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Journal of Neuro-oncology Nov 1992Meningeal hemangiopericytoma is a rare neoplasm arising from perivascular pericytes. Accounting for < 1% of all brain tumors, these neoplasms are characterized by a high... (Review)
Review
Meningeal hemangiopericytoma is a rare neoplasm arising from perivascular pericytes. Accounting for < 1% of all brain tumors, these neoplasms are characterized by a high local recurrence rate and metastatic potential. Meningeal hemangiopericytoma occur most frequently during the fifth decade of life, with an almost equal sex incidence. To evaluate and define the role for primary, postoperative, or palliative radiotherapy in meningeal hemangiopericytoma, data were gathered from our own tumor registry and compiled with an extensive analysis of published series and case reports. This analysis reveals a 90%, 9 year actuarial risk for local recurrence following surgical resection only. Interestingly, less than 33% of these recurrences were noted within the first five years, which may account for the false assumption that these tumors are highly curable with surgical resection only. Radiation therapy appears to reduce this local recurrence rate, prolonging disease-free and overall survival. Radiation responses are dose dependent, with > 50 Gray providing superior long-term disease-free survival. Meningeal hemangiopericytoma are characterized by a slow, but progressive radiographic response to ionizing radiation, not unlike other radiated, highly vascular brain lesions, such as arteriovenous malformations. A retrospective review of clinical demographics, sites of meningeal origin, radiographic and pathologic findings and the role of chemotherapy is also presented.
Topics: Adolescent; Adult; Age Factors; Aged; Child; Female; Hemangiopericytoma; Humans; Male; Meningeal Neoplasms; Middle Aged; Neoplasm Recurrence, Local; Postoperative Care; Sex Factors; Survival Analysis
PubMed: 1460491
DOI: 10.1007/BF00172604 -
Neurosurgery Dec 1986A very unusual case of metastatic spread of a meningioma is described. The clinical presentation was of extradural spinal cord compression, without evidence of a primary...
A very unusual case of metastatic spread of a meningioma is described. The clinical presentation was of extradural spinal cord compression, without evidence of a primary tumor. Computed tomography did not reveal any intracranial meningioma; the histopathology of the extradural spinal tumor was identical with that of two intracranial meningiomas previously excised.
Topics: Adult; Humans; Male; Meningeal Neoplasms; Meningioma; Neoplasm Recurrence, Local; Spinal Neoplasms; Thoracic Vertebrae
PubMed: 3808235
DOI: 10.1227/00006123-198612000-00022 -
Journal of Neuro-oncology 1994Treatment objectives for meningiomas of the cranial base include relief of neurologic disability and prevention of clinical progression or recurrence with the least... (Review)
Review
Treatment objectives for meningiomas of the cranial base include relief of neurologic disability and prevention of clinical progression or recurrence with the least morbidity. Recent advances in skull base surgical techniques, through an appreciation of skull base anatomy and institutional specialization, have contributed major improvements to the outlook for patients with these tumors, and previously inoperable cases may now often be removed completely with acceptable risk. Since significant morbidity may be incurred during surgical resection of these difficult lesions, especially in terms of cranial nerve dysfunction, the value of aggressive surgical resection must be weighted against the often indolent natural history of these lesions, and must be individualized in each patient. Completeness of resection is the major prognostic factor determining the outcome of patients with typical benign meningiomas in terms of length of survival, risk of recurrence, and neurological disability. Various means of prognosticating the growth potential of a given tumor are being investigated, though none have yet been confirmed for their predictive value in typical, histologically benign meningiomas. The role of external beam radiotherapy has not been subjected to adequately controlled, prospective studies, and there is currently insufficient followup to assess the risks and benefits of stereotactic radiosurgery. Advances in the clinical management of tumors of the skull base has had perhaps the greatest impact for patients with meningiomas who constitute a large portion of tumors seen in these locations. Although the majority have benign histological features, skull base meningiomas can present a formidable challenge due to their proximity to vital structures, surgical inaccessibility, and occasional aggressive features. The combination in recent years of advances in skull base surgical techniques, adjuvant therapy, and rehabilitation methods have dramatically improved the outcome for these tumors.
Topics: Adolescent; Adult; Brain Neoplasms; Cavernous Sinus; Cerebellopontine Angle; Child; Combined Modality Therapy; Craniotomy; Disease Progression; Female; Humans; Magnetic Resonance Imaging; Male; Meningeal Neoplasms; Meningioma; Neoplasm Recurrence, Local; Radiosurgery; Radiotherapy, Adjuvant; Risk; Tomography, X-Ray Computed
PubMed: 7844622
DOI: 10.1007/BF01053043 -
Surgical Neurology Oct 1986The authors report a case of recurrent meningothelial meningioma with a large cyst. At the first operation, the mural nodule was totally resected and the cyst wall was...
The authors report a case of recurrent meningothelial meningioma with a large cyst. At the first operation, the mural nodule was totally resected and the cyst wall was removed as much as possible. This cystic tumor recurred six years later at the site where the first operation was performed. Histologically, the cyst wall contained islands of the same neoplastic cells as were previously found in the mural nodule. The authors discuss the preoperative diagnosis and mechanism of cyst formation, and emphasize the importance of complete removal of the cyst wall for permanent cure.
Topics: Adult; Cysts; Female; Humans; Meningeal Neoplasms; Meningioma; Neoplasm Recurrence, Local; Reoperation; Time Factors; Tomography, X-Ray Computed
PubMed: 3750200
DOI: 10.1016/0090-3019(86)90145-x -
Journal of Neurosurgery Aug 2006
Topics: Cell Division; Humans; Ki-67 Antigen; Meningeal Neoplasms; Meninges; Meningioma; Mitotic Index; Neoplasm Invasiveness; Prognosis; Receptors, Estrogen; Receptors, Progesterone
PubMed: 17219817
DOI: 10.3171/jns.2006.105.2.161 -
Seminars in Neurology Feb 2024Meningiomas are the most frequent nonmalignant tumors of the central nervous system (CNS). Despite their benign nature and slow-growing pattern, if not diagnosed early,... (Review)
Review
Meningiomas are the most frequent nonmalignant tumors of the central nervous system (CNS). Despite their benign nature and slow-growing pattern, if not diagnosed early, these tumors may reach relatively large sizes causing significant morbidity and mortality. Some variants are located in hard-to-access locations, compressing critical neurovascular structures, and making the surgical management even more challenging. Although most meningiomas have a good long-term prognosis after treatment, there are still controversies over their management in a subset of cases. While surgery is the first-line treatment, the use of fractionated radiotherapy or stereotactic radiosurgery is indicated for residual or recurrent tumors, small lesions, and tumors in challenging locations. Advances in molecular genetics and ongoing clinical trial results have recently helped both to refine the diagnosis and provide hope for effective biomolecular target-based medications for treatment. This article reviews the natural history and current therapeutic options for CNS meningiomas.
Topics: Humans; Meningioma; Meningeal Neoplasms; Neoplasm Recurrence, Local; Radiosurgery; Treatment Outcome
PubMed: 38052237
DOI: 10.1055/s-0043-1777352 -
Seminars in Neurology Dec 2004Neoplastic meningitis is a common problem in neuro-oncology, occurring in approximately 5% of all patients with cancer. Notwithstanding frequent focal signs and... (Review)
Review
Neoplastic meningitis is a common problem in neuro-oncology, occurring in approximately 5% of all patients with cancer. Notwithstanding frequent focal signs and symptoms, neoplastic meningitis is a disease affecting the entire neuraxis; therefore, staging and treatment must encompass all cerebrospinal fluid (CSF) compartments. Central nervous system staging of neoplastic meningitis includes contrast-enhanced cranial computerized tomography or magnetic resonance imaging, contrast-enhanced spine magnetic resonance imaging, or computerized tomographic myelography and radionuclide CSF flow study (FS). Treatment of neoplastic meningitis includes involved-field radiotherapy of bulky or symptomatic disease sites and intra-CSF drug therapy. The inclusion of concomitant systemic therapy may benefit patients with neoplastic meningitis and may obviate the need for intra-CSF chemotherapy. At present, intra-CSF drug therapy is confined to three chemotherapeutic agents (i.e., methotrexate, cytosine arabinoside, and thio-triethylenephosphoramide) administered by a variety of schedules either by intralumbar or intraventricular drug delivery. Although treatment of neoplastic meningitis is palliative with an expected median patient survival of 2 to 6 months, it often affords stabilization and protection from further neurological deterioration.
Topics: Antineoplastic Combined Chemotherapy Protocols; Central Nervous System Neoplasms; Combined Modality Therapy; Diagnostic Imaging; Humans; Meningeal Neoplasms; Neoplasm Staging; Prognosis; Radiotherapy
PubMed: 15637648
DOI: 10.1055/s-2004-861531 -
Cutis May 2018Meningiomas generally present as slow-growing, expanding intracranial lesions and are the most common benign intracranial tumor in adults. Rarely, meningiomas can...
Meningiomas generally present as slow-growing, expanding intracranial lesions and are the most common benign intracranial tumor in adults. Rarely, meningiomas can exhibit malignant potential and present as extracranial soft-tissue masses through extension or as primary extracranial cutaneous neoplasms. Although they are uncommonly encountered by dermatologists, it is important to include meningioma in the differential diagnosis for scalp neoplasms. We present a rare case of a 68-year-old woman with scalp metastasis of meningioma 11 years after initial resection of the primary tumor.
Topics: Aged; Diagnosis, Differential; Female; Humans; Meningeal Neoplasms; Meningioma; Neoplasm Recurrence, Local; Scalp; Skin Neoplasms
PubMed: 29894530
DOI: No ID Found -
Clinical manifestation, management and prognosis of clear cell meningioma: an evidence-based review.The International Journal of... Jun 2023Clear cell meningioma (CCM) is an uncommon histologic subtype of meningioma classified as a WHO grade II tumor and accounting for less than 1% of all meningiomas.... (Review)
Review
Clear cell meningioma (CCM) is an uncommon histologic subtype of meningioma classified as a WHO grade II tumor and accounting for less than 1% of all meningiomas. Demographically, younger patients are commonly affected without any remarkable gender preference. Moreover, CCM shows a unique anatomical site of involvement. It tends to occur in the cranium than the spine, whereas the basilar skull, posterior fossa and lumbar spine have been the most frequently affected area. Although most cases present as typical the mass effect by the tumor, CCM exhibits characteristic imaging and histologic patterns. Even though surgical resection is the treatment of choice, recurrence-free survival is the biggest challenge and has been attempting to improve by adjuvant therapy. There is still debate about its management, outcome and factors defining it. Herein, we aimed to summarize natural history, radiographic characteristics, histological features, treatment strategies to guide the best possible individualized care for the most favorable outcome.
Topics: Humans; Meningioma; Meningeal Neoplasms; Prognosis; Combined Modality Therapy; Neurosurgical Procedures; Neoplasm Recurrence, Local; Retrospective Studies
PubMed: 34319820
DOI: 10.1080/00207454.2021.1956919 -
Acta Neurochirurgica Dec 2023Atypical meningioma (AM) recurs in up to half of patients after surgical resection and may require adjuvant therapy to improve patient prognosis. Various... (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
Atypical meningioma (AM) recurs in up to half of patients after surgical resection and may require adjuvant therapy to improve patient prognosis. Various clinicopathological features have been shown to have prognostic implications in AM, but an integrated prediction model is lacking. Thus, in this study, we aimed to develop and validate an integrated prognostic model for AM.
METHODS
A retrospective cohort of 528 adult AM patients surgically treated at our institution were randomly assigned to a training or validation group in a 7:3 ratio. Sixteen baseline demographic, clinical, and pathological parameters, progression-free survival (PFS), and overall survival (OS) were analysed. Sixty-five combinations of machine learning (ML) algorithms were used for model training and validation to predict tumour recurrence and patient mortality.
RESULTS
The random survival forest (RSF) model was the best model for predicting recurrence and death. Primary or secondary tumour, Ki-67 index, extent of resection, tumour size, brain involvement, tumour necrosis, and age contributed significantly to the model. The C-index value of the RSF recurrence prediction model reached 0.8080. The AUCs for 1-, 3-, and 5-year PFS were 0.83, 0.82, and 0.86, respectively. The C-index value of the RSF death prediction model reached 0.8890. The AUCs for 3-year and 5-year OS were 0.88 and 0.89, respectively.
CONCLUSION
A high-performing integrated RSF predictive model for AM recurrence and patient mortality was proposed that may guide therapeutic decision-making and long-term monitoring.
Topics: Adult; Humans; Meningioma; Retrospective Studies; Neoplasm Recurrence, Local; Prognosis; Meningeal Neoplasms; Machine Learning
PubMed: 37819396
DOI: 10.1007/s00701-023-05831-z