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Revista de NeurologiaMeningeal carcinomatosis is a serious complication of solid tumors, particularly adenocarcinomas of breast, lung and melanoma. (Review)
Review
INTRODUCTION
Meningeal carcinomatosis is a serious complication of solid tumors, particularly adenocarcinomas of breast, lung and melanoma.
OBJECTIVE
In this paper we present a review of the bibliography on this disease, with particular emphasis on etiopathogenic, clinical--especially otoneurophthalmological--diagnostic and therapeutic aspects.
DEVELOPMENT
Meningeal carcinomatosis presents in advanced stages of cancer and has an ominous prognosis with average untreated survival of from four to six weeks. Its frequency has increased in recent years since patients with systemic cancer now live longer. The characteristic of the disease is involvement of various levels of the nervous system, including encephalic, cranial or spinal nerve and spinal symptoms. Sudden loss of vision or hearing which may progress rapidly may be the initial sign of the disease. Neuroimaging studies (computerized axial tomography, magnetic resonance and isotope studies of cerebrospinal fluid flow) are necessary to evaluate associated metastases and detect obstruction of cerebrospinal fluid flow. Positive cerebrospinal fluid cytological findings confirm the diagnosis. Treatment should be tailored to the individual according to the clinical condition and nature of the tumour and should combine intrathecal chemotherapy and local radiotherapy, although recent studies have shown good results with systemic chemotherapy.
CONCLUSION
A high degree of clinical suspicion is necessary for diagnosis of this uncommon disease, with neurological signs show to be present at different levels and the finding of malignant cells in the cerebrospinal fluid for confirmation of the diagnosis.
Topics: Antineoplastic Agents; Biomarkers, Tumor; Carcinoma; Cell Movement; Combined Modality Therapy; Cranial Irradiation; Diagnostic Imaging; Humans; Injections, Spinal; Meningeal Neoplasms; Neoplasm Metastasis; Neoplasm Proteins; Prognosis
PubMed: 11205566
DOI: No ID Found -
Journal of Neurosurgery Dec 2012
Topics: Female; Humans; Male; Meningeal Neoplasms; Meningioma; Neoplasm Recurrence, Local; Neurosurgical Procedures
PubMed: 23061390
DOI: 10.3171/2012.5.JNS12865 -
Journal of Neurosurgery Oct 1999
Topics: Brain Neoplasms; Humans; Magnetic Resonance Imaging; Meningeal Neoplasms; Meningioma; Neoplasm Recurrence, Local; Prognosis
PubMed: 10507404
DOI: 10.3171/jns.1999.91.4.0720 -
Journal of Neurosurgery May 2000
Topics: Brain Edema; Forecasting; Humans; Meningeal Neoplasms; Meningioma; Neoplasm Recurrence, Local; Tomography, X-Ray Computed
PubMed: 10794314
DOI: 10.3171/jns.2000.92.5.0897 -
Neuro-Chirurgie 2010Sphenoorbital meningiomas account for 20% of all orbital tumors treated by neurosurgeons. Proptosis is the main clinical sign but this can be reduced with accurate...
Sphenoorbital meningiomas account for 20% of all orbital tumors treated by neurosurgeons. Proptosis is the main clinical sign but this can be reduced with accurate surgical management. Complete tumor removal is often difficult considering the frequent extensions of the meningioma to the superior orbital fissure, the cavernous sinus, and the periorbita.
Topics: Cohort Studies; Craniotomy; Dura Mater; Exophthalmos; Humans; Meningeal Neoplasms; Meningioma; Neoplasm Recurrence, Local; Postoperative Complications; Tomography, X-Ray Computed; Treatment Outcome; Visual Acuity
PubMed: 20303557
DOI: 10.1016/j.neuchi.2010.02.022 -
Clinical Neurology and Neurosurgery Apr 2010The primary treatment of meningiomas is surgery which can be curative if the tumor is completely removed. For parasagittal, lateral sphenoid wing and olfactory groove... (Review)
Review
The primary treatment of meningiomas is surgery which can be curative if the tumor is completely removed. For parasagittal, lateral sphenoid wing and olfactory groove meningiomas, gross-total resection should be the goal. Tuberculum and diaphragma sella meningiomas can be resected through the subfrontal or the pterional approaches. In meningiomas of the sphenoid wing with osseous involvement or involvement of the cavernous sinus subtotal resection can be achieved via several surgical approaches. Similarly, subtotal resection rather than gross-total resection of meningiomas of the petroclival, parasellar, and posterior fossa regions can preserve neurological function. Prior to surgery, embolization may reduce intraoperative bleeding and prevent postoperative complications. Stereotactic radiosurgery can be used as an alternative treatment to surgery either as a first-line treatment or at recurrence. Various conventional radiotherapy techniques can be employed for residual tumor post surgery or at recurrence. Chemotherapy has modest activity and is reserved for selected cases.
Topics: Antineoplastic Agents; Chemotherapy, Adjuvant; Humans; Meningeal Neoplasms; Meningioma; Neoplasm Staging; Neurosurgical Procedures; Radiosurgery; Radiotherapy, Adjuvant; Treatment Outcome
PubMed: 20056312
DOI: 10.1016/j.clineuro.2009.12.011 -
Expert Review of Neurotherapeutics 2023Meningiomas represent the most common primary neoplasms of the central nervous system (CNS). 20% present with atypical (WHO grade II) or malignant (grade III)... (Review)
Review
INTRODUCTION
Meningiomas represent the most common primary neoplasms of the central nervous system (CNS). 20% present with atypical (WHO grade II) or malignant (grade III) meningiomas, which show aggressive biologic behavior and high recurrence. Although surgical resection and radiation therapy are the primary treatment options for these tumors, there is a subgroup of patients who do not respond well to or are poor candidates for these approaches, leading to the exploration of systemic therapies as an alternative.
AREAS COVERED
The literature on different therapeutic groups of systemic drugs for recurrent meningiomas is reviewed, with a focus on the different molecular targets. Past and current ongoing clinical trials are also discussed.
EXPERT OPINION
To date, there is no recognized treatment that has demonstrated a substantial increase in progression-free or overall survival rates. Nonetheless, therapies targeting anti-VEGF have exhibited more encouraging results in general. The examination of genomic and epigenomic traits of meningiomas, along with the integration of molecular markers into the latest WHO tumor grading system, has provided valuable insights. This has opened avenues for exploring numerous intracellular and extracellular pathways, as well as mutations, that have been targeted in ongoing clinical trials.
Topics: Humans; Meningioma; Meningeal Neoplasms; Neoplasm Recurrence, Local
PubMed: 37695700
DOI: 10.1080/14737175.2023.2254498 -
Neurology India 2017
Topics: Biomarkers, Tumor; Cell Proliferation; Humans; Meningeal Neoplasms; Meningioma; Neoplasm Grading
PubMed: 29133693
DOI: 10.4103/0028-3886.217989 -
Folia Medica Feb 2021Spinal meningiomas are found in all age groups, predominantly in women aged over 50 years. The clinical symptoms of this condition may range from mild to significant... (Review)
Review
Spinal meningiomas are found in all age groups, predominantly in women aged over 50 years. The clinical symptoms of this condition may range from mild to significant neurological deficit, varying widely depending on the location, position in relation to the spinal cord, size and histological type of the tumor. Magnetic resonance imaging is the diagnostic tool of choice because it shows the location, size, the axial position of the tumor, and the presence of concomitant conditions such as spinal malformations, edema or syringomyelia. According to the degree of malignancy, the World Health Organization divides meningiomas into three grades: grade I - benign; grade II - atypical, and grade III - malignant. The goal of the surgery is total resection which is achievable in 82%-98% of cases. Advances in radiosurgery have led to its increased use as primary or adjunct therapy. The current paper aims to review the fundamental clinical as-pects of spinal meningiomas such as their epidemiology, clinical presentation, histological characteristics, diagnostics, and management.
Topics: Disease Management; Global Health; Humans; Magnetic Resonance Imaging; Meningeal Neoplasms; Meningioma; Morbidity; Neoplasm Staging; Radiosurgery
PubMed: 33650392
DOI: 10.3897/folmed.63.e52967 -
Journal of Neuro-oncology May 2003Secretory meningiomas are a rare meningioma subtype. Among meningiomas, the frequency of secretory meningiomas is 1.6%. Unlike other meningioma types, most of the... (Comparative Study)
Comparative Study Review
Secretory meningiomas are a rare meningioma subtype. Among meningiomas, the frequency of secretory meningiomas is 1.6%. Unlike other meningioma types, most of the patients were female (ratio 3:1). No recurrence was reported during the 24-180 months follow-up period of our secretory meningiomas in which, a low level of 0.3% Ki-67 proliferative index was reported. In this meningioma subtype, the percentage of cases with positive progesterone receptor is 33%. With carcinoembryonic antigen, cytokeratin and epithelial membrane antigen, in all the cases positivity was observed in both, the inclusions and the cells surrounding them. With human milk fat globulin 2, a high ratio (92%) of positivity was observed. Majority of the cases were negative with CA125, only three of the cases had suspicious positivity. Distribution of inclusions was irregular and their positive reactions showed varying staining features. Positivity with alpha-1-antitripsin was seen not only in the inclusions but also in some meningothelial cells as well. Ubiquitin was positive in inclusions of the 83% of cases. Staining features of the inclusions pointed out the possibility of them being in a varying age and/or content. Secretory meningiomas are a different type compared to other meningiomas, not only with their histological features but also with their clinical features as well.
Topics: Adult; Aged; Biomarkers, Tumor; Female; Humans; Immunoenzyme Techniques; Male; Meningeal Neoplasms; Meningioma; Middle Aged; Neoplasm Proteins; Tomography, X-Ray Computed
PubMed: 12777074
DOI: 10.1023/a:1023319407645