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Future Oncology (London, England) Sep 2018Meningiomas are the most common primary intracranial tumor. Important advances are occurring in meningioma research. These are expected to accelerate, potentially... (Review)
Review
Meningiomas are the most common primary intracranial tumor. Important advances are occurring in meningioma research. These are expected to accelerate, potentially leading to impactful changes on the management of meningiomas in the near and medium term. This review will cover the histo- and molecular pathology of meningiomas, including recent 2016 updates to the WHO classification of CNS tumors. We will discuss clinical and radiographic presentation and therapeutic management. Surgery and radiotherapy, the two longstanding primary therapeutic modalities, will be discussed at length. In addition, data from prior and ongoing investigations of other treatment modalities, including systemic and targeted therapies, will be covered. This review will quickly update the reader on the contemporary management and future directions in meningiomas. [Formula: see text].
Topics: Animals; Biopsy; Combined Modality Therapy; Humans; Meningeal Neoplasms; Meningioma; Multimodal Imaging; Neoplasm Staging; Prognosis; Symptom Assessment; Treatment Outcome
PubMed: 30084265
DOI: 10.2217/fon-2018-0006 -
Expert Review of Neurotherapeutics Mar 2018With an annual incidence of 5/100,000, meningioma is the most frequent primary tumor of the central nervous system. Risk factors are radiotherapy and hormone intake.... (Review)
Review
With an annual incidence of 5/100,000, meningioma is the most frequent primary tumor of the central nervous system. Risk factors are radiotherapy and hormone intake. Most meningiomas are grade I benign tumors, but up to 15% are atypical and 2% anaplastic according to the WHO 2016 histological criteria. Areas covered: This review details the current standard therapy based on international guidelines and recent literature, and describes new approaches developed to treat refractory cases. First-line treatments are observation and surgery, but adjuvant radiotherapy/radiosurgery is discussed for atypical and indicated for anaplastic meningiomas. The most problematic cases include skull base meningiomas that enclose vasculo-nervous structures and surgery- and radiation-refractory tumors that present with significant morbidity and mortality. The treatment of recurrent tumors is based on radiotherapy and repeated surgery. Systematic therapies are not effective in general but several clinical trials are ongoing. Expert commentary: Molecular characterization of the tumors, based on genetic mutations such as NF2, SMO, TERT, TRAF7, and on the methylation profile are developing, completing the histological classification and giving new insights into prognosis and treatment options.
Topics: Humans; Meningeal Neoplasms; Meningioma; Mutation; Neoplasm Grading; Neoplasm Recurrence, Local; Prognosis; Radiosurgery; Radiotherapy, Adjuvant; Risk Factors; Skull Base Neoplasms
PubMed: 29338455
DOI: 10.1080/14737175.2018.1429920 -
Critical Reviews in Oncology/hematology Aug 2008Meningiomas are mostly benign tumours originating from the arachnoid cap cells, represent 13-26% of all intracranial tumours. They are more common in older age and in... (Review)
Review
Meningiomas are mostly benign tumours originating from the arachnoid cap cells, represent 13-26% of all intracranial tumours. They are more common in older age and in females. Deletion in NF2 gene and exposure to ionizing radiation are established risk factors, while the role of sex hormones is yet not clarified. Five-year survival for typical meningiomas exceeds 80%, but is poorer (5-year survival <60%) in malignant and atypical meningiomas. Papillary and haemangiopericytic morphology, large tumour size, high mitotic index, absence of progesterone receptors, deletions and loss of heterozygosity are poor prognostic factors. Complete surgical excision is the standard treatment. Radiotherapy is currently used in the clinical practice in atypical, malignant or recurrent meningioma at a total dose of 45-60Gy. However, the role of adjuvant irradiation is still controversial and has to be compared in a randomised prospective setting with a policy of watchful waiting. Radiosurgery has gained more and more importance in the management of meningiomas, especially in meningiomas that cannot be completely resected as for many skull base meningiomas. Medical therapy for patients with recurrent, progressive and symptomatic disease after repeated surgery, radiosurgery and radiotherapy is investigational. Hormonal therapy with progesterone antagonists has shown modest results, while chemotherapy with hydroxyurea appears moderately active.
Topics: Combined Modality Therapy; Humans; Meningeal Neoplasms; Meningioma; Neoplasm Staging; Prognosis; Risk Factors
PubMed: 18342535
DOI: 10.1016/j.critrevonc.2008.01.010 -
BMJ Case Reports Jan 2024Myeloid sarcoma is a very rare extramedullary malignant tumour, most often associated with acute myeloid leukaemia. We report the case of a man in his early 20s who...
Myeloid sarcoma is a very rare extramedullary malignant tumour, most often associated with acute myeloid leukaemia. We report the case of a man in his early 20s who presented with chronic headache, raised intracranial pressure and progressive vision loss of 2 years duration with no systemic manifestations. He had a history of myeloid sarcoma of the left thigh 15 years ago, treated with external beam radiotherapy and in complete remission for more than 13 years. However, the progressive blindness remained unexplained for 2 years, and he was eventually diagnosed with isolated meningeal relapse without marrow or systemic involvement. Imaging revealed subarachnoid haemorrhage, diffuse leptomeningeal enhancement and involvement of lower dorsal cord and conus, and cerebrospinal fluid cytology showed myeloid blasts. He was managed with intrathecal chemotherapy and craniospinal irradiation, after which he had mild improvement in vision.
Topics: Male; Humans; Sarcoma, Myeloid; Neoplasm Recurrence, Local; Meningeal Neoplasms; Blindness; Granulocyte Precursor Cells
PubMed: 38191225
DOI: 10.1136/bcr-2023-256821 -
Current Neurology and Neuroscience... Apr 2013Meningiomas represent the most common primary brain tumor and comprise 3 World Health Organization (WHO) grades, the most frequent being WHO grade I (90%). Surgery is... (Review)
Review
Meningiomas represent the most common primary brain tumor and comprise 3 World Health Organization (WHO) grades, the most frequent being WHO grade I (90%). Surgery is mandatory to establish the diagnosis and to remove the tumor; however, complete resection can be achieved in only <50% of patients. Depending on the extent of resection, tumor location and the WHO grade radiation therapy can be applied. The issue of systemic treatment such as chemotherapy or targeted therapy (eg, somatostatin receptors, antiangiogenic agents) is yet not solved, particularly as current data are derived from small uncontrolled series in patients with long-standing disease and after several pretreatments. A more thorough understanding of molecular genetics, signaling pathways and prognostic factors in meningiomas should lead to the design of studies which stratify according to these factors. These studies have to be conducted in newly diagnosed patients after incomplete resection and in tumors of WHO grade II and III.
Topics: Antineoplastic Agents; Cranial Irradiation; Diagnostic Imaging; Endoscopy; Humans; Meningeal Neoplasms; Meningioma; Microsurgery; Molecular Targeted Therapy; Neoplasm Recurrence, Local; Neuronavigation; Prognosis; Receptors, Somatostatin; Somatostatin
PubMed: 23463172
DOI: 10.1007/s11910-013-0337-4 -
Surgical Neurology Nov 1986If meningeal hemangiopericytoma could be diagnosed prior to operation, the neurosurgeon might be better prepared to deal with excessive bleeding during the operation....
If meningeal hemangiopericytoma could be diagnosed prior to operation, the neurosurgeon might be better prepared to deal with excessive bleeding during the operation. This type of tumor should be completely excised because of the high risk of recurrence and remote metastasis. Computed tomography as well as cerebral angiography would aid in the preoperative diagnosis of hemangiopericytoma. Early detection and periodic observation by computed tomography may minimize the morbidity and mortality associated with late detection.
Topics: Adult; Hemangiopericytoma; Humans; Male; Meningeal Neoplasms; Middle Aged; Neoplasm Recurrence, Local; Tomography, X-Ray Computed
PubMed: 3764655
DOI: 10.1016/0090-3019(86)90265-x -
Neurosurgery Clinics of North America Jan 2011Leptomeningeal metastasis (LMD) is a lethal complication caused by a variety of cancers, typically developing late in the disease course. It is associated with major... (Review)
Review
Leptomeningeal metastasis (LMD) is a lethal complication caused by a variety of cancers, typically developing late in the disease course. It is associated with major neurologic disabilities and short survival. The incidence of LMD may increase because of longer survival of patients who have cancer, and because of the use of newer large-molecule therapies with poor central nervous system penetration. To achieve improved outcomes for patients who have LMD, new treatments need to reach the meninges and cerebrospinal fluid and interact with relevant molecular targets. Some of the agents currently in testing may contribute to this goal. To allow for better outcomes through earlier treatment, advances in diagnosis are needed. By using agents with higher therapeutic indices, in patients with a lower burden of disease (identified earlier with clinical or molecular markers) it should be possible to achieve gradual improvements in outcomes for patients suffering from this devastating disease.
Topics: Antineoplastic Protocols; Combined Modality Therapy; Humans; Meningeal Carcinomatosis; Meningeal Neoplasms; Neoplasm Metastasis
PubMed: 21109151
DOI: 10.1016/j.nec.2010.08.006 -
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 -
International Journal of Radiation... Mar 2023
Topics: Humans; Meningioma; Meningeal Neoplasms; Neoplasm Recurrence, Local
PubMed: 36725163
DOI: 10.1016/j.ijrobp.2022.07.030 -
Journal of Neurosurgical Sciences Jun 1993The authors present two cases of non-traumatic subdural haematomas associated with a meningioma. Relevant literature is reviewed and the pathogenesis of this rare... (Review)
Review
The authors present two cases of non-traumatic subdural haematomas associated with a meningioma. Relevant literature is reviewed and the pathogenesis of this rare condition is discussed.
Topics: Aged; Aged, 80 and over; Chronic Disease; Female; Hematoma, Subdural; Humans; Male; Meningeal Neoplasms; Tomography, X-Ray Computed
PubMed: 8301370
DOI: No ID Found