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World Neurosurgery Dec 2022Melanocytes are neural crest derivatives. Intracranial meningeal melanocytomas (MM) are rare tumors and the available literature is sparse for these neoplasms. This... (Review)
Review
OBJECTIVE
Melanocytes are neural crest derivatives. Intracranial meningeal melanocytomas (MM) are rare tumors and the available literature is sparse for these neoplasms. This review aims to provide a detailed and comprehensive literature review of these tumors.
METHODS
By searching online databases, a literature review was performed to include and analyze all cases of cranial MM reported to date. PRISMA guidelines were followed for the review process.
RESULTS
A total of 109 cases were analyzed. The male/female ratio was 1.2:1. The mean age was 40.3 years. The mean duration of symptoms was 23.9 months (range, 2 days-15 years). Cerebellopontine (CP) angle, suprasellar, and Meckel cave were the most common locations. Sixty-four patients (58%) underwent gross total resection (GTR). Twenty-eight patients (26%) received some form of adjuvant radiation. There were 29 recurrences (26%) and mean time to recurrence was 50.2 months. The recurrence rates (RRs) for GTR and subtotal resection were 20% and 42%, respectively. The extent of resection (subtotal resection) and tumor locations (CP angle and Meckel cave) were significantly associated with higher RR. Six patients (6.5%) had higher-grade transformations.
CONCLUSIONS
Complete surgical resection is the ideal treatment and adjuvant radiation is to be considered for residual/recurrent tumors. Adjuvant radiotherapy may also be prescribed despite GTR, in locations with higher RR such as CP angle and Meckel cave. Because of higher-grade transformations and delayed recurrences, long-term follow-up is required.
Topics: Adult; Humans; Female; Male; Neoplasm Recurrence, Local; Meningeal Neoplasms; Nevus, Pigmented; Melanocytes; Skin Neoplasms
PubMed: 35977682
DOI: 10.1016/j.wneu.2022.08.051 -
Journal of Neuro-oncology Jan 2023Meningiomas are the most common primary intracranial tumor in older adults (Ostrom et al. in Neuro Oncol 21(Suppl 5):v1-v100, 2019). Treatment is largely driven by, in... (Review)
Review
PURPOSE
Meningiomas are the most common primary intracranial tumor in older adults (Ostrom et al. in Neuro Oncol 21(Suppl 5):v1-v100, 2019). Treatment is largely driven by, in addition to patient characteristics and extent of resection/Simpson grade, the World Health Organization (WHO) grading of meningiomas. The current grading scheme, based predominantly on histologic features and only limited molecular characterization of these tumors (WHO Classification of Tumours Editorial Board, in: Central nervous system tumours, International Agency for Research on Cancer, Lyon, 2021), (Mirian et al. in J Neurol Neurosurg Psychiatry 91(4):379-387, 2020), does not consistently reflect the biologic behavior of meningiomas. This leads to both under-treatment and over-treatment of patients, and hence, suboptimal outcomes (Rogers et al. in Neuro Oncol 18(4):565-574). The goal of this review is to synthesize studies to date investigating molecular features of meningiomas as they relate to patient outcomes, in order to clarify best practices in assessing and, therefore, treating meningiomas.
METHODS
The available literature of genomic landscape and molecular features of in meningioma was screened using PubMed.
RESULTS
Greater understanding of meningiomas is reached by integrating histopathology, mutational analysis, DNA copy number changes, DNA methylation profiles, and potentially additional modalities to fully capture the clinical and biologic heterogeneity of these tumors.
CONCLUSION
Diagnosis and classification of meningioma is best accomplished using a combination of histopathology with genomic and epigenomic factors. Future classification schemes may benefit from such an integrated approach.
Topics: Humans; Aged; Meningioma; Meningeal Neoplasms; Central Nervous System Neoplasms; Genomics; Biological Products; Neoplasm Grading; Retrospective Studies
PubMed: 36802047
DOI: 10.1007/s11060-022-04228-9 -
Handbook of Clinical Neurology 2020Meningiomas in children are poorly understood because they are rare. Recent reports have provided a more complete description of their incidence, genetics, imaging...
Meningiomas in children are poorly understood because they are rare. Recent reports have provided a more complete description of their incidence, genetics, imaging features, and outcome. In general, meningiomas in children are more likely to be higher grade, present in atypical locations, and have a higher risk of recurrence. The challenges encountered in children with respect to surgical and postoperative management are unique. Improved understanding of pediatric meningiomas, as well as the availability of new surgical, medical, and radiation therapies, creates opportunities to improve outcomes in this unique population.
Topics: Child; Child, Preschool; Diagnostic Imaging; Humans; Incidence; Meningeal Neoplasms; Meningioma; Neoplasm Recurrence, Local; Neurosurgical Procedures
PubMed: 32553293
DOI: 10.1016/B978-0-12-804280-9.00016-0 -
Neurology India 2022Chordoid meningioma, classified as WHO grade II, are rare tumors comprising only 0.5% of all meningiomas. Chordoid meningioma is an aggressive tumor with high local...
Chordoid meningioma, classified as WHO grade II, are rare tumors comprising only 0.5% of all meningiomas. Chordoid meningioma is an aggressive tumor with high local recurrence. Orbital chordoid meningioma is a much rare entity with very few cases reported in the literature. We report a case of a 77-year-old male who presented with a painless progressive swelling over the right lateral orbital wall.
Topics: Male; Humans; Aged; Meningioma; Meningeal Neoplasms
PubMed: 36352628
DOI: 10.4103/0028-3886.359271 -
Current Oncology Reports Aug 2023Leptomeningeal disease (LMD) is a devastating complication of advanced metastatic cancer associated with a poor prognosis and limited treatment options. This study... (Review)
Review
PURPOSE OF REVIEW
Leptomeningeal disease (LMD) is a devastating complication of advanced metastatic cancer associated with a poor prognosis and limited treatment options. This study reviews the current understanding of the clinical presentation, pathogenesis, diagnosis, and treatment of LMD. We highlight opportunities for advances in this disease.
RECENT FINDINGS
In recent years, the use of soluble CSF biomarkers has expanded, suggesting improved sensitivity over traditional cytology, identification of targetable mutations, and potential utility for monitoring disease burden. Recent studies of targeted small molecules and intrathecal based therapies have demonstrated an increase in overall and progression-free survival. In addition, there are several ongoing trials evaluating immunotherapy in LMD. Though overall prognosis of LMD remains poor, studies suggest a potential role for soluble CSF biomarkers in diagnosis and management and demonstrate promising findings in patient outcomes with targeted therapies for specific solid tumors. Despite these advances, there continues to be a gap of knowledge in this disease, emphasizing the importance of inclusion of LMD patients in clinical trials.
Topics: Humans; Meningeal Neoplasms; Prognosis; Mutation
PubMed: 37256537
DOI: 10.1007/s11912-023-01432-2 -
Handbook of Clinical Neurology 2020Information on the vascular supply to meningiomas is critical to the neurosurgeon. Most meningiomas are supplied by the external carotid artery, though many get pial...
Information on the vascular supply to meningiomas is critical to the neurosurgeon. Most meningiomas are supplied by the external carotid artery, though many get pial contribution as well. Angiogenesis is critical for these neoplasms to grow. Vascular endothelial growth factor (VEGF) has been a popular target of research to decrease angiogenesis. Peritumoral brain edema (PTBE) is occasionally seen in meningiomas, which makes surgical resection more challenging. The exact cause of PTBE remains unclear, but a number of factors have been postulated to contribute. Assessment of the vascularity of meningiomas is best carried out with angiography, but noninvasive techniques are improving, diminishing the need for more invasive imaging. Embolization of tumors can be performed to minimize perioperative blood loss and potentially lower surgical morbidity. However, it has not been shown to improve outcomes, and procedural risks exist. Higher grade tumors commonly have higher vascularity. Higher vascular meningiomas are more likely to recur and have higher levels of VEGF. The vascularity of meningiomas remains a topic of interest and is the focus of many research projects.
Topics: Aged; Brain Edema; Female; Humans; Male; Meningeal Neoplasms; Meningioma; Middle Aged; Neoplasm Recurrence, Local; Vascular Endothelial Growth Factor A
PubMed: 32553286
DOI: 10.1016/B978-0-12-804280-9.00010-X -
Hematology/oncology Clinics of North... Feb 2022Meningiomas are largely indolent tumors with a benign clinical course, but a minority exhibit aggressive behavior characterized by rapid growth, neurologic deficits, and... (Review)
Review
Meningiomas are largely indolent tumors with a benign clinical course, but a minority exhibit aggressive behavior characterized by rapid growth, neurologic deficits, and increased mortality. Identifying high-risk patients requiring intervention is challenging, but recent insights into meningioma biology provide a useful guide for decision making. Standard of care for recurrent or biologically aggressive tumors consists of surgery and radiation therapy. Systemic therapies targeting vascular endothelial growth factor signaling and somatostatin analogues are potential options for those with refractory disease but display only modest activity. New paradigms in meningioma clinical trial design provide hope for improved options in the future.
Topics: Biology; Humans; Meningeal Neoplasms; Meningioma; Neoplasm Recurrence, Local; Vascular Endothelial Growth Factor A
PubMed: 34801160
DOI: 10.1016/j.hoc.2021.09.003 -
Handbook of Clinical Neurology 2020We know that the extent of resection is the greatest predictor of long-term survival. However, the potential tradeoff for gross total resection in difficult locations is... (Review)
Review
We know that the extent of resection is the greatest predictor of long-term survival. However, the potential tradeoff for gross total resection in difficult locations is diminished quality of life. Benign subtotally resected or small incidentally discovered meningiomas may be followed clinically especially in the elderly. In addition, radiosurgery plays a role in the treatment of meningiomas as a primary treatment modality, or as a salvage therapy. Decisions regarding management should be made with an understanding of the natural history and rate of growth. In this chapter we review the known meningioma epidemiology as well as the growth patterns of meningiomas based upon location.
Topics: Humans; Meningeal Neoplasms; Meningioma; Microsurgery; Neoplasm Recurrence, Local; Quality of Life
PubMed: 32553291
DOI: 10.1016/B978-0-12-804280-9.00014-7 -
Journal of Cutaneous Pathology Feb 2023Cutaneous meningiomas are rare tumors of ectopic meningeal tissue in the dermis or subcutis and are most commonly located on the scalp and around the eyes, ears, nose,...
Cutaneous meningiomas are rare tumors of ectopic meningeal tissue in the dermis or subcutis and are most commonly located on the scalp and around the eyes, ears, nose, and mouth. We present a case of cutaneous meningioma with an unusual presentation on the upper arm, but with positivity for epithelial membrane antigen to support the diagnosis of meningioma. Lack of pancytokeratin AE1/3 and p63 allowed us to rule out a keratinocytic tumor, such as squamous cell carcinoma and basal cell carcinoma. The absence of smooth muscle actin, FXIIIa, CD163, and CD34 allowed us to rule out a leiomyoma, dermatofibroma, and vascular neoplasm respectively. Weak staining of S100 allowed us to rule out a perineuroma. The purpose of this case report is to increase awareness of a rare presentation of cutaneous meningioma not located within the scalp/face region. This may broaden its inclusion within differential diagnoses of neoplasms of uncertain behavior and encourage correct clinical diagnosis, thus improving treatment outcomes.
Topics: Humans; Meningioma; Skin Neoplasms; Carcinoma, Squamous Cell; Treatment Outcome; Diagnosis, Differential; Meningeal Neoplasms
PubMed: 35996326
DOI: 10.1111/cup.14316 -
International Journal of Radiation... Mar 2023
Topics: Humans; Meningioma; Meningeal Neoplasms; Neoplasm Recurrence, Local
PubMed: 36725163
DOI: 10.1016/j.ijrobp.2022.07.030