Triple approach for diagnosis and grading of meningiomas: Histology, morphometry of Ki-67/feulgen stainings, and cytogenetics

Kolles, H; Niedermayer, Isolde; Schmitt, C.; Henn, Wolfram; Feld, Robert S.; Steudel, Wolf-Ingo; Zang, K. D.; Feiden, W.

doi:10.1007/bf02187190

Cited by 101 publications

(69 citation statements)

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“…Biological indices of proliferative potential for the prognostic assessment of meningiomas have been the subject of many papers in recent years. [6,12,22,29,30,32,37] Parameters such as the cytogenetic pattern [22,37] and flow-cytometric analysis of DNA content, [30] and proliferation indices such as in situ bromodeoxyuridine incorporation, [32] Ki-67, and the proliferating cell nuclear antigen index [6,12,22,29,30] have been considered. The data acquired so far show a good but incomplete correlation between high proliferative index at initial presentation and malignant clinical behavior.…”

Section: Prognosis and Histology: The Problem Of Atypical Meningiomasmentioning

confidence: 99%

“…The data acquired so far show a good but incomplete correlation between high proliferative index at initial presentation and malignant clinical behavior. [6,12,22,29,30,32] The group of atypical meningiomas was found to be heterogeneous even with respect to the biological markers of proliferative potential and showed a considerable overlap of values with benign and malignant meningiomas. [12,22,37] The systematic study of proliferation indices will presumably help to reveal potentially malignant tumors hitherto misclassified as atypical on the basis of traditional histology, thus improving their prognostic assessment.…”

Section: Prognosis and Histology: The Problem Of Atypical Meningiomasmentioning

confidence: 99%

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Long-term prognosis for atypical and malignant meningiomas: a study of 71 surgical cases

Palma¹,

Celli²,

Franco³

et al. 1997

FOC

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To contribute to a better understanding of the prognostic differences between atypical and malignant meningiomas as defined by the World Health Organization (WHO) and the influence of the grade of initial surgical excision on postoperative course, 42 cases of atypical and 29 of malignant meningioma were studied, along with long-term follow up. The two groups were compared with respect to long-term survival, recurrence-free survival, and median time to recurrence. The prognostic significance of the Simpson grade of surgical resection and tumor location was also considered. Survival at 5 and 10 years was recorded in 95% and 79%, respectively, of patients with atypical meningioma and in 64.3% and 34.5% of patients with malignant meningioma (p = 0.001). Recurrence-free survival and median time to recurrence were also significantly longer in patients with atypical than in those with malignant meningiomas: 11.9 versus 2 years (p = 0.001) and 5 versus 2 years (p < 0.0041), respectively. Six (26%) of the 23 recurring atypical meningiomas became malignant. Simpson Grade I resection and location in the cerebral convexity, which were closely related, were found to be associated with a significantly better clinical course in the entire series (p ¾ 0.0016). Patients with atypical meningiomas fared better than those with malignant meningiomas after incomplete surgical excision (Simpson Grades II-III), but the difference was not statistically significant. Multivariate analysis using the Cox model indicated that radical extirpation (Simpson Grade I vs. II-III) and histological findings (atypical meningioma vs. malignant meningioma) were significantly related to prolonged survival (p < 0.0003 and p < 0.0388, respectively). In conclusion, the current study shows that for most patients with atypical meningioma the prognosis was less severe than for those with malignant meningioma, but the risk of a downhill course resulting from malignancy after incomplete resection and recurrence was not negligible (26%). In addition, the WHO classification was found to be inadequate for a minority of the atypical meningioma cases, which currently have the same unfavorable course as cases of malignant meningioma. The results also indicate that objective Simpson Grade I extirpation of convexity meningiomas can be successful despite histological findings of malignancy.

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Section: Prognosis and Histology: The Problem Of Atypical Meningiomasmentioning

confidence: 99%

Section: Prognosis and Histology: The Problem Of Atypical Meningiomasmentioning

confidence: 99%

Long-term prognosis for atypical and malignant meningiomas: a study of 71 surgical cases

Palma¹,

Celli²,

Franco³

et al. 1997

FOC

View full text Add to dashboard Cite

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“…Although meningiomas are usually benign WHO grade I tumors, about 10% of meningiomas are more aggressive (grades II or III) and tend to recur [1]. The most common primary cytogenetic feature of all grades of meningioma is monosomy 22, whereas tumor progression and recurrence is associated with stronger hypodiploidy, in particular monosomy of chromosomes 14 and/or 18, and loss of the short arm of a chromosome 1 [2][3][4][5][6]. Hyperdiploidy, on the other hand, has long been known to be found in rare instances of meningiomas [2,7,8].…”

Section: Introductionmentioning

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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“…Typical meningiomas have recurrence rates of approximately 7%-20% and atypical meningiomas have rates of 29%-40%, whereas anaplastic meningiomas tend to reappear in 50%-78% of cases. [3][4][5] Rhabdoid meningioma (RM) was first described in 1998 as an unusual variant of meningiomas. 6 It has an increased proliferative activity and is classified as a WHO grade III meningioma.…”

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confidence: 99%