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Journal of Neuro-oncology Mar 2024This study investigated whether Ki-67 labeling index (LI) correlated with clinical outcomes after SRS for atypical meningiomas.
PURPOSE
This study investigated whether Ki-67 labeling index (LI) correlated with clinical outcomes after SRS for atypical meningiomas.
METHODS
This retrospective study examined 39 patients with atypical meningiomas who underwent SRS over a 10-year study period. Ki-67 LI was categorized into 3 groups: low (< 5%), intermediate (5%-10%), and high (> 10%). Local tumor control rates (LCRs), progression-free rates (PFRs), disease-specific survival (DSS) rates, and adverse radiation-induced events (AREs) were evaluated.
RESULTS
The median follow-up periods were 26 months. SRS was performed at a median prescription dose of 18 Gy for tumors with a median Ki-67 LI of 9.6%. The 3-year LCRs were 100%, 74%, and 25% in the low, intermediate, and high LI groups, respectively (p = 0.011). The 3-year PFRs were 100%, 40%, and 0% in the low, intermediate, and high LI groups (p = 0.003). The 5-year DSS rates were 100%, 89%, and 50% in the low, intermediate, and high LI groups (p = 0.019). Multivariable Cox proportional hazard analysis showed a significant correlation of high LI with lower LCR (hazard ratio [HR], 3.92; 95% confidence interval [CI] 1.18-13.04, p = 0.026), lower PFR (HR 3.80; 95% CI 1.46-9.88, p = 0.006), and shorter DSS (HR 6.55; 95% CI 1.19-35.95, p = 0.031) compared with intermediate LI. The ARE rates were minimal (8%) in the entire group.
CONCLUSION
Patients with high Ki-67 LI showed significantly more tumor progression and tumor-related death. Ki-67 LI might offer valuable predictive insights for the post-SRS management of atypical meningiomas.
Topics: Humans; Meningioma; Treatment Outcome; Radiosurgery; Ki-67 Antigen; Retrospective Studies; Meningeal Neoplasms; Follow-Up Studies
PubMed: 38369575
DOI: 10.1007/s11060-023-04537-7 -
The Kaohsiung Journal of Medical... May 2024
Topics: Humans; Meningitis; Meningioma; Diagnostic Errors; Magnetic Resonance Imaging; Immunoglobulin G; Meningeal Neoplasms; Male; Female; Middle Aged; Hypertrophy
PubMed: 38362805
DOI: 10.1002/kjm2.12816 -
BMC Ophthalmology Feb 2024To report a case of tuberculum meningioma with recovery of glaucoma-like visual field defects after chiasmal decompression.
BACKGROUND
To report a case of tuberculum meningioma with recovery of glaucoma-like visual field defects after chiasmal decompression.
CASE PRESENTATION
A 39-year-old woman presenting with headache was found to have bilateral arcuate retinal nerve fiber layer (RNFL) thinning on optical coherence tomography (OCT) with a corresponding arcuate scotomas consistent with glaucomatous change. However a suprasellar tumor compressing the anterior chiasm from below was found on magnetic resonance imaging of the brain. After resection of the mass, which was diagnosed as meningothelial meningioma by the pathological examination, the glaucoma-like visual field defects resolved despite the RNFL thinning on the OCT showing no improvement.
CONCLUSIONS
Chiasmal compression may mimic glaucoma and produce arcuate scotoma rather than temporal visual field loss. There is a possibility that the development of chiasmal compression somehow converted preperimetric glaucoma into a more advanced form accompanied by visual field defects and that the glaucoma reverted to the preperimetric state after chiasmal decompression.
Topics: Female; Humans; Adult; Visual Fields; Meningioma; Nerve Fibers; Retinal Ganglion Cells; Visual Field Tests; Glaucoma; Scotoma; Vision Disorders; Tomography, Optical Coherence; Meningeal Neoplasms; Decompression
PubMed: 38355425
DOI: 10.1186/s12886-024-03332-w -
Journal of Imaging Informatics in... Jun 2024The aim of this study was to use multimodal imaging (contrast-enhanced T1-weighted (T1C), T2-weighted (T2), and diffusion-weighted imaging (DWI)) to develop a radiomics...
The aim of this study was to use multimodal imaging (contrast-enhanced T1-weighted (T1C), T2-weighted (T2), and diffusion-weighted imaging (DWI)) to develop a radiomics model for preoperatively predicting venous sinus invasion in meningiomas. This prediction would assist in selecting the appropriate surgical approach and forecasting the prognosis of meningiomas. A retrospective analysis was conducted on 331 participants who had been pathologically diagnosed with meningiomas. For each participant, 3948 radiomics features were acquired from the T1C, T2, and DWI images. Minimum redundancy maximum correlation, rank sum test, and multi-factor recursive elimination were used to extract the most significant features of different models. Then, multivariate logistic regression was used to build classification models to predict meningioma venous sinus invasion. The diagnostic capabilities were assessed using receiver operating characteristic (ROC) analysis. In addition, a nomogram was constructed by incorporating clinical and radiological characteristics and a radiomics signature. To assess the clinical usefulness of the nomogram, a decision curve analysis (DCA) was performed. Tumor shape, boundary, and enhancement features were independent predictors of meningioma venous sinus invasion (p = 0.013, p = 0.013, p = 0.005, respectively). Eleven (T2:1, T1C:4, DWI:6) of the 3948 radiomics features were screened for strong association with meningioma sinus invasion. The areas under the ROC curves for the training and external test sets were 0.946 and 0.874, respectively. The clinicoradiomic model showed excellent predictive performance for invasive meningioma, which may help to guide surgical approaches and predict prognosis.
Topics: Humans; Meningioma; Female; Diffusion Magnetic Resonance Imaging; Male; Middle Aged; Retrospective Studies; Meningeal Neoplasms; Neoplasm Invasiveness; Magnetic Resonance Imaging; Adult; Aged; ROC Curve; Nomograms; Radiomics
PubMed: 38351221
DOI: 10.1007/s10278-024-01024-x -
Journal of Medical Case Reports Feb 2024Ependymomas are the third most common central nervous system tumor in the pediatric population; however, spinal ependymomas in children are rare. Ependymomas affecting... (Review)
Review
BACKGROUND
Ependymomas are the third most common central nervous system tumor in the pediatric population; however, spinal ependymomas in children are rare. Ependymomas affecting the spinal cord most frequently occur in adults of 20-40 years of age. The current World Health Organization classification system for ependymomas is now composed of ten different entities based on histopathology, location, and molecular studies, with evidence that the new classification system more accurately predicts clinical outcomes.
CASE PRESENTATION
We present the case of a 16-year-old Caucasian female patient with a history of type 2 neurofibromatosis with multiple schwannomas, meningioma, and spinal ependymoma. Chromosome analysis of the harvested spinal ependymoma tumor sample revealed a 46,XX,-6,+7,-22,+mar[16]/46,XX[4] karyotype. Subsequent OncoScan microarray analysis of the formalin-fixed paraffin-embedded tumor sample confirmed + 7, -22 and clarified that the marker chromosome represents chromothripsis of the entire chromosome 6 with more than 100 breakpoints. Fluorescent in situ hybridization and microarray analysis showed no evidence of MYCN amplification. The final integrated pathology diagnosis was spinal ependymoma (central nervous system World Health Organization grade 2 with no MYCN amplification.
CONCLUSION
This case adds to the existing literature of pediatric patients with spinal ependymomas and expands the cytogenetic findings that may be seen in patients with this tumor type. This case also highlights the value of cytogenetics and microarray analysis in solid tumors to provide a more accurate molecular diagnosis.
Topics: Adult; Humans; Child; Female; Adolescent; Chromothripsis; Chromosomes, Human, Pair 6; In Situ Hybridization, Fluorescence; Spinal Cord Neoplasms; Ependymoma; Meningeal Neoplasms
PubMed: 38351155
DOI: 10.1186/s13256-023-04283-4 -
Journal of Neuro-oncology Feb 2024The risk of recurrence is overestimated by the Kaplan-Meier method when competing events, such as death without recurrence, are present. Such overestimation can be...
BACKGROUND
The risk of recurrence is overestimated by the Kaplan-Meier method when competing events, such as death without recurrence, are present. Such overestimation can be avoided by using the Aalen-Johansen method, which is a direct extension of Kaplan-Meier that accounts for competing events. Meningiomas commonly occur in older individuals and have slow-growing properties, thereby warranting competing risk analysis. The extent to which competing events are considered in meningioma literature is unknown, and the consequences of using incorrect methodologies in meningioma recurrence risk analysis have not been investigated.
METHODS
We surveyed articles indexed on PubMed since 2020 to assess the usage of competing risk analysis in recent meningioma literature. To compare recurrence risk estimates obtained through Kaplan-Meier and Aalen-Johansen methods, we applied our international database comprising ~ 8,000 patients with a primary meningioma collected from 42 institutions.
RESULTS
Of 513 articles, 169 were eligible for full-text screening. There were 6,537 eligible cases from our PERNS database. The discrepancy between the results obtained by Kaplan-Meier and Aalen-Johansen was negligible among low-grade lesions and younger individuals. The discrepancy increased substantially in the patient groups associated with higher rates of competing events (older patients with high-grade lesions).
CONCLUSION
The importance of considering competing events in recurrence risk analysis is poorly recognized as only 6% of the studies we surveyed employed Aalen-Johansen analyses. Consequently, most of the previous literature has overestimated the risk of recurrence. The overestimation was negligible for studies involving low-grade lesions in younger individuals; however, overestimation might have been substantial for studies on high-grade lesions.
Topics: Humans; Aged; Meningioma; Meningeal Neoplasms; Neoplasm Recurrence, Local; Retrospective Studies; Risk Assessment
PubMed: 38336917
DOI: 10.1007/s11060-024-04572-y -
Asian Journal of Surgery May 2024
Topics: Humans; Meningeal Carcinomatosis; Rectal Neoplasms; Adenocarcinoma; Disease Progression; Fatal Outcome; Male; Middle Aged; Magnetic Resonance Imaging
PubMed: 38336490
DOI: 10.1016/j.asjsur.2024.01.174 -
Asian Journal of Surgery May 2024
Topics: Female; Humans; Diagnosis, Differential; Hypertrophy; Magnetic Resonance Imaging; Meningeal Neoplasms; Meningioma; Meningitis; Tuberculosis, Meningeal; Middle Aged
PubMed: 38336489
DOI: 10.1016/j.asjsur.2024.01.167 -
Photodiagnosis and Photodynamic Therapy Feb 2024Brain tumors have serious adverse effects on public health and social economy. Accurate detection of brain tumor types is critical for effective and proactive treatment,...
BACKGROUND
Brain tumors have serious adverse effects on public health and social economy. Accurate detection of brain tumor types is critical for effective and proactive treatment, and thus improve the survival of patients.
METHODS
Four types of brain tumor tissue sections were detected by Raman spectroscopy. Principal component analysis (PCA) has been used to reduce the dimensionality of the Raman spectra data. Linear discriminant analysis (LDA) and quadratic discriminant analysis (QDA) methods were utilized to discriminate different types of brain tumors.
RESULTS
Raman spectra were collected from 40 brain tumors. Variations in intensity and shift were observed in the Raman spectra positioned at 721, 854, 1004, 1032, 1128, 1248, 1449 cm for different brain tumor tissues. The PCA results indicated that glioma, pituitary adenoma, and meningioma are difficult to differentiate from each other, whereas acoustic neuroma is clearly distinguished from the other three tumors. Multivariate analysis including QDA and LDA methods showed the classification accuracy rate of the QDA model was 99.47 %, better than the rate of LDA model was 95.07 %.
CONCLUSIONS
Raman spectroscopy could be used to extract valuable fingerprint-type molecular and chemical information of biological samples. The demonstrated technique has the potential to be developed to a rapid, label-free, and intelligent approach to distinguish brain tumor types with high accuracy.
Topics: Humans; Spectrum Analysis, Raman; Photochemotherapy; Photosensitizing Agents; Brain Neoplasms; Meningeal Neoplasms
PubMed: 38336147
DOI: 10.1016/j.pdpdt.2024.104010 -
Medicine Feb 2024Cellular blue nevus is an uncommon neoplasm in the spine.
INTRODUCTION
Cellular blue nevus is an uncommon neoplasm in the spine.
PATIENT CONCERNS
Here, we present a case of a 24 years old male with a 2 months history of numbness in the right upper limb and shoulder.
DIAGNOSIS
Cervical spine and subcutaneous tissue invasive cellular blue nevus.
INTERVENTIONS
The patient underwent C4 laminectomy and partial C3 and C5 laminectomy for total resection of the lesion. Histopathology revealed a nodular tumor with unclear boundaries, which was composed of heavily pigmented dendritic cells and more pigmented spindle cells.
OUTCOMES
There was no recurrence during 3 years follow-up.
CONCLUSION
Invasive cellular blue nevus of the spine can be wrongly diagnosed as spinal meningeal melanocytoma and meningeal melanoma due to its special cell behavior and rarity. Therefore, it is important to understand its pathological and clinical characteristics to avoid over-treatment.
Topics: Humans; Male; Young Adult; Cervical Vertebrae; Melanoma; Meningeal Neoplasms; Nevus, Blue; Nevus, Pigmented; Skin Neoplasms
PubMed: 38335405
DOI: 10.1097/MD.0000000000037097