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CNS Oncology Jun 2021Meningiomas are the most common primary intracranial tumors. The majority of meningiomas are benign, but they can present different grades of dedifferentiation from... (Review)
Review
Meningiomas are the most common primary intracranial tumors. The majority of meningiomas are benign, but they can present different grades of dedifferentiation from grade I to grade III (anaplastic/malignant) that are associated with different outcomes. Radiological surveillance is a valid option for low-grade asymptomatic meningiomas. In other cases, the treatment is usually surgical, aimed at achieving a complete resection. The use of adjuvant radiotherapy is the gold standard for grade III, is debated for grade II and is not generally indicated for radically resected grade I meningiomas. The use of systemic treatments is not standardized. Here we report a review of the literature on the clinical, radiological and molecular characteristics of meningiomas, available treatment strategies and ongoing clinical trials.
Topics: Brain Neoplasms; Child; Humans; Meningeal Neoplasms; Meningioma; Radiotherapy, Adjuvant
PubMed: 34015955
DOI: 10.2217/cns-2021-0003 -
Journal of Neuro-oncology Sep 2010Although most meningiomas are encapsulated and benign tumors with limited numbers of genetic aberrations, their intracranial location often leads to serious and... (Review)
Review
Although most meningiomas are encapsulated and benign tumors with limited numbers of genetic aberrations, their intracranial location often leads to serious and potentially lethal consequences. They are the most frequently diagnosed primary brain tumor accounting for 33.8% of all primary brain and central nervous system tumors reported in the United States between 2002 and 2006. Inherited susceptibility to meningioma is suggested both by family history and candidate gene studies in DNA repair genes. People with certain mutations in the neurofibromatosis gene (NF2) have a very substantial increased risk for meningioma. High dose ionizing radiation exposure is an established risk factor for meningioma, and lower doses may also increase risk, but which types and doses are controversial or understudied. Because women are twice as likely as men to develop meningiomas and these tumors harbor hormone receptors, an etiologic role for hormones (both endogenous and exogenous) has been hypothesized. The extent to which immunologic factors influence meningioma etiology has been largely unexplored. Growing emphasis on brain tumor research coupled with the advent of new genetic and molecular epidemiologic tools in genetic and molecular epidemiology promise hope for advancing knowledge about the causes of intra-cranial meningioma. In this review, we highlight current knowledge about meningioma epidemiology and etiology and suggest future research directions.
Topics: Humans; Meningeal Neoplasms; Meningioma
PubMed: 20821343
DOI: 10.1007/s11060-010-0386-3 -
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 -
Ophthalmic Plastic and Reconstructive... 2020
Topics: Humans; Meningeal Neoplasms; Meningioma; Skull Neoplasms
PubMed: 31574040
DOI: 10.1097/IOP.0000000000001439 -
Journal of Medical Case Reports Jun 2021Spontaneous subdural hematoma rarely presents with a hypervascular or malignant tumor but even less frequently in a benign tumor like meningioma. We encountered a... (Review)
Review
BACKGROUND
Spontaneous subdural hematoma rarely presents with a hypervascular or malignant tumor but even less frequently in a benign tumor like meningioma. We encountered a patient with acute subdural hematoma associated with benign meningioma. Here, we report this case along with a review of previous reports, especially focusing on their clinical features and possible bleeding mechanisms.
CASE PRESENTATION
A 53-year-old Asian woman presented with severe headache and progressive neurologic deterioration due to cerebral edema. The patient was submitted to open surgery for evacuation of the subdural hematoma and concurrent tumor removal on the ipsilateral parietal convexity. A hypervascular, encapsulated mass was identified during surgery and completely removed including the adjacent dura mater (Simpson grade 0). The tumor was histologically confirmed as an angiomatous meningioma (World Health Organization grade I). Her clinical course was uneventful after surgery.
CONCLUSIONS
Although meningiomas are commonly benign according to their histological traits, they can lead to spontaneous bleeding and cause neurologically unstable condition. Therefore, meningiomas need to be considered as a cause of spontaneous subdural hematoma if radiologically suspicious, which should be reflected by proper management for a positive outcome.
Topics: Brain Edema; Female; Hematoma, Subdural; Hematoma, Subdural, Acute; Humans; Meningeal Neoplasms; Meningioma; Middle Aged
PubMed: 34187580
DOI: 10.1186/s13256-021-02935-x -
World Neurosurgery Apr 2020Meningioma is an intracranial tumor frequently encountered in the neurosurgical setting. Extracranial disease is a rare occurrence, with a reported incidence in 0.1% of... (Review)
Review
BACKGROUND
Meningioma is an intracranial tumor frequently encountered in the neurosurgical setting. Extracranial disease is a rare occurrence, with a reported incidence in 0.1% of cases. Metastasis is associated with previous craniotomy, venous sinus invasion, local recurrence, and World Health Organization (WHO) grade III tumor. Metastasis of a benign, grade I meningioma is extraordinarily rare.
CASE DESCRIPTION
We report a case of a 41-year-old with a WHO grade I intracranial meningioma that had invaded and occluded the superior sagittal sinus. Chest computed tomography (CT) scan revealed pulmonary nodules, which were biopsied and confirmed benign meningioma. The metastatic meningiomas were found before resection of the primary tumor, suggesting direct seeding through the venous system versus iatrogenic seeding. Thirteen years later, an additional lung mass was found incidentally on abdominal CT scan for workup of a sarcoidosis. Biopsy and subsequent resection confirmed benign meningioma. A retrospective review of earlier chest CT scans revealed a small lesion that corresponded to the larger lesion found 13 years later.
CONCLUSIONS
This a rare case of a WHO grade I meningioma involving the sagittal sinus with direct seeding of the pulmonary vascular bed leading to multiple meningioma metastases. The report highlights an increased risk of distant metastases for a benign meningioma with invasion of dural sinuses.
Topics: Adult; Humans; Lung Neoplasms; Male; Meningeal Neoplasms; Meningioma; Middle Aged; Superior Sagittal Sinus
PubMed: 31899401
DOI: 10.1016/j.wneu.2019.12.131 -
Journal of Clinical Neuroscience :... Sep 2016Meningiomas are one of the most common brain tumors. World Health Organisation (WHO) Grade II and Grade III meningiomas are grouped together as non-benign meningioma... (Review)
Review
Meningiomas are one of the most common brain tumors. World Health Organisation (WHO) Grade II and Grade III meningiomas are grouped together as non-benign meningioma (NBM). There are several controversies surrounding NBM management, including the significance of extent of resection and the efficacy of post-operative radiation and drug treatment. We reviewed the literature to develop recommendations for management of NBM. The questions we sought to answer were: Does gross total resection (GTR) improve patient outcome? Is radiation therapy (RT) warranted after complete or after incomplete resection of NBM? What drug therapies have been proven to improve outcome in patients with NBM? We found that GTR improves outcome in WHO Grade II meningioma, and should be attempted whenever considered safe. GTR correlates less closely to outcome in Grade III meningioma compared to subtotal resection (STR). Extreme measures to completely resect Grade III meningioma are not warranted. RT following GTR of Grade II meningioma does not improve patient outcome, and may be reserved for recurrence. RT improves outcome following STR of Grade II meningioma. RT improves outcome after resection of Grade III meningioma. No drug therapy has been shown to improve outcome in NBM. This review elucidates recommendations for some of the controversies involving NBM.
Topics: Antineoplastic Agents; Brain Neoplasms; Combined Modality Therapy; Humans; Meningioma; Neoplasm Recurrence, Local
PubMed: 27338209
DOI: 10.1016/j.jocn.2016.03.014 -
Nederlands Tijdschrift Voor Geneeskunde Nov 2001Meningioma was diagnosed in four women, aged 40, 24, 41 and almost 75 years, respectively. The first of these patients was treated with surgery, the second and third... (Review)
Review
Meningioma was diagnosed in four women, aged 40, 24, 41 and almost 75 years, respectively. The first of these patients was treated with surgery, the second and third patients underwent surgery followed by conventional radiotherapy because of a tumour residue or dural tail, and the last patient was treated with stereotactic radiosurgery. They recovered well and were followed by means of regular outpatient check-ups. Twenty percent of all primary brain tumours are meningiomas, over 90% of which are benign. Nevertheless, a large hospital-based population study showed a 5-year survival rate of only 70%. Microsurgery is usually the treatment of first choice. However, in about 25% of cases, excision is incomplete and tumour growth almost always continues. Further surgery influences prognosis unfavourably. New sophisticated radiation techniques help to control tumour progression in about 80-90% of cases. This success, however, may be associated with new cranial nerve deficits or panhypopituitarism. Prospective, comparative studies are not available.
Topics: Adult; Age Factors; Aged; Anti-Inflammatory Agents; Brain Edema; Craniotomy; Dexamethasone; Epilepsy; Female; Headache; Humans; Meningeal Neoplasms; Meningioma; Microsurgery; Neoplasm, Residual; Radiosurgery; Radiotherapy, Adjuvant; Treatment Outcome
PubMed: 11727610
DOI: No ID Found -
The Journal of Craniofacial SurgeryMeningiomas are usually dura-based primary nonmalignant neoplasms of the central nervous system. It is extremely rare that a meningioma is located at the convexity of...
BACKGROUND
Meningiomas are usually dura-based primary nonmalignant neoplasms of the central nervous system. It is extremely rare that a meningioma is located at the convexity of the brain, but shows no dura attachment and causes osteolysis of the skull.
CASE PRESENTATION
A 57-year-old woman presented with an incidentally discovered scalp lump on the head. Neurological deficits were not found. Radiological examination revealed a localized osteolytic lesion in the right parietal bone, which was initially diagnosed as a bone tumor and was surgically resected. At surgery, a tumor mass was found located at the brain convexity without dura attachment. It was tightly attached to the brain parenchyma and had no distinct boundary from the brain. The mass was rather small, but resulted in significant osteolysis of the skull and destruction of the dura. Simpson grade I resection of the tumor was performed. Histological and immunohistochemical results indicated a meningothelial meningioma.
CONCLUSIONS
Both preoperative and intraoperative diagnoses are difficult for this case. Knowledge of this case is crucial for clinicians to be aware of this entity because it can be easily confused with bone tumors. Further research on the relationship between meningioma and bone metabolism is required to investigate the mechanism of osteolysis.
Topics: Female; Humans; Middle Aged; Meningioma; Meningeal Neoplasms; Osteolysis; Magnetic Resonance Imaging; Dura Mater; Bone Neoplasms
PubMed: 35882350
DOI: 10.1097/SCS.0000000000008766 -
Biological Chemistry Jun 2021Meningiomas are the most common non-malignant intracranial tumors. Like most tumors, meningiomas prefer anaerobic glycolysis for energy production (Warburg effect). This...
Meningiomas are the most common non-malignant intracranial tumors. Like most tumors, meningiomas prefer anaerobic glycolysis for energy production (Warburg effect). This leads to an increased synthesis of the metabolite methylglyoxal (MGO). This metabolite is known to react with amino groups of proteins. This reaction is called glycation, thereby building advanced glycation endproducts (AGEs). In this study, we investigated the influence of glycation on two meningioma cell lines, representing the WHO grade I (BEN-MEN-1) and the WHO grade III (IOMM-Lee). Increasing MGO concentrations led to the formation of AGEs and decreased growth in both cell lines. When analyzing the influence of glycation on adhesion, chemotaxis and invasion, we could show that the glycation of meningioma cells resulted in increased invasive potential of the benign meningioma cell line, whereas the invasive potential of the malignant cell line was reduced. In addition, glycation increased the E-cadherin- and decreased the N-cadherin-expression in BEN-MEN-1 cells, but did not affect the cadherin-expression in IOMM-Lee cells.
Topics: Cell Adhesion; Cell Survival; Glycation End Products, Advanced; Glycolysis; Humans; Meningeal Neoplasms; Meningioma; Pyruvaldehyde; Tumor Cells, Cultured
PubMed: 33725749
DOI: 10.1515/hsz-2020-0376