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Asian Pacific Journal of Cancer... Dec 2022Visual disturbances that can heal after a complete resection of orbital meningiomas are only about 2.9%. Grading and expression of the progesterone receptor (PR) in... (Observational Study)
Observational Study
OBJECTIVE
Visual disturbances that can heal after a complete resection of orbital meningiomas are only about 2.9%. Grading and expression of the progesterone receptor (PR) in orbital meningiomas, according to World Health Organization (WHO) is a useful predictive value of recurrence in the treatment management of orbital meningiomas. This study aims to determine the relationship of PR expression on the grading of orbital meningiomas as tumour prognostic factors.
METHODS
This cross-sectional observational analysis observed 44 orbital meningioma in Cicendo Eye Hospital Bandung and Hasan Sadikin Hospital between 2017-2020. We performed of mRNA PR with RT-qPCR technique and calculation with the 2∆∆Ct formula. Statistical analysis used the Kruskal-Wallis Test, followed by the Mann-Whitney post hoc test with p<0.005.
RESULTS
Relative expression of mRNA PR in meningioma orbita grade I to grade III decreased significantly the expression of relative mRNA PR at grade I, II, III of 21.69±44.35, 20.39±26.30 and 1.25±0.85, with Kruskal-Wallis test, p =0.007. Mann Whitney's test results showed relative mRNA PR expression between grades I and II not different (p = 0.055), relative expression mRNA PR between grades I and III differed significantly (p = 0.024), and relative expression mRNA PR between grades I and III was not different (p = 0.638).
CONCLUSION
mRNA PR expression is viable for prognostic value, predicting recurrence and implementing more effective management of subsequent therapy, it must be combined with other markers to determine the nature of the orbital meningioma.
Topics: Humans; Cross-Sectional Studies; Indonesia; Meningeal Neoplasms; Meningioma; Neoplasm Recurrence, Local; Receptors, Progesterone; Retrospective Studies; RNA, Messenger; Eye Neoplasms
PubMed: 36579995
DOI: 10.31557/APJCP.2022.23.12.4137 -
Medicine Apr 2023Meningeal melanocytoma is a rare benign pigmented tumor originat from leptomeningeal melanocytes. Here, we report the case of a female who presented with numbness and... (Review)
Review
RATIONALE
Meningeal melanocytoma is a rare benign pigmented tumor originat from leptomeningeal melanocytes. Here, we report the case of a female who presented with numbness and weakness of the limbs for approximately 6 months.
PATIENT CONCERNS
We report the case of a 60-year-old Chinese female who presented with numbness and weakness of the limbs for approximately 6 months. computed tomography (CT) and magnetic resonance imaging (MRI) revealed a dumbbell-shaped tumor inside and outside the cervical (C) spinal canal.
DIAGNOSES
The patient was using CT and MRI. Subsequently, the patient underwent surgery, and low-grade melanocytoma was diagnosed pathologically.
INTERVENTIONS
Subsequently, the patient underwent a surgery, and the tumor was completely removed.
OUTCOMES
The tumor did not recur after 6 months.
CONCLUSION
This case suggested 2 "take-away" lessons: first, spinal meningeal melanocytomas may be dumbbell-shaped; and second, melanocytoma could appear as hyperintense, isointense, or hypointense on T2-weighted MRI.
Topics: Adult; Humans; Female; Middle Aged; Melanoma; Hypesthesia; Neoplasm Recurrence, Local; Melanocytes; Nevus, Pigmented; Meningeal Neoplasms; Retinal Neoplasms; Magnetic Resonance Imaging; Skin Neoplasms
PubMed: 37026914
DOI: 10.1097/MD.0000000000033435 -
Acta Neuropathologica Communications Jan 2023Extracranial metastases of intracranial meningiomas are rare. Little is known about the mutational pattern of these tumors and their metastatic seeding. Here, we...
Extracranial metastases of intracranial meningiomas are rare. Little is known about the mutational pattern of these tumors and their metastatic seeding. Here, we retrospectively explored the molecular alterations of these metastatic lesions and their respective intracranial tumor manifestations.Histology and genome sequencing were performed in intracranial meningiomas and their extracranial metastatic lesions operated upon between 2002 and 2021. Next-generation DNA/RNA sequencing (NGS) and methylome analysis were performed to determine molecular alterations.We analyzed the tumors of five patients with clinically suspected metastases of a meningioma using methylome analysis and next generation panel sequencing of the primary tumors as well as the metastatic lesions. Metastases were found in the spinal cord and one in the lung. In four of these patients, molecular analyses confirmed metastatic disease, while the fifth patient was found to harbor two molecularly distinct meningiomas. On pathological assessment, the primary lesions ranged from CNS WHO grades 1 to 3 (integrated molecular-morphologic meningioma classification scores 2 to 6). Of the four true metastatic cases, three out of the four metastasizing tumors harbored alterations in the BAP1 gene, comprising a stop-mutation combined with copy-number loss (WHO grade 1), copy number loss (WHO grade 3) and a frameshift mutation (WHO grade 2). Furthermore, the latter was confirmed to harbor a BAP1 tumor predisposition syndrome. The fourth metastasizing tumor had copy-number losses in NF2 and PTEN. Only one of four showed CDKN2A homozygous deletion; none showed TERT promotor mutation.Our results molecularly confirm true metastatic disease in four meningioma patients. BAP1 gene alterations were the most frequent. Larger cohorts, most likely from multicenter studies are necessary to evaluate the role of BAP-1 alterations to further understand the metastatic spread in meningiomas. for metastatic spread and might indicate patients at risk for metastatic spread. Further explorations within larger cohorts are necessary to validate these findings which might influence the clinical management in the future.
Topics: Humans; Homozygote; Meningeal Neoplasms; Meningioma; Mutation; Retrospective Studies; Sequence Deletion; Neoplasm Metastasis
PubMed: 36641486
DOI: 10.1186/s40478-023-01505-0 -
BMJ Case Reports Nov 2021We discuss an extremely rare case of low-grade Schwann cell leptomeningeal neoplasm with no evident intradural primary, presenting with rapid neurological decline...
We discuss an extremely rare case of low-grade Schwann cell leptomeningeal neoplasm with no evident intradural primary, presenting with rapid neurological decline leading to death reflecting the aggressive biological behaviour of this entity despite its low-grade morphology. Notwithstanding extensive investigations, the diagnosis was only established on autopsy as clinical presentation is non-specific making diagnosis challenging. This condition could be considered in patients presenting with leptomeningeal disease if initial workup of more common causes is non-revealing.
Topics: Autopsy; Humans; Magnetic Resonance Imaging; Meningeal Neoplasms; Meninges; Schwann Cells
PubMed: 34799389
DOI: 10.1136/bcr-2021-244440 -
Neurologia Medico-chirurgica Sep 2022No previous study has histopathologically investigated whether a meningioma capsule presents with tumor cells. We investigated which types of tumor capsules (TCs)...
No previous study has histopathologically investigated whether a meningioma capsule presents with tumor cells. We investigated which types of tumor capsules (TCs) included tumor cells to help intraoperatively determine those TCs that do not need to be removed and have a low recurrence risk. We investigated 22 specimens of 14 newly diagnosed meningiomas from February 2011 to June 2021. The capsules were classified into three types: TC, capsule-like thickened arachnoid membrane (CAM), and extended membrane (EM). Capsule properties were scored by hardness (soft = 1, medium = 2, hard = 3) and transparency (high = 1, medium = 2, low = 3). The hardness, transparency, and score sums were compared between capsules with and without tumor invasion in the CAM and EM types. The mean follow-up duration was 40.6 months, and there was only one recurrence in a remote location from the residual capsule. Nine capsules were classified as TC, seven as CAM, and six as EM. The tumor cells invaded 88.9% of TCs, 42.9% of CAMs, and 50% of EMs. The hardness, transparency, and score sums for CAMs with tumor invasion were lower than those for CAMs without tumor invasion, although not significant (P = 0.114, P = 0.114, P = 0.057, respectively). A thickened TC or soft and highly transparent CAM indicated a high risk for tumor cell invasion; thus, such cases require a careful and long-term follow-up. Hard and low transparent residual CAMs may have had a low risk for tumor invasion; therefore, leaving such capsules that tightly adhere to the eloquent cortex can be theoretically justified to avoid damaging the brain surface.
Topics: Brain; Humans; Meningeal Neoplasms; Meningioma; Neoplasm Recurrence, Local
PubMed: 35944984
DOI: 10.2176/jns-nmc.2021-0402 -
Chinese Medical Journal Aug 2022Meningiomas are the most common primary intracranial neoplasm with diverse pathological types and complicated clinical manifestations. The fifth edition of the WHO...
ABSTRACT
Meningiomas are the most common primary intracranial neoplasm with diverse pathological types and complicated clinical manifestations. The fifth edition of the WHO Classification of Tumors of the Central Nervous System (WHO CNS5), published in 2021, introduces major changes that advance the role of molecular diagnostics in meningiomas. To follow the revision of WHO CNS5, this expert consensus statement was formed jointly by the Group of Neuro-Oncology, Society of Neurosurgery, Chinese Medical Association together with neuropathologists and evidence-based experts. The consensus provides reference points to integrate key biomarkers into stratification and clinical decision making for meningioma patients.
REGISTRATION
Practice guideline REgistration for transPAREncy (PREPARE), IPGRP-2022CN234.
Topics: Humans; Meningioma; Consensus; Neurosurgical Procedures; Meningeal Neoplasms
PubMed: 36179152
DOI: 10.1097/CM9.0000000000002391 -
Turkish Neurosurgery 2020To analyze the correlation of clinicopathologic prognostic parameters with atypical meningiomas (AMs) and recurrence development as well as progression-free survival...
AIM
To analyze the correlation of clinicopathologic prognostic parameters with atypical meningiomas (AMs) and recurrence development as well as progression-free survival (PFS).
MATERIAL AND METHODS
The neuropathology archive and hospital records of 75 patients with AM who underwent surgery in our institution between 2010 and 2019 were retrospectively reviewed. The pathological revision was performed according to the 2016 World Health Organization (WHO) criteria. Other clinicopathological parameters, such as age, gender, tumor location, preoperative tumor size, degree of resection, Psammoma body, nuclear atypia, main histological pattern, Ki67 labeling index (LI), radiotherapy, and dura and bone invasion, were also analyzed. Statistically, univariate and multivariate analyses were assessed to determine their potential impact on recurrence-related prognostic factors.
RESULTS
Recurrence occurred in 20 patients. The mean PFS and follow-up time were 38.9 and 44.8 months, respectively. In univariate analysis, clinical and pathological features such as age of ?55 years, female sex, skull base tumor location, larger preoperative tumor size, increased mitotic count, small cells, hypercellularity, sheeting, necrosis, and dura and bone invasion were remarkable in patients with recurrence, but were not statistically significant. In multivariate analysis, increased mitotic activity and brain invasion either considered alone or combined were significantly associated with PFS. Nuclear atypia was also not associated with both tumor recurrence and PFS. However, clinical features did not significantly influence the PFS.
CONCLUSION
This study found that recurrence could not be predicted by the presence of any of the clinicopathological features of AMs. We believe that molecular variables determined through routine neuropathological analysis will be needed in the future.
Topics: Adult; Aged; Female; Humans; Male; Meningeal Neoplasms; Meningioma; Middle Aged; Neoplasm Recurrence, Local; Prognosis; Progression-Free Survival; Retrospective Studies
PubMed: 32705671
DOI: 10.5137/1019-5149.JTN.31161-20.1 -
Radiation Oncology (London, England) Jan 2021For meningiomas, complete resection is recommended as first-line treatment while stereotactic radiosurgery (SRS) is established for meningiomas of smaller size... (Clinical Trial)
Clinical Trial
BACKGROUND
For meningiomas, complete resection is recommended as first-line treatment while stereotactic radiosurgery (SRS) is established for meningiomas of smaller size considered inoperable. If the patient´s medical condition or preference excludes surgery, SRS remains a treatment option. We evaluated the efficacy and safety of SRS in a cohort comprising these cases.
METHODS
In this retrospective single-centre analysis we included patients receiving single fraction SRS either by modified LINAC or robotic guidance by Cyberknife for potentially resectable intracranial meningiomas. Treatment-related adverse events as well as local and regional control rates were determined from follow-up imaging and estimated by the Kaplan-Meier method.
RESULTS
We analyzed 188 patients with 218 meningiomas. The median radiological, and clinical follow-up periods were 51.4 (6.2-289.6) and 55.8 (6.2-300.9) months. The median tumor volume was 4.2 ml (0.1-22), and the mean marginal radiation dose was 13.0 ± 3.1 Gy, with reference to the 80.0 ± 11.2% isodose level. Local recurrence was observed in one case (0.5%) after 239 months. The estimated 2-, 5-, 10- and 15-year regional recurrence rates were 1.5%, 3.0%, 6.6% and 6.6%, respectively. Early adverse events (≤ 6 months after SRS) occurred in 11.2% (CTCEA grade 1-2) and resolved during follow-up in 7.4% of patients, while late adverse events were documented in 14.4% (grade 1-2; one case grade 3). Adverse effects (early and late) were associated with the presence of symptoms or neurological deficits prior to SRS (p < 0.03) and correlated with the treatment volume (p < 0.02).
CONCLUSION
In this analysis SRS appears to be an effective treatment for patients with meningiomas eligible for complete resection and provides reliable long-term local tumor control with low rates of mild morbidity.
Topics: Adult; Aged; Aged, 80 and over; Female; Follow-Up Studies; Humans; Male; Meningeal Neoplasms; Meningioma; Middle Aged; Neoplasm Recurrence, Local; Radiosurgery; Retrospective Studies; Treatment Outcome; Young Adult
PubMed: 33509211
DOI: 10.1186/s13014-021-01748-y -
Neurosurgical Review Aug 2022The expression of somatostatin receptors in meningioma is well established. First, suggestions of a prognostic impact of SSTRs in meningioma have been made. However, the...
The expression of somatostatin receptors in meningioma is well established. First, suggestions of a prognostic impact of SSTRs in meningioma have been made. However, the knowledge is based on few investigations in small cohorts. We recently analyzed the expression of all five known SSTRs in a large cohort of over 700 meningiomas and demonstrated significant correlations with WHO tumor grade and other clinical characteristics. We therefore expanded our dataset and additionally collected information about radiographic tumor recurrence and progression as well as clinically relevant factors (gender, age, extent of resection, WHO grade, tumor location, adjuvant radiotherapy, neurofibromatosis type 2, primary/recurrent tumor) for a comprehensive prognostic multivariate analysis (n = 666). The immunohistochemical expression scores of SSTR1, 2A, 3, 4, and 5 were scored using an intensity distribution score ranging from 0 to 12. For recurrence-free progression analysis, a cutoff at an intensity distribution score of 6 was used. Univariate analysis demonstrated a higher rate of tumor recurrence for increased expression scores for SSTR2A, SSTR3, and SSTR4 (p = 0.0312, p = 0.0351, and p = 0.0390, respectively), while high expression levels of SSTR1 showed less frequent tumor recurrences (p = 0.0012). In the Kaplan-Meier analysis, a higher intensity distribution score showed a favorable prognosis for SSTR1 (p = 0.0158) and an unfavorable prognosis for SSTR2A (0.0143). The negative prognostic impact of higher SSTR2A expression remained a significant factor in the multivariate analysis (RR 1.69, p = 0.0060). We conclude that the expression of SSTR2A has an independent prognostic value regarding meningioma recurrence.
Topics: Humans; Immunohistochemistry; Meningeal Neoplasms; Meningioma; Neoplasm Recurrence, Local; Prognosis; Receptors, Somatostatin
PubMed: 34601710
DOI: 10.1007/s10143-021-01651-w -
World Neurosurgery May 2024Meningiomas show variable tendency to recur. While risk factors of recurrence have been largely investigated in literature, a paucity of data is available on the time to...
BACKGROUND
Meningiomas show variable tendency to recur. While risk factors of recurrence have been largely investigated in literature, a paucity of data is available on the time to recurrence. Our purpose was to identify main factors affecting the time to recurrence to assist preoperative treatment decision-making strategy and to define a tailored clinical and neuroradiological follow-up.
METHODS
Data of 35 patients with intracranial meningioma recurrences have been retrospectively reviewed. Demographic (patient age at initial diagnosis and sex), radiologic (meningioma location, pattern of regrowth and topography of recurrences at first reoperation), pathologic (WHO grade and Ki67-MIB1 at initial surgery and at first reoperation, progesterone receptor [PR] expression), and surgical (extent of resection at initial surgery according to Simpsons grading system, number of reoperations) factors were analyzed.
RESULTS
Time to recurrence ranged from 20 to 120 months. Extent of resection at initial surgery was Simpson grade I in 7 patients (20%), grade II in 10 (28.5%), grade III in 14 (40%), and grade IV in 4 (11.5%). Longer median time to recurrence was observed for skull base localization (P < 0.01), Simpson grades I and II versus grades III (P = 0.01) and IV (P = 0.02), values of Ki67-MIB1 ≤ 4% (P = 0.001), and PR > 60% (P = 0.03); conversely, sex, age, number of reoperations, unchanged/progression of Ki67, and/or World Health Organization grade between first surgery and reoperation did not correlate in statistically significant way with time to recurrence.
CONCLUSIONS
The extent of resection and the Ki67-MIB1 represent the most important factors predicting shorter recurrence time of intracranial meningiomas. Patients with incomplete (Simpson grades III and IV) resection and high Ki67-MIB1 values, especially at non-skull base localization and with low PR values, require a closer short-term clinical and radiologic follow-up in the first years after surgery.
Topics: Humans; Meningioma; Female; Male; Middle Aged; Neoplasm Recurrence, Local; Meningeal Neoplasms; Aged; Retrospective Studies; Adult; Time Factors; Reoperation; Neurosurgical Procedures; Aged, 80 and over; Follow-Up Studies; Young Adult; Ki-67 Antigen
PubMed: 38417623
DOI: 10.1016/j.wneu.2024.02.087