confidence: 99%

Hyperdiploidy defines a distinct cytogenetic entity of meningiomas

et al. 2007

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“…Overall, atypical and anaplastic meningiomas recur in > 30% of cases. 23,24 Recurrence is also related to tumor size and extent of resection: tumors that have been completely resected have a recurrence rate of 10% to 30% at 10 years, whereas subtotally resected tumors (Simpson grade IV) have a recurrence rate of 61% at 10 years. 23,[25][26][27] Currently, meningioma metastases are found incidentally.…”

Section: Discussionmentioning

confidence: 99%

“…23,24 Recurrence is also related to tumor size and extent of resection: tumors that have been completely resected have a recurrence rate of 10% to 30% at 10 years, whereas subtotally resected tumors (Simpson grade IV) have a recurrence rate of 61% at 10 years. 23,[25][26][27] Currently, meningioma metastases are found incidentally. Because virtually 100% of meningiomas in culture 15 and in vivo 5 contain somatostatin receptors, 28 and because SSTR2 and SSTR5 bind octreotide, a somatostatin analog, 29 111 In-octreotide scintigraphy can be used to identify intracranial meningiomas with high sensitivity (90%-100%).…”

Section: Discussionmentioning

confidence: 99%

Pulmonary metastases in patients with recurrent, treatment‐resistant meningioma

Alexandru

Glantz

Kim

et al. 2011

Cancer

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BACKGROUND:Meningioma is the most common extra-axial primary intracranial tumor in adults that rarely metastasizes outside of the central nervous system (CNS). Among recognized sites of metastases, the lung is the most common, but the importance of lung metastases relative to prognosis is unknown. 111 Indium ( 111 In)-octreotide scintigraphy (octreotide scanning) is a valuable imaging modality with which to evaluate intracranial meningiomas and their response to treatment with somatostatin analogues and has the potential to identify extracranial metastatic disease. METHODS: In this retrospective multicenter study, adult patients treated for recurrent meningioma were identified. These patients underwent 111 In-octreotide positron emission tomography/computed tomography imaging (octreotide scintigraphy) and were found to have positive octreotide uptake in their lungs. RESULTS: Six cases were identified with recurrent meningioma (after surgery, radiotherapy, and at least 1 chemotherapy agent) and pulmonary lesions by octreotide scintigraphy. Biopsy of a pulmonary lesion in 1 patient confirmed the diagnosis of metastatic meningioma. Patients with metastatic pulmonary involvement identified by 111 In-octreotide scintigraphy in this case series had an overall survival of 6 months, which is less than that reported from previously published series of patients with unknown systemic disease status. CONCLUSIONS: 111 In-octreotide scintigraphy is useful for assessing both CNS disease and extracranial metastases. The presence of pulmonary metastases appears to negatively affect survival in patients with recurrent meningioma. The usefulness of 111 In-octreotide scintigraphy should be considered in staging patients with recurrent meningioma who are considered for further treatment. A prospective study to confirm this finding is warranted.

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“…12 Roux et al 15 described two patients who underwent subtotal tumour removal and presented with recurrences 2 years after initial surgery, despite electrocoagulation of the dural attachment. Simpson 16 recommended radical resection, including surrounding dural tissue to minimize likelihood of recurrence. Klekamp and Samii 14 also emphasised that except for encapsulated tumours, extended dura resections probably are required to lower the chance of recurrence.…”

Section: Discussionmentioning

confidence: 99%

Clinical features associated with recurrence of tumours of the spinal cord and cauda equina

et al. 2003

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Study design: Retrospective review of consecutive cases of recurrent spinal cord and cauda equina tumours. Objectives: We sought to identify factors and conditions resulting in re-operation to treat recurrences of spinal cord and cauda equina tumours. Setting: Keio University Hospital, Tokyo, Japan. Methods: Re-operation was performed in 39 patients with spinal cord and cauda equina tumours. Times of operation, interval between operations, a ected spinal level, tumour site on cross section, con®gurations among dumb-bell tumours, and pathologic diagnoses were analysed. Recurrence rates were de®ned in terms of the number of cases with re-operation due to tumour recurrence relative to the total number of surgical cases for the same period at our institution. Results: Recurrence rates were relatively high for intradural, extramedullary tumours and for tumours located anteriorly rather than laterally. Of patients with intradural, extramedullary plus extradural tumours who underwent initial surgery at our hospital, 75% (9/12) recurred; all tumours had dumb-bell-type con®gurations. The overall rate of re-operation due to tumour recurrence in 249 cases was 7.2% at our institution. By tumour types, 40% of malignant schwannomas recurred (2/5), as did 35.7% of neuro®bromas (5/14), and 33.3% of ependymomas (6/18). Conclusion: Risk factors for tumour recurrence were anterior location, an intradural, extramedullary plus extradural site, extensive dumb-bell tumours, and pathologic diagnoses of neuro®broma, ependymoma, or malignant schwannoma.

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The Recurrence of Intracranial Meningiomas After Surgical Treatment

Cited by 2,126 publications

References 19 publications

Hyperdiploidy defines a distinct cytogenetic entity of meningiomas

Hyperdiploidy defines a distinct cytogenetic entity of meningiomas

Pulmonary metastases in patients with recurrent, treatment‐resistant meningioma

Clinical features associated with recurrence of tumours of the spinal cord and cauda equina

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