Trigone ventricular meningiomas — clinical characteristics, histopathology and results of surgical treatment

Abstract

Aim of the study. Intraventricular meningiomas (IVMs) are rare tumours accounting for 0.5-3.0% of all meningiomas. IVMs require different surgical approaches and preparation in deep brain areas. The aim of our study was to present the clinico-histopathological characteristics and treatment outcomes of trigone IVMs in a series of 15 patients. Materials and methods. Eight women and seven men (mean age 52) with 15 trigone IVMs were retrospectively analysed. Patients presented with headache (47%), psychoorganic syndrome (40%), hemianopsia (33%) or paresis (20%), including three (20%) patients with Karnofsky Performance Scale (KPS) < 80. Mean tumour size was 55.2 mm (range: 30-100 mm). Results. Gross total tumour resection was performed in 14 (93%) cases, and subtotal in one (7%). A new deficit appeared in 83% (5/6) following a transparietal approach, in 14% (1/7) following a transtemporal approach, and in none of two patients following a transoccipital approach. Postoperative complications occurred in six (40%) patients; no patient died, but in two (13%) the new deficit was permanent. Tumour re-growth was found in two (13%) patients after 14 and 31 months. Meningiomas of WHO grade I occurred in 12, grade II in three, and grade III in one tumour recurrence. In long-term follow-up (mean: 60.8 months), including the results of revision operations, KPS: 80-100 was in 13 (87%) patients, KPS: 50 in one (severe hemiparesis after revision) and one patient was lost to follow-up (KPS: 100 on discharge). Conclusions. 20% of IVMs in our series were atypical. The results of surgery for IVMs, although satisfactory in general, require further improvement by reducing the rate of focal deficits resulting from a surgical approach.

Successful Surgical Treatment of a Giant Intraventricular Meningioma: A Case Report and Literature Review

“…In cases where the diagnosis is clear, radiosurgery alone may suffice [12]. The choice of surgical technique depends on various factors, including the tumor's specific location within the ventricle, its side, and its size [13,14].…”

Challenges in Intraventricular Meningiomas Surgery, Case Presentation and Review of the Literature

“…One of the great challenges of neurosurgery is access to intraventricular pathology [1][2][3]. Intraventricular meningiomas are rare tumors and constitute 1% to 5% of all intracranial meningiomas and 13% to 30% of all intraventricular tumors [4,[5][6][7][8][9]. The most common location of intraventricular meningiomas is the trigone that is formed by the confluence of the temporal and occipital horns [8].…”

“…The most common location of intraventricular meningiomas is the trigone that is formed by the confluence of the temporal and occipital horns [8]. Intracranial meningiomas arise from the cells of the arachnoid layer that cover the arachnoid villi or arachnoid granulations, their leptomeningeal origin comprises cells and the progenitor cells at the level of the telencephalon have origin in the neural crest, progenitor cells at the base of the skull have an origin mesodermal, however studies have been carried out where the origin of these intraventricular tumors is presumed to originate in the precursor cells of the epithelium of the choroid plexus [3,6]. Surgical treatment of intraventricular meningioma is a considerable challenge due to the deep location of the tumor and the presence of eloquent structures adjacent to the ventricles [7].…”

Cerebellopontine angle meningioma originating from choroid plexus of the foramen of Luschka: An extremely rare entity and overlook of literature

“…Most intraventricular meningiomas are settled in the atrium, which refers to the junction of the occipital and temporal horn and the lateral ventricle's posterior body. It, however, could be found in any ventricular room containing the choroid plexus [ 11 , 12 ]. The authors describe a sporadic case of a meningioma originating from CPFOL, protruding to the cerebellomedullary cistern and CPA without dural attachment, highlighting its differential diagnosis, which may require certain management.…”