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Rastogi S, Bhattacharya K, Mathur A, Sahu AA, Chaudhari A, Shridhar E. Atypical Meningioma with Perineural Spread Along Hypoglossal Nerve. Indian J Radiol Imaging 2024; 34:566-568. [PMID: 38912230 PMCID: PMC11188714 DOI: 10.1055/s-0043-1777743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2024] Open
Affiliation(s)
- Shivam Rastogi
- Department of Radiodiagnosis, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India
| | - Kajari Bhattacharya
- Department of Radiodiagnosis, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India
| | - Aayush Mathur
- Department of Radiodiagnosis, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India
| | - Arpita A. Sahu
- Department of Radiodiagnosis, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India
| | - Amit Chaudhari
- Department of Radiodiagnosis, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India
| | - Epari Shridhar
- Department of Pathology, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India
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Menlibayeva K, Nurimanov C, Nuradilov S, Akshulakov S. Study of the stress in adults diagnosed with meningioma: Insights from a tertiary neurosurgical hospital. Cancer Rep (Hoboken) 2024; 7:e2105. [PMID: 39051552 PMCID: PMC11270326 DOI: 10.1002/cnr2.2105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 03/20/2024] [Accepted: 04/30/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Meningiomas are the most common type of primary brain tumor, originating from the meninges - the protective membranes that surround the brain and spinal cord. Several well-studied risk factors for meningiomas include gender, age, radiation exposure, genetic factors, and hormonal factors. Moreover, the influence of a person's psycho-emotional stateon their overall health and mental well-being, specifically stress, iscurrently a significant and relevant topic of discussion. AIMS This case-control study aimed to study the association between perceived stress, chronic stress, and meningioma in adult patients. METHODS AND RESULTS The study included cases, which comprised adult patients with histologically confirmed meningioma, and controls, consisting of adult patients with no history of brain cancer. Data collection involved the use of three types of questionnaires. The first questionnaire focused on patients' personal information, geographic factors, and lifestyle habits. Two additional questionnaires "The Perceived Stress Scale" and "The Chronic Stress Scale" were employed to assess perceived stress and chronic stress. The questioning was conducted by a neurologist. Microsoft Excel and Stata 14 were used for the data analysis. Overall, 148 questionnaires were completed and included in the analyses. The average age of participants was 45.60 ± 13.90 years. Females outnumbered males in both groups. Patients with meningioma diagnosis had a higher level of perceived high stress compared to those without meningioma (p = .045). Respondents without a diagnosis of meningioma have reported having more chronic stress in general and ambient problems (p = .004), financial issues (p = .006), work (p < .001), non-employment (p = .008), love and marriage (p < .001), isolation (p < .001), and residence (p < .001). Patients with meningioma, however, had less chronic stress compared to meningioma-free patients. CONCLUSION This study revealed no discernible connection between stress and meningioma within our study sample. Further research with matched case-control methodology with a larger sample size is warranted to thoroughly evaluate the potential role of stress in patients with meningioma.
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Affiliation(s)
| | - Chingiz Nurimanov
- Vascular and Functional Neurosurgery DepartmentNational Centre for NeurosurgeryAstanaKazakhstan
| | - Saken Nuradilov
- Vascular and Functional Neurosurgery DepartmentNational Centre for NeurosurgeryAstanaKazakhstan
| | - Serik Akshulakov
- Hospital Management DepartmentNational Centre for NeurosurgeryAstanaKazakhstan
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Salehipour A, Sabahi M, Arjipour M, Borghei-Razavi H. Concurrence of craniopharyngioma and meningioma: a case report and systematic review of the literature. Br J Neurosurg 2024; 38:585-590. [PMID: 34124976 DOI: 10.1080/02688697.2021.1937520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 05/28/2021] [Indexed: 10/21/2022]
Abstract
Craniopharyngioma (CPG) is a benign epithelial tumor that originates from Rathke's pouch. Meningiomas (MNG) are neoplasms of meningothelial cell. The patient is a 42-year-old female who presented with left-sided temporal headaches and visual acuity impairment. Neurological examination revealed bilateral peripheral visual field defects. Imaging of the brain showed a hypointense solid-cystic sellar lesion with suprasellar extension without calcification which enhanced with contrast. Also present was a second, contrast-enhancing extra axial lesion overlying the olfactory groove. The patient had no history of tumor surgery or radiation therapy. Both of the lesions were operated for resection and post operation status was uneventful. This study reports non-radiation related co-occurrence of a craniopharyngioma (CPG) and a meningioma (MNG). We reviewed published articles between 1966 and 2020, and found that although MNGs are the most commonly occurring brain tumors, the occurrence of MNG and CPG together with no relation to radiation is relatively rare, reported only 7 times in living patients. By analyzing the data and keeping in mind that there is no proven common genetic background and risk factor between them, their co-occurrence, shows the importance of further investigation to clear any possible relationship between the two other than mere coincidence.
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Affiliation(s)
- Arash Salehipour
- NeurosurgeryResearch Group (NRG), Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadmahdi Sabahi
- NeurosurgeryResearch Group (NRG), Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdi Arjipour
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Neurosurgery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Hamid Borghei-Razavi
- Department of Neurological Surgery, Pauline Braathen Neurological Center, Cleveland Clinic Florida, Weston, FL, USA
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Onerup A, Mirzaei S. S, Bhatia S, Ware ME, Joffe L, Turcotte LM, Goodenough CG, Sapkota Y, Dixon SB, Wogksch MD, Ehrhardt MJ, Armstrong GT, Hudson MM, Ness KK. Lifestyle and subsequent meningioma in childhood cancer survivors: A report from the St. Jude Lifetime Cohort study. Cancer Rep (Hoboken) 2024; 7:e1944. [PMID: 38009808 PMCID: PMC10809185 DOI: 10.1002/cnr2.1944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/24/2023] [Accepted: 11/11/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Lifestyle is associated with meningioma risk in the general population. AIMS We assessed longitudinal associations between lifestyle-associated factors and subsequent meningiomas in childhood cancer survivors. METHODS AND RESULTS Childhood cancer survivors age ≥18 years in the St. Jude Lifetime Cohort Study were evaluated for body composition, self-reported physical activity, cardiopulmonary fitness, muscle strength, smoking, and alcohol consumption at baseline. Time to first meningioma analyses were performed, adjusted for sex, age at diagnosis and baseline assessment, treatment decade, and childhood cancer treatment exposures. The study included 4,072 survivors (47% female; [mean (SD)] 9 (6) years at diagnosis; 30 (8.5) years at the start of follow-up, with 7.0 (3.3) years of follow-up). 30% of the participants were survivors of acute lymphoblastic leukemia and 29% of the participants had received cranial radiation. During follow-up, 90 participants developed ≥1 meningioma, of whom 73% were survivors of acute lymphoblastic leukemia, with cranial radiation being the strongest risk factor (relative risk [RR] 29.7, 95% confidence interval [CI] 10.6-83.2). Muscle strength assessed by knee extension was associated with a lower risk of developing a meningioma in the adjusted analyses (RR 0.5, 95% CI 0.2-1.0, p = 0.04 for quartiles 3-4 vs. 1). No other lifestyle-associated variable was associated with subsequent meningioma. CONCLUSION Independent of cranial radiation, muscle strength was associated with a lower risk of developing a subsequent meningioma in childhood cancer survivors.
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Affiliation(s)
- Aron Onerup
- Department of Epidemiology and Cancer ControlSt Jude Children's Research HospitalMemphisTennesseeUSA
- Department of PediatricsInstitute of Clinical Sciences, Sahlgrenska Academy, University of GothenburgGothenburgSweden
| | - Sedigheh Mirzaei S.
- Department of BiostatisticsSt Jude Children's Research HospitalMemphisTennesseeUSA
| | - Shalini Bhatia
- Department of BiostatisticsSt Jude Children's Research HospitalMemphisTennesseeUSA
| | - Megan E. Ware
- Department of Epidemiology and Cancer ControlSt Jude Children's Research HospitalMemphisTennesseeUSA
| | - Lenat Joffe
- Department of PediatricsZucker School of Medicine at Hofstra/NorthwellNew Hyde ParkNew YorkUSA
| | - Lucie M. Turcotte
- Department of PediatricsUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Chelsea G. Goodenough
- Department of Epidemiology and Cancer ControlSt Jude Children's Research HospitalMemphisTennesseeUSA
| | - Yadav Sapkota
- Department of Epidemiology and Cancer ControlSt Jude Children's Research HospitalMemphisTennesseeUSA
| | - Stephanie B. Dixon
- Department of Epidemiology and Cancer ControlSt Jude Children's Research HospitalMemphisTennesseeUSA
- Department of OncologySt Jude Children's Research HospitalMemphisTennesseeUSA
| | - Matthew D. Wogksch
- Department of Epidemiology and Cancer ControlSt Jude Children's Research HospitalMemphisTennesseeUSA
| | - Matthew J. Ehrhardt
- Department of Epidemiology and Cancer ControlSt Jude Children's Research HospitalMemphisTennesseeUSA
- Department of OncologySt Jude Children's Research HospitalMemphisTennesseeUSA
| | - Gregory T. Armstrong
- Department of Epidemiology and Cancer ControlSt Jude Children's Research HospitalMemphisTennesseeUSA
| | - Melissa M. Hudson
- Department of Epidemiology and Cancer ControlSt Jude Children's Research HospitalMemphisTennesseeUSA
- Department of OncologySt Jude Children's Research HospitalMemphisTennesseeUSA
| | - Kirsten K. Ness
- Department of Epidemiology and Cancer ControlSt Jude Children's Research HospitalMemphisTennesseeUSA
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Ahmed AK, Wilhelmy B, Oliver J, Serra R, Chen C, Gandhi D, Eisenberg HM, Labib MA, Woodworth GF. Variability in the Arterial Supply of Intracranial Meningiomas: An Anatomic Study. Neurosurgery 2023; 93:1346-1352. [PMID: 37530524 DOI: 10.1227/neu.0000000000002608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 05/14/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Intracranial meningiomas are a diverse group of tumors, which vary by grade, genetic composition, location, and vasculature. Expanding the understanding of the supply of skull base (SBMs) and non-skull base meningiomas (NSBMs) will serve to further inform resection strategies. We sought to delineate the vascular supply of a series of intracranial meningiomas by tumor location. METHODS A retrospective study of intracranial meningiomas that were studied using preoperative digital subtraction angiograms before surgical resection at a tertiary referral center was performed. Patient, tumor, radiologic, and treatment data were collected, and regression models were developed. RESULTS One hundred sixty-five patients met inclusion criteria. The mean age was 57.1 years (SD: 12.6). The mean tumor diameter was 4.9 cm (SD: 1.5). One hundred twenty-six were World Health Organization Grade I, 37 Grade II, and 2 Grade III. Arterial feeders were tabulated by Al-Mefty's anatomic designations. SBMs were more likely to derive arterial supply from the anterior circulation, whereas NSBMs were supplied by external carotid branches. NSBMs were larger (5.61 cm vs 4.45 cm, P = <.001), were more often presented with seizure (20% vs 8%, P = .03), were higher grade ( P = <.001) had more frequent peritumoral brain edema (84.6% vs 66%, P = .04), and had more bilateral feeders (47.7% vs 28%, P = .01) compared with SBMs. More arterial feeders were significantly associated with lower tumor grade ( P = .023, OR = 0.59). Higher tumor grade (Grade II/III) was associated with fewer arterial feeders ( P = .017, RR = 0.74). CONCLUSION Meningioma location is associated with specific vascular supply patterns, grade, and patient outcomes. This information suggests that grade I tumors, especially larger tumors, are more likely to have diverse vascular supply patterns, including internal carotid branches. This study may inform preoperative embolization and surgical considerations, particularly for large skull base tumors.
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Affiliation(s)
- Abdul-Kareem Ahmed
- Department of Neurosurgery, University of Maryland School of Medicine, Baltimore , Maryland , USA
| | - Bradley Wilhelmy
- Department of Neurosurgery, University of Maryland School of Medicine, Baltimore , Maryland , USA
| | - Jeffrey Oliver
- Department of Neurosurgery, University of Maryland School of Medicine, Baltimore , Maryland , USA
| | - Riccardo Serra
- Department of Neurosurgery, University of Maryland School of Medicine, Baltimore , Maryland , USA
| | - Chixiang Chen
- Department of Neurosurgery, University of Maryland School of Medicine, Baltimore , Maryland , USA
| | - Dheeraj Gandhi
- Department of Neurosurgery, University of Maryland School of Medicine, Baltimore , Maryland , USA
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore , Maryland , USA
- Department of Neurology, University of Maryland School of Medicine, Baltimore , Maryland , USA
| | - Howard M Eisenberg
- Department of Neurosurgery, University of Maryland School of Medicine, Baltimore , Maryland , USA
| | - Mohamed A Labib
- Department of Neurosurgery, University of Maryland School of Medicine, Baltimore , Maryland , USA
| | - Graeme F Woodworth
- Department of Neurosurgery, University of Maryland School of Medicine, Baltimore , Maryland , USA
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Petsaros S, Chatzipetros E, Donta C, Karaiskos P, Boziari A, Papadakis E, Angelopoulos C. Scattered Radiation Distribution Utilizing Three Different Cone-Beam Computed Tomography Devices for Maxillofacial Diagnostics: A Research Study. J Clin Med 2023; 12:6199. [PMID: 37834843 PMCID: PMC10573760 DOI: 10.3390/jcm12196199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 09/21/2023] [Accepted: 09/24/2023] [Indexed: 10/15/2023] Open
Abstract
This study aimed to estimate scattered radiation and its spatial distribution around three cone-beam computed tomography (CBCT) devices, in order to determine potential positions for an operator to stand if they needed to be inside the CBCT room. The following devices were tested: Morita Accuitomo (CBCT1), Newtom Giano HR (CBCT2), Newtom VGi (CBCT3). Scattered radiation measurements were performed using different kVp, mA, and Field of View (FOV) options. An anthropomorphic phantom (NATHANIA) was placed inside the X-ray gantry to simulate clinical conditions. Scattered measurements were taken with the Inovision model 451P Victoreen ionization chamber once placed at fixed distances from each irradiation isocenter, away from the primary beam. A statistically significant (p < 0.001) difference was found in the mean value of the scattered radiation estimations between the CBCT devices. Scattered radiation was reduced with a different rate for each CBCT device as distance was increased. For CBCT1 the reduction was 0.047 μGy, for CBCT2 it was 0.036 μGy, and for CBCT3 it was 0.079 μGy, for every one meter from the X-ray gantry. Therefore, at certain distances from the central X-ray, the scattered radiation was below the critical level of 1 mGy, which is defined by the radiation protection guidelines as the exposure radiation limit of the general population. Consequently, an operator could stay inside the room accompanying the patient being scanned, if necessary.
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Affiliation(s)
- Sotirios Petsaros
- Department of Oral Diagnosis and Radiology, Faculty of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Street, Goudi, 11527 Athens, Greece; (S.P.); (E.C.); (C.D.); (E.P.)
| | - Emmanouil Chatzipetros
- Department of Oral Diagnosis and Radiology, Faculty of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Street, Goudi, 11527 Athens, Greece; (S.P.); (E.C.); (C.D.); (E.P.)
| | - Catherine Donta
- Department of Oral Diagnosis and Radiology, Faculty of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Street, Goudi, 11527 Athens, Greece; (S.P.); (E.C.); (C.D.); (E.P.)
| | - Pantelis Karaiskos
- Medical Physics Laboratory, Faculty of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias Street, Goudi, 11527 Athens, Greece;
| | - Argiro Boziari
- Greek Atomic Energy Commission, Agia Paraskevi, 15310 Attiki, Greece;
| | - Evangelos Papadakis
- Department of Oral Diagnosis and Radiology, Faculty of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Street, Goudi, 11527 Athens, Greece; (S.P.); (E.C.); (C.D.); (E.P.)
| | - Christos Angelopoulos
- Department of Oral Diagnosis and Radiology, Faculty of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Street, Goudi, 11527 Athens, Greece; (S.P.); (E.C.); (C.D.); (E.P.)
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Al-Mufti F, Gandhi CD, Couldwell WT, Rybkin I, Abou-Al-Shaar H, Dodson V, Amin AG, Wainwright JV, Cohen E, Schmidt MH, Cole C, Bowers CA. Preoperative meningioma embolization reduces perioperative blood loss: a multi-center retrospective matched case-control study. Br J Neurosurg 2023; 37:67-70. [PMID: 34569389 DOI: 10.1080/02688697.2021.1979191] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND PURPOSE The utility of preoperative embolization remains controversial within the literature. Here, we evaluate whether preoperative meningioma embolization is effective in reducing intraoperative blood loss, safe to perform, and cost-effective when compared with surgical resection without preoperative embolization. METHODS Twenty-nine patients with meningiomas were matched by tumor size and location to 29 control patients with meningiomas at another institution where preoperative embolization was not practiced. The variables evaluated were pre- and post-operative hemoglobin and hematocrit levels as a measure of operative blood loss and postoperative morbidity. The additional cost of undergoing angiography and embolization was calculated from hospital charges obtained from the billing department. RESULTS The mean decrease in perioperative hemoglobin and hematocrit was 0.9 and 2.7, respectively, in the embolization group and 2.8 and 10.0, respectively, in the control group for a significant decrease in operative blood loss as measured by change in hematocrit and hemoglobin levels after surgery. There was no significant difference in operative blood loss when subdividing patients based on tumor location. There were no angiogram-related complications. Twenty-two of 29 patients (76%) underwent embolization of a feeding artery, whereas 7 patients underwent only a diagnostic angiogram. The mean additional charge per patient in the embolization group was $88,767. CONCLUSIONS Preoperative embolization was safe and effective in reducing the overall perioperative blood loss in patients undergoing meningioma resection, as measured by the change in postoperative hemoglobin and hematocrit levels. However, the cost of embolization was significant.
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Affiliation(s)
- Fawaz Al-Mufti
- Department of Neurosurgery, Westchester Medical Center at New York Medical College, Valhalla, NY, USA.,Department of Neurology, Westchester Medical Center at New York Medical College, Valhalla, NY, USA
| | - Chirag D Gandhi
- Department of Neurosurgery, Westchester Medical Center at New York Medical College, Valhalla, NY, USA.,Department of Neurology, Westchester Medical Center at New York Medical College, Valhalla, NY, USA
| | | | - Ilya Rybkin
- School of Medicine, New York Medical College, Valhalla, NY, USA
| | - Hussam Abou-Al-Shaar
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Vincent Dodson
- Department of Neurosurgery, Rutgers University, New Jersey Medical School, 90 Bergen Street, Newark, NJ, USA
| | - Anubhav G Amin
- Department of Neurosurgery, Westchester Medical Center at New York Medical College, Valhalla, NY, USA.,Department of Neurology, Westchester Medical Center at New York Medical College, Valhalla, NY, USA
| | - John V Wainwright
- Department of Neurosurgery, Westchester Medical Center at New York Medical College, Valhalla, NY, USA.,Department of Neurology, Westchester Medical Center at New York Medical College, Valhalla, NY, USA
| | - Eric Cohen
- Department of Neurosurgery, Rutgers University, New Jersey Medical School, 90 Bergen Street, Newark, NJ, USA
| | - Meic H Schmidt
- Department of Neurosurgery, University of New Mexico, 1 University of New Mexico, Albuquerque, NM, USA
| | - Chad Cole
- Department of Neurosurgery, University of New Mexico, 1 University of New Mexico, Albuquerque, NM, USA
| | - Christian A Bowers
- Department of Neurosurgery, University of New Mexico, 1 University of New Mexico, Albuquerque, NM, USA
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Hennig CL, Schüler IM, Scherbaum R, Buschek R, Scheithauer M, Jacobs C, Mentzel HJ. Frequency of Dental X-ray Diagnostics in Children and Adolescents: What Is the Radiation Exposure? Diagnostics (Basel) 2023; 13:394. [PMID: 36766499 PMCID: PMC9913895 DOI: 10.3390/diagnostics13030394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/18/2023] [Accepted: 01/19/2023] [Indexed: 01/24/2023] Open
Abstract
Children are exposed to ionizing radiation through radiographs during their development for various reasons. At present, there are no officially valid reference values for dental X-rays in children and adolescents for dental X-ray diagnostics. This study retrospectively examined 9680 extraoral dental radiographs in pediatric patients between 2002 and 2020. The aim was to analyze the radiation doses in pediatric patients, which indications were used, and whether there were specific age and gender differences. The evaluation showed that radiation doses were considered low, with dose area products of 2.2 cGy × cm2 for a lateral cephalogram, 14 cGy × cm2 for an orthopantomogram (OPG), and 45 cGy × cm2 for cone beam computer tomography (CBCT). This corresponds to an effective dose of 1.5 μSv for a lateral cephalogram, 7 μSv for an OPG, and 33.8 μSv for CBCT. Of the 9680 images, 78% were orthopantomograms, and only 0.4% were CBCT images. OPG has become more important over the years, as reflected in the indication. Approximately one-third of all extraoral exposures are orthodontic indications. Overall, the indications were similar for both genders. According to the dental indications, boys were X-rayed slightly more frequently than girls (54.5-45.5%). A future publication of dose guide values and corresponding guidelines is of high priority.
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Affiliation(s)
- Christoph-Ludwig Hennig
- Department of Orthodontics, Center of Dental Medicine, Jena University Hospital, An der Alten Post 4, 07743 Jena, Germany
| | - Ina Manuela Schüler
- Section Preventive Dentistry and Pediatric Dentistry, Department of Orthodontics, Center of Dental Medicine, Jena University Hospital, An der Alten Post 4, 07743 Jena, Germany
| | - Rebecca Scherbaum
- Section of Pediatric Radiology, Department of Radiology, Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany
| | - Rika Buschek
- Section of Pediatric Radiology, Department of Radiology, Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany
| | - Marcel Scheithauer
- Radiation Protection, Center for Health and Safety Management, Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany
| | - Collin Jacobs
- Department of Orthodontics, Center of Dental Medicine, Jena University Hospital, An der Alten Post 4, 07743 Jena, Germany
| | - Hans-Joachim Mentzel
- Section of Pediatric Radiology, Department of Radiology, Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany
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Bin-Alamer O, Bhenderu LS, Palmisciano P, Balasubramanian K, Upadhyay P, Ferini G, Viola A, Zagardo V, Yu K, Cohen-Gadol AA, El Ahmadieh TY, Haider AS. Tumors Involving the Infratemporal Fossa: A Systematic Review of Clinical Characteristics and Treatment Outcomes. Cancers (Basel) 2022; 14:cancers14215420. [PMID: 36358837 PMCID: PMC9655731 DOI: 10.3390/cancers14215420] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/23/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Infratemporal fossa (ITF) tumors represent various pathologies and are seldom described in the literature, reflecting their rarity. Here we review the literature on tumors invading ITF and describe patient characteristics, treatment strategies, and clinical outcomes. METHODS Relevant articles were retrieved from PubMed, Scopus, and Cochrane. A systematic review and meta-analysis were conducted on the clinical presentation, treatment protocols, and clinical outcomes. RESULT A total of 27 articles containing 106 patients with ITF tumors (median tumor size: 24.3 cm3 [interquartile range, 15.2-42 cm3]) were included (median age: 46 years [interquartile range, 32-55 years]; 59.4% were males]). Of the confirmed tumor pathology data, schwannomas (n = 24; 26.1%) and meningiomas (n = 13; 14.1%) were the most common tumors. Facial hypoesthesia (n = 22; 18.5%), auricular/preauricular pain (n = 20; 16.8%), and headaches (n = 11; 9.2%) were the most common presenting symptoms. Of patients who had surgical resection (n = 97; 95.1%), 70 (73.7%) had transcranial surgery (TCS) and 25 (26.3%) had endoscopic endonasal surgery (EES). Among available details on the extent of resection (n = 84), gross-total resection (GTR) was achieved in 62 (73.8%), and 5 (6.0%) had biopsy only. Thirty-five (33.0%) patients had postoperative complications. Among cases with available data on reconstruction techniques (n = 8), four (50%) had adipofascial antero-lateral thigh flap, three (37.5%) had latissimus dorsi free flap, and one (12.5%) had antero-lateral thigh flap. Fourteen (13.2%) patients had adjuvant chemotherapy, and sixteen (15.1%) had adjuvant radiotherapy. During a median follow-up time of 28 months (IQR, 12.25-45.75 months), 15 (14.2%) patients had recurrences, and 18 (17.0%) patients died. The median overall survival (OS) time was 36 months (95% confidence interval: 29-41 months), and the 5-year progression-free survival (PFS) rate was 61%. CONCLUSION Various tumor types with different biological characteristics invade the ITF. The present study describes patient demographics, clinical presentation, management, and outcomes. Depending on the tumor type and patient condition, patient-tailored management is recommended to optimize treatment outcomes.
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Affiliation(s)
- Othman Bin-Alamer
- Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA
- Correspondence: ; Tel.: +1-(412)-251-2145
| | - Lokeshwar S. Bhenderu
- Department of Neuroscience and Experimental Therapeutics, Texas A&M University Health Science Center, Texas A&M University, Bryan, TX 77807, USA
| | - Paolo Palmisciano
- Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - Kishore Balasubramanian
- Department of Neuroscience and Experimental Therapeutics, Texas A&M University Health Science Center, Texas A&M University, Bryan, TX 77807, USA
| | - Prashant Upadhyay
- Faculty of Medicine, Government Medical College Jalaun, Orai 285001, Uttar Pradesh, India
| | - Gianluca Ferini
- Department of Radiation Oncology, REM Radioterapia srl, 95125 Viagrande, Italy
| | - Anna Viola
- Department of Radiation Oncology, REM Radioterapia srl, 95125 Viagrande, Italy
| | - Valentina Zagardo
- Department of Radiation Oncology, REM Radioterapia srl, 95125 Viagrande, Italy
| | - Kenny Yu
- Department of Neurosurgery, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Aaron A. Cohen-Gadol
- Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | | | - Ali S. Haider
- Department of Neurosurgery, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA
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10
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Gunasekaran T, Teow Kheng Leong K, Tze Hui P. Orbital Cellulitis in a Patient With Sphenoid Wing Meningioma. Cureus 2021; 13:e19323. [PMID: 34909289 PMCID: PMC8653855 DOI: 10.7759/cureus.19323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2021] [Indexed: 11/05/2022] Open
Abstract
We report a case of a 43-year-old woman with an underlying right sphenoid wing meningioma (SWM) who complained of increased right eye swelling, proptosis, redness and severe pain for two weeks. Her symptoms started one week after completing radiotherapy. She seeked treatment after a worsening of symptoms. An urgent computed tomography (CT) scan of the brain was done and showed increasing extension of tumour and hypodense areas within intraorbital region of the tumour with intraorbital fat stranding. She was treated as right eye orbital cellulitis with a differential diagnosis of tumour lysis syndrome. She was started on a combination of intravenous antibiotics and improvements were noticed after two days of treatment. This report presents the diagnostic challenge in managing orbital swelling in a patient with sphenoid wing meningioma with inconclusive radiological findings. Orbital cellulitis is an ocular emergency that requires prompt treatment and can potentially be vision and life-threatening, if not addressed early. In such cases with diagnostic dilemma, the decision to treat should be made as early as possible.
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Affiliation(s)
- Thiruvarasu Gunasekaran
- Department of Ophthalmology, Hospital Seri Manjung, Sitiawan, MYS.,Department of Ophthalmology, Hospital Bintulu, Bintulu, MYS
| | | | - Pua Tze Hui
- Department of Ophthalmology, Hospital Bintulu, Bintulu, MYS
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11
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Rahman R, Sulman E, Haas-Kogan D, Cagney DN. Update on Radiation Therapy for Central Nervous System Tumors. Hematol Oncol Clin North Am 2021; 36:77-93. [PMID: 34711456 DOI: 10.1016/j.hoc.2021.08.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Radiation therapy has long been a critical modality of treatment of patients with central nervous system tumors, including primary brain tumors, brain metastases, and meningiomas. Advances in radiation technology and delivery have allowed for more precise treatment to optimize patient outcomes and minimize toxicities. Improved understanding of the molecular underpinnings of brain tumors and normal brain tissue response to radiation will allow for continued refinement of radiation treatment approaches to improve clinical outcomes for brain tumor patients. With continued advances in precision and delivery, radiation therapy will continue to be an important modality to achieve optimal outcomes of brain tumor patients.
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Affiliation(s)
- Rifaquat Rahman
- Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, 75 Francis Street, ASB1-L2, Boston, MA 02115, USA
| | - Erik Sulman
- Department of Radiation Oncology, New York University Grossman School of Medicine, 160 East 34th Street, New York, NY 10016, USA
| | - Daphne Haas-Kogan
- Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, 75 Francis Street, ASB1-L2, Boston, MA 02115, USA
| | - Daniel N Cagney
- Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, 75 Francis Street, ASB1-L2, Boston, MA 02115, USA.
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12
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Atypical Presentation of Transcranial Extension of Intracranial Meningiomas. Am J Dermatopathol 2021; 44:207-211. [DOI: 10.1097/dad.0000000000002061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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13
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Salehi M, Merve A, Yancheva S, Kadlec J. Ectopic thoracic meningioma: a diagnostically challenging case. BMJ Case Rep 2021; 14:14/5/e242020. [PMID: 34039546 DOI: 10.1136/bcr-2021-242020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Whilst meningiomas are common neoplasms of the central nervous system; ectopic meningiomas are very rare. When they do occur, they are typically in the head and neck. Due to their rarity, they propose a diagnostic challenge with interesting pathological findings. To date, only seven ectopic meningiomas arising in the mediastinum have been reported in the literature. We aim to shift the focus on the diagnostic journey of this rare entity which involved various imaging and histopathological techniques. Our patient was successfully treated with no complications after four years through input from specialists and the multidisciplinary team.
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Affiliation(s)
- Mahan Salehi
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK .,University of East Anglia Faculty of Medicine and Health Sciences, Norwich, UK
| | - Ashirwad Merve
- Department of Neuropathology, National Hospital for Neurology and Neurosurgery, London, UK
| | - Slaveya Yancheva
- Department of Cellular Pathology, John Radcliffe Hospital, Oxford, UK
| | - Jakub Kadlec
- Thoracic Surgery Department, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
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14
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Sato H, Mizumoto M, Okumura T, Sakurai H, Sakamoto N, Akutsu H, Ishikawa E, Tsuboi K. Long-term outcomes of patients with unresectable benign meningioma treated with proton beam therapy. JOURNAL OF RADIATION RESEARCH 2021; 62:427-437. [PMID: 33855438 PMCID: PMC8127652 DOI: 10.1093/jrr/rrab017] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 02/01/2021] [Indexed: 05/07/2023]
Abstract
This study aimed to evaluate the long-term efficacy of proton beam therapy (PBT) for unresectable benign meningiomas at the University of Tsukuba, Japan. From 1986-1998, 10 patients were treated at the Particle Radiation Medical Science Center (PRMSC) with a relative biological effectiveness (RBE) value of 1.0 using an accelerator built for physics experiments. The total dose was compensated with an X-ray in three patients. Following that, from 2002-2017, 17 patients were treated with a RBE value of 1.1 at the Proton Medical Research Center (PMRC) which was built for medical use. At the PRMSC, the total dose ranged from 50.4-66 Gy (median: 54 Gy). During the follow-up, which lasted between 3.8 and 31.6 years (median: 25.1 years), the 5-, 10-, 15-, 20- and 30-year local control rates were 100%, and the 5-, 10-, 15-, 20- and 30-year survival rates were 90, 80, 70, 70 and 36%, respectively. One patient died of brainstem radiation necrosis 5.1 years after PBT. At PMRC, the total dose ranged from 45.0-61.2 GyE, with a median of 50.4 GyE. During the follow-up, which lasted between 3 and 17 years with a median of 10.5 years, the 5-, 10- and 15-year local control rates were 94.1%, and the 5-, 10- and 15-year survival rates were 100, 100 and 88.9%, respectively. Neither malignant transformation nor secondary malignancy was observed, indicating that fractionated PBT may be effective and safely control benign unresectable meningioma even for the lifelong period of time.
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Affiliation(s)
- Hiroshige Sato
- Biomedical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennohdai, Tsukuba, Ibaraki 305-8575, Japan
| | - Masashi Mizumoto
- Department of Radiation Oncology, Proton Beam Therapy Center, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki 305-8576, Japan
| | - Toshiyuki Okumura
- Department of Radiation Oncology, Proton Beam Therapy Center, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki 305-8576, Japan
| | - Hideyuki Sakurai
- Department of Radiation Oncology, Proton Beam Therapy Center, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki 305-8576, Japan
| | - Noriaki Sakamoto
- Department of Diagnostic Pathology, Faculty of Medicine, University of Tsukuba, 2-1-1 Amakubo, Tsukuba, Ibaraki 305-8576, Japan
| | - Hiroyoshi Akutsu
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, 2-1-1 Amakubo, Tsukuba, Ibaraki 305-8576, Japan
| | - Eiichi Ishikawa
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, 2-1-1 Amakubo, Tsukuba, Ibaraki 305-8576, Japan
| | - Koji Tsuboi
- Tumor Therapy Center, Tsukuba Central Hospital, 1589-3 Kashiwada, Ushiku, Ibaraki 300-1211, Japan
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15
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Girardelli S, Albano L, Mangili G, Valsecchi L, Rabaiotti E, Cavoretto PI, Mortini P, Candiani M. Meningiomas in Gynecology and Reproduction: an Updated Overview for Clinical Practice. Reprod Sci 2021; 29:2452-2464. [PMID: 33970444 DOI: 10.1007/s43032-021-00606-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 05/03/2021] [Indexed: 10/21/2022]
Abstract
There is various evidence to suggest a relationship between female hormones and meningiomas; as clinicians, we often come to face challenging situations involving female patients diagnosed with meningiomas during the post-pubertal phases of their life. We aimed to review the specific circumstances (pregnancy, postpartum, hormonal contraception and hormone replacement therapy, gender-affirming hormonal treatment) clinicians might come to face during their daily clinical practice, given the absence of available guidelines. We therefore conducted a narrative review on articles found in PubMed and Embase databases using appropriate keywords. Ninety-six relevant articles were included. The available evidence on managing meningiomas in post-pubertal women often implies personal strategies, highlighting the lack of a unified approach. The knowledge of the biological links between female hormones and meningiomas is fundamental to correctly counsel patients in various life phases. Prospective randomized studies are required to improve available guidelines on how to best manage meningiomas in female post-pubertal patients.
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Affiliation(s)
- Serena Girardelli
- Obstetrics and Gynecology Department, I.R.C.C.S. San Raffaele Scientific Institute, Vita-Salute University, Via Olgettina 60, 20132, Milan, Italy.
| | - Luigi Albano
- Neurosurgery and Radiosurgery Department, I.R.C.C.S. San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
| | - Giorgia Mangili
- Obstetrics and Gynecology Department, I.R.C.C.S. San Raffaele Scientific Institute, Vita-Salute University, Via Olgettina 60, 20132, Milan, Italy
| | - Luca Valsecchi
- Obstetrics and Gynecology Department, I.R.C.C.S. San Raffaele Scientific Institute, Vita-Salute University, Via Olgettina 60, 20132, Milan, Italy
| | - Emanuela Rabaiotti
- Obstetrics and Gynecology Department, I.R.C.C.S. San Raffaele Scientific Institute, Vita-Salute University, Via Olgettina 60, 20132, Milan, Italy
| | - Paolo Ivo Cavoretto
- Obstetrics and Gynecology Department, I.R.C.C.S. San Raffaele Scientific Institute, Vita-Salute University, Via Olgettina 60, 20132, Milan, Italy
| | - Pietro Mortini
- Neurosurgery and Radiosurgery Department, I.R.C.C.S. San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
| | - Massimo Candiani
- Obstetrics and Gynecology Department, I.R.C.C.S. San Raffaele Scientific Institute, Vita-Salute University, Via Olgettina 60, 20132, Milan, Italy
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16
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Vega-Moreno DA, Santellán-Hernández JO, Velázquez-Domínguez HE, Martínez-Nava AO, Vicuña-González RM, Mendoza-Trillo PR, Reyes-Rodríguez VA, de la-Torre AI, González-González IE, Ochoa-Cacique D, Sánchez-Mata R, Molina-Martínez RP, García-González U. Histopathological Correlation (World Health Organization Classification) of Meningiomas and Their Anatomical Localization: A Multicenter Epidemiological Study in Mexico. World Neurosurg 2021; 151:e888-e898. [PMID: 33974982 DOI: 10.1016/j.wneu.2021.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/01/2021] [Accepted: 05/03/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To determine the epidemiology of the localization and histological type of meningiomas in the Mexican population and the distribution of the different histological patterns and their relationship to tumor localization and patient demographics. METHODS A retrospective analysis was performed in 5 hospitals in Mexico from 2009 to 2019. For qualitative variables, mean values were compared using Pearson χ2 test for the correlation between location and histological pattern as well as the clinical presentation and the patient's sex. Student t test was performed for age and its correlation with location and histology. RESULTS Analysis of 179 patients revealed significant differences in histopathological pattern, patient sex, and tumor location. No significant differences were found for age or clinical presentation in association with any specific histological pattern. CONCLUSIONS There was a correlation between the histology of the 15 histopathological varieties of meningiomas and the predilection site of appearance as well as certain demographic aspects, such as sex. This study lays the foundation for future studies in Mexico on the differentiation and typing of meningiomas regardless of the histological grade to which they belong, as the exact behavior of these tumors, including grade I tumors, remains unknown to date.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Diego Ochoa-Cacique
- Neurosurgery Department, Hospital Central Sur de Alta Especialidad PEMEX, Mexico City, Mexico
| | - Rafael Sánchez-Mata
- Neurosurgery Department, Hospital Central Sur de Alta Especialidad PEMEX, Mexico City, Mexico
| | | | - Ulises García-González
- Neurosurgery Department, Hospital Central Sur de Alta Especialidad PEMEX, Mexico City, Mexico
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17
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Ganai F, Tanki HN, Sherwani A, Altaf K, Chisti N, Ramzan A. Incidence, Clinicopathological Profile and Location - Based Outcome of Intracranial Meningiomas: 10-Year Institutional Study with Review of Literature. INDIAN JOURNAL OF NEUROSURGERY 2021. [DOI: 10.1055/s-0040-1714436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Abstract
Intracranial meningiomas are the most common extra-axial tumors, representing 15% of all brain tumors. Arising from the arachnoid cells, and common in middle-aged women, 90% meningiomas are benign. We conducted a 10-year study on 183 cases of intracranial meningiomas and observed a lower and decreasing trend; the mean age was 43.3 years but there was also a significant incidence in young females. Parasagittal/falx (29%), sphenoid ridge, convexity meningiomas and middle cranial fossa locations were more common. Histopathologically, meningothelial meningioma was the most common. Benign (WHO I) tumors were found in above 90%, atypical (WHO II) in 5% cases, and malignant (WHO III) in < 4% patients. Most patients underwent Simpsons Grade I excision (35.6%) with dural reconstruction because of late presentations. Posterior fossa meningiomas were mostly benign, while intraventricular ones were mostly malignant with highest postoperation mortality. Mortality in operated patients was 9.8% but was highest in anterior fossa tumors (12.5%).
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Affiliation(s)
- Feroze Ganai
- Department of Neurosurgery and Surgery, Sheri Kashmir Institute of Medical Sciences, Kashmir, Jammu & Kashmir, India
| | - Humam Nisar Tanki
- Department of Neurosurgery and Surgery, Sheri Kashmir Institute of Medical Sciences, Kashmir, Jammu & Kashmir, India
| | - Afaq Sherwani
- Department of Neurosurgery and Surgery, Sheri Kashmir Institute of Medical Sciences, Kashmir, Jammu & Kashmir, India
| | - Kirmani Altaf
- Department of Neurosurgery and Surgery, Sheri Kashmir Institute of Medical Sciences, Kashmir, Jammu & Kashmir, India
| | - Nazish Chisti
- Department of Neurosurgery and Surgery, Sheri Kashmir Institute of Medical Sciences, Kashmir, Jammu & Kashmir, India
| | - Altaf Ramzan
- Department of Neurosurgery and Surgery, Sheri Kashmir Institute of Medical Sciences, Kashmir, Jammu & Kashmir, India
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18
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Slavik H, Balik V, Vrbkova J, Rehulkova A, Vaverka M, Hrabalek L, Ehrmann J, Vidlarova M, Gurska S, Hajduch M, Srovnal J. Identification of Meningioma Patients at High Risk of Tumor Recurrence Using MicroRNA Profiling. Neurosurgery 2021; 87:1055-1063. [PMID: 32125436 PMCID: PMC7566524 DOI: 10.1093/neuros/nyaa009] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 12/15/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Meningioma growth rates are highly variable, even within benign subgroups, with some remaining stable, whereas others grow rapidly. OBJECTIVE To identify molecular-genetic markers for more accurate prediction of meningioma recurrence and better-targeted therapy. METHODS Microarrays identified microRNA (miRNA) expression in primary and recurrent meningiomas of all World Health Organization (WHO) grades. Those found to be deregulated were further validated by quantitative real-time polymerase chain reaction in a cohort of 172 patients. Statistical analysis of the resulting dataset revealed predictors of meningioma recurrence. RESULTS Adjusted and nonadjusted models of time to relapse identified the most significant prognosticators to be miR-15a-5p, miR-146a-5p, and miR-331-3p. The final validation phase proved the crucial significance of miR-146a-5p and miR-331-3p, and clinical factors such as type of resection (total or partial) and WHO grade in some selected models. Following stepwise selection in a multivariate model on an expanded cohort, the most predictive model was identified to be that which included lower miR-331-3p expression (hazard ratio [HR] 1.44; P < .001) and partial tumor resection (HR 3.90; P < .001). Moreover, in the subgroup of total resections, both miRNAs remained prognosticators in univariate models adjusted to the clinical factors. CONCLUSION The proposed models might enable more accurate prediction of time to meningioma recurrence and thus determine optimal postoperative management. Moreover, combining this model with current knowledge of molecular processes underpinning recurrence could permit the identification of distinct meningioma subtypes and enable better-targeted therapies.
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Affiliation(s)
- Hanus Slavik
- Laboratory of Experimental Medicine, Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Czech Republic
| | - Vladimir Balik
- Laboratory of Experimental Medicine, Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Czech Republic.,Department of Neurosurgery, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Czech Republic
| | - Jana Vrbkova
- Laboratory of Experimental Medicine, Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Czech Republic
| | - Alona Rehulkova
- Laboratory of Experimental Medicine, Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Czech Republic
| | - Miroslav Vaverka
- Department of Neurosurgery, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Czech Republic
| | - Lumir Hrabalek
- Department of Neurosurgery, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Czech Republic
| | - Jiri Ehrmann
- Laboratory of Experimental Medicine, Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Czech Republic.,Institute of Clinical and Molecular Pathology, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Czech Republic, Czech Republic
| | - Monika Vidlarova
- Laboratory of Experimental Medicine, Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Czech Republic
| | - Sona Gurska
- Laboratory of Experimental Medicine, Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Czech Republic
| | - Marian Hajduch
- Laboratory of Experimental Medicine, Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Czech Republic
| | - Josef Srovnal
- Laboratory of Experimental Medicine, Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Czech Republic
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19
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Dedhia K, Marchica C, Mattox D. Unilateral Facial Paralysis in the Pediatric Patient. Cureus 2021; 13:e12701. [PMID: 33614309 PMCID: PMC7883570 DOI: 10.7759/cureus.12701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Unilateral facial paralysis (FP) in the pediatric population is a rare entity secondary to multiple etiologies including infectious, vascular, and neoplastic. In persistent or recurrent FP, imaging can demonstrate a peripheral facial nerve (FN) lesion. Given the rarity of FN lesions, however, there is limited literature regarding optimal management. In this case series, we describe the presentation, evaluation, and management of unilateral FP in three pediatric patients along with a review of the literature. All patients presented with complete FP due to a peripheral FN lesion or compression of the FN. A combined mastoid and middle cranial fossa approach was utilized for excision in two cases, and the other child underwent a translabyrinthine approach. The pathology of the lesions revealed a meningioma, an arachnoid cyst, and a hemangioma. Presentation, evaluation, post-operative outcomes, as well as final pathologies are discussed.
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Affiliation(s)
- Kavita Dedhia
- Otolaryngology, Children's Hospital of Philadelphia, Philadelphia, USA
| | | | - Douglas Mattox
- Otolaryngology, Emory University School of Medicine, Atlanta, USA
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20
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Chaudhry SK, Raza R, Naveed MA, Rehman I. Suprasellar Meningiomas: An Experience of Four Cases With Brief Review of Literature. Cureus 2021; 13:e12470. [PMID: 33552786 PMCID: PMC7854335 DOI: 10.7759/cureus.12470] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Suprasellar meningiomas make a relevant differential when it comes to sellar/suprasellar masses. The most common pathology in this location is pituitary adenomas. It is imperative to differentiate the two entities based on imaging as the clinical picture, and sometimes the biochemical profile can show significant overlap. It is also essential for the neurosurgeons to have a preoperative diagnosis as the behavior of both tumors is different. This piece will give a pictorial review of the imaging features of suprasellar meningiomas, in patients who presented to us with sellar/suprasellar masses. The aim is to help the radiologists as well as fellow clinicians to diagnose this entity with confidence based on imaging.
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Affiliation(s)
- Saad Khalil Chaudhry
- Radiology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK
| | - Rabail Raza
- Radiology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK
| | | | - Iffat Rehman
- Radiology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK
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21
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Ramirez Grueso R, Barcenas L, Arias JA, Colegial C, Avendaño CL, Chaves J, Galvis J, Moreno S. Characterization of Progesterone Receptor Expression in Intracranial Meningiomas of Patients Treated in a High-Complexity Hospital in Bogota, Colombia. Cureus 2020; 12:e12355. [PMID: 33527044 PMCID: PMC7842106 DOI: 10.7759/cureus.12355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2020] [Indexed: 11/05/2022] Open
Abstract
Background Meningiomas are the single most common brain tumor. The incidence of these tumors increases with age; different studies have shown that meningiomas usually appear after the age of 50. These tumors are more common in women than in men, and women are twice as likely to suffer from the condition. Surgery is the primary form of treatment, which can be curative with complete resection. If the tumor is unresectable or other treatments such as surgery and radiotherapy have failed, hormonal therapy or chemotherapy may be considered. There is limited information about the clinical, demographic, and histopathological characteristics of these tumors in the population of Bogotá, Colombia. Objective To evaluate the expression of progesterone receptors in patients over 18 years old who have been diagnosed with meningiomas in a high-complexity hospital in Bogota, Colombia, and to describe the demographic and histopathological characteristics of these patients. Methods This is a descriptive and retrospective case series. Patients with meningioma who underwent surgical resection at a high-complexity hospital in Bogota, Colombia, from 2016 to 2019 were retrospectively identified and studied. Demographic variables, such as age and gender, were extracted from the clinical chart. Indirect immunoperoxidase staining was carried out for the progesterone receptor (PR) and Ki67. PR is analyzed as positive and negative, and the Ki67 proliferation index was determined. Results Thirty-two meningiomas from patients who underwent surgery were available for analysis. Twenty-five (78.1%) were positive for PR, 71.8% were females, and 93% were World Health Organization (WHO) grade I. Meningothelial (28%), fibrous (25%), and transitional (25%) meningiomas were the most frequent subtypes, correspondingly. The Ki67 mean value was 1.14 (0.11-10.71). Conclusion Our case series showed a greater frequency of meningiomas in women, with a high PR expression and a low Ki67 proliferation rate. These data correlate with literature worldwide.
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Affiliation(s)
| | - Linda Barcenas
- Department of Pathology, National University of Colombia, Bogota, COL
| | - Jaime A Arias
- Department of Neurosurgery, National University of Colombia, Bogota, COL
| | - Carlos Colegial
- Department of Pathology, National University of Colombia, Bogota, COL
| | - Claudia L Avendaño
- Inmunohistochemistry/Electron Microscopy, Bio-Molecular Diagnostica, Bogota, COL
| | - Jose Chaves
- Department of Neurosurgery, National University of Colombia, Bogota, COL
| | - Jorge Galvis
- Department of Neurosurgery, Santander University Hospital, Bogota, COL
| | - Santiago Moreno
- Department of Neurosurgery, Subred Integrada de Servicios de Salud Sur Occidente, Bogota, COL
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22
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Wilson TA, Huang L, Ramanathan D, Lopez-Gonzalez M, Pillai P, De Los Reyes K, Kumal M, Boling W. Review of Atypical and Anaplastic Meningiomas: Classification, Molecular Biology, and Management. Front Oncol 2020; 10:565582. [PMID: 33330036 PMCID: PMC7714950 DOI: 10.3389/fonc.2020.565582] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 09/17/2020] [Indexed: 12/12/2022] Open
Abstract
Although the majority of meningiomas are slow-growing and benign, atypical and anaplastic meningiomas behave aggressively with a penchant for recurrence. Standard of care includes surgical resection followed by adjuvant radiation in anaplastic and partially resected atypical meningiomas; however, the role of adjuvant radiation for incompletely resected atypical meningiomas remains debated. Despite maximum treatment, atypical, and anaplastic meningiomas have a strong proclivity for recurrence. Accumulating mutations over time, recurrent tumors behave more aggressively and often become refractory or no longer amenable to further surgical resection or radiation. Chemotherapy and other medical therapies are available as salvage treatment once standard options are exhausted; however, efficacy of these agents remains limited. This review discusses the risk factors, classification, and molecular biology of meningiomas as well as the current management strategies, novel therapeutic approaches, and future directions for managing atypical and anaplastic meningiomas.
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Affiliation(s)
| | - Lei Huang
- Loma Linda University, Loma Linda, CA, United States
| | | | | | - Promod Pillai
- Loma Linda University, Loma Linda, CA, United States
| | | | | | - Warren Boling
- Loma Linda University, Loma Linda, CA, United States
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Alghabban FA, Alhamss YJ, Farag AA, Alfahmi JA, Al-Saiari SA, Alghamdi F, Abdoh MG. Incidental intraoperative finding of meningioma in spontaneous acute subdural hematoma: A case report from Saudi Arabia and review of literature. Int J Surg Case Rep 2020; 77:314-317. [PMID: 33197775 PMCID: PMC7677660 DOI: 10.1016/j.ijscr.2020.10.136] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 10/29/2020] [Accepted: 10/29/2020] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION An association of meningioma with spontaneous acute subdural hematoma has been rarely reported in the literature. Up to date, 38 cases have been reported. PRESENTATION OF CASE A 74-year-old Saudi female known case of hypertension presented suddenly with dizziness, headache, and left lower limb weakness for 6 h. No history of trauma or anticoagulant medication. Computed tomography scan showed acute subdural hematoma. Pre-operative images were negative for any vascular pathology or lesional tissue. The patient underwent surgery for evacuation of the subdural collection. The presence of abnormal soft tissues within the hematoma was discovered during the surgery and sent for analysis. Histopathological results showed meningothelial subtype grade I meningioma. The patient recovered well, with no obvious neurological deficit or immediate complication. DISCUSSION Spontaneous acute subdural hematoma without a predisposing factor is a rare occurrence; consequently, a thorough investigation is mandatory in such case to reach the hidden aetiology. CONCLUSION In this report a rare association of meningioma with an acute subdural hematoma described. Our case was the first one reported where meningioma incidentally discovered during procedure without preoperative suspicion. A small size intracranial lesion may not be detected by preoperative radiological assessment in the presence of a hematoma. Systematic inspection of the operative field is an important surgical step despite negative preoperative radiological images. Our case supports the mechanism of rupture of abnormal vascular structure. More cases needed to understand the mechanism of such a rare association.
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Affiliation(s)
- Fatimah Abdulrahim Alghabban
- Neurosurgery Department, Neuroscience Center, King Abdullah Medical City, Holy Capital, Saudi Arabia; Neurosurgery Department, King Abdulaziz Speciality Hospital, Taif, Saudi Arabia
| | - Yoseri Jameel Alhamss
- Neurosurgery Department, Neuroscience Center, King Abdullah Medical City, Holy Capital, Saudi Arabia
| | - Ahmed A Farag
- Neurosurgery Department, Neuroscience Center, King Abdullah Medical City, Holy Capital, Saudi Arabia
| | - Julnar Ayman Alfahmi
- Neurosurgery Department, Al-Noor Specialist Hospital, Holy Capital, Saudi Arabia
| | - Sultan Ali Al-Saiari
- Neurosurgery Department, Neuroscience Center, King Abdullah Medical City, Holy Capital, Saudi Arabia
| | - Faisal Alghamdi
- Interventional Neuroradiology Department, King Abdullah Medical City, Holy Capital, Saudi Arabia
| | - Mohammad Ghazi Abdoh
- Neurosurgery Department, Neuroscience Center, King Abdullah Medical City, Holy Capital, Saudi Arabia.
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Young J, Mdanat F, Dharmasena A, Cannon P, Leatherbarrow B, Hammerbeck-Ward C, Rutherford S, Ataullah S. Combined neurosurgical and orbital intervention for spheno-orbital meningiomas - the Manchester experience. Orbit 2020; 39:251-257. [PMID: 31658848 DOI: 10.1080/01676830.2019.1673782] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 09/21/2019] [Indexed: 06/10/2023]
Abstract
PURPOSE Surgical resection of spheno-orbital meningioma (SOM) is challenging, requiring a multidisciplinary surgical approach. We present our experience of the surgical management of patients with SOM. METHODS A retrospective analysis of patients with SOM who underwent joint neurosurgical and orbital surgical procedures between January 2000 and June 2017. Pre-operative clinical signs, indication for surgery, surgical complications and post-operative outcomes were recorded. RESULTS Twenty-four operations were performed. Mean age was 49.5 years. Ninety-two percent of patients were female. Pre-operatively mean Snellen acuity vision was 6/12; 13 (54%) had an RAPD; 12 (50%) had reduced colour vision; 16 (67%) had a visual field defect. The majority (21 patients, 88%) had proptosis (average 4.5 mm ± 2.8 mm). The indication for surgery was evidence of visual dysfunction in 17 (71%), the remaining 7 (29%) had high risk of visual loss clinically or radiologically. Three-months post operatively, vision was stable in 13 (58%), improved in 6 (21%) and worse in 5 (17%). Average long-term follow-up was 82 months (1-220). Fourteen (58%) maintain improved or stable visual function. Four (17%) had reduced vision due to regrowth of the tumour at an average of 24 months. CONCLUSION SOMs are very challenging to treat surgically. In this cohort the patients were predominantly young females with aggressive disease. Visual function was improved or stabilised in 79% of the patients.
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Affiliation(s)
- J Young
- Oculoplastic Department, Manchester Royal Eye Hospital , Manchester, UK
| | - F Mdanat
- School of Medical Sciences, The University of Manchester , Manchester, UK
| | - A Dharmasena
- Oculoplastic Department, Manchester Royal Eye Hospital , Manchester, UK
| | - P Cannon
- Oculoplastic Department, Manchester Royal Eye Hospital , Manchester, UK
| | - B Leatherbarrow
- Oculoplastic Department, Manchester Royal Eye Hospital , Manchester, UK
| | - C Hammerbeck-Ward
- Neurosurgical Department, Salford Royal Foundation Trust , Salford, UK
| | - S Rutherford
- Neurosurgical Department, Salford Royal Foundation Trust , Salford, UK
| | - S Ataullah
- Oculoplastic Department, Manchester Royal Eye Hospital , Manchester, UK
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Patterns of recurrence in patients receiving conformal radiation for intracranial meningioma: a single-institution experience. JOURNAL OF RADIOTHERAPY IN PRACTICE 2020. [DOI: 10.1017/s1460396920000539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractAim:To evaluate the patterns of recurrence following postoperative conformal radiotherapy (RT) for intracranial meningioma.Materials and methods:Eighty-six patients who received conformal RT for intracranial meningiomas from 2014 to 2017 were retrospectively analysed. For documented recurrences, recurrence imaging was deformably co-registered to planning CT scan. In-field recurrence was defined as recurrence within the 90% isodose line, and out-of-field recurrences were those that occurred outside the 90% isodose line. We present the demographic details, surgical and RT details, outcomes and patterns of recurrence.Results:The median age was 46 years (range 17–72); 82·6% underwent surgery [46·5% had subtotal resection (STR), 43·7% gross tumour resection (GTR), 5·6% biopsy] and 17·4% had no surgery. Among these, 53·5% were WHO grade 2; 27·9% grade 1; and 1·2% grade 3 meningioma. Fifty per cent received stereotactic RT (SRT), 46·5% 3D conformal RT (3DCRT) and 3·5% intensity-modulated RT (IMRT). The mean clinical target volume (CTV) and planning target volume (PTV) margins were 4·5 mm (range 0–15) and 3·9 mm (range 1–5), respectively. The doses ranged from 54 to 59·4 Gy. The median follow-up after RT was 1·7 years (range 0·2–4·7). 17·4% were lost to follow-up, 5·4% had recurrence, and the median time to recurrence after completion of RT was 2 years (range 0·7–2·9). The 3-year recurrence-free rate was 81·5%. Three patients had in-field and two had in-field and out-of-field recurrence. Among the cases with recurrence, three received SRT, one 3DCRT and one IMRT. Four were grade 2 and one was grade 3 tumour, and the CTV margin ranged from 0 to 5 mm, and the PTV margin ranged from 3 to 5 mm.Conclusion:Local recurrence was seen in grade 2 and 3 meningiomas. SRT probably had more recurrence as they had lesser CTV margin. Increased CTV margin, escalated dose up to 59·4 Gy and 3DCRT/IMRT may be helpful in preventing local recurrences in grade 2 and grade 3 meningiomas.
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Computed tomographic imaging of meningiomas. HANDBOOK OF CLINICAL NEUROLOGY 2020. [PMID: 32553287 DOI: 10.1016/b978-0-12-804280-9.00011-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register]
Abstract
Although magnetic resonance imaging (MRI) has surpassed computerized tomography (CT) as the imaging modality of choice, there are certain instances when CT should be a preoperative requisite for meningioma surgical resection. Given its superior bone definition and the propensity for meningiomas to invade bone (as evidenced by hyperostosis on imaging), CT can be extremely helpful to the surgeon when planning and evaluating postoperatively the extent of bone removal during tumor resection. Advances in CT imaging also allow for visualization of the adjacent arterial and venous vasculature to determine feasibility of resection and likelihood of adjuvant treatments such as radiosurgery to a tumor residuum. For skull base tumors high-resolution CT imaging as part of the standard neuronavigation sequences can help evaluate bony anatomy and planning of surgical approaches, in particular for cranial base tumors. Finally, 3D-CT imaging is important in the design of cranial prostheses, which may be required to repair defects as a result of resection.
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Li X, Zhang W, Liang L, Duan X, Deng J, Zhou Y. Natural product-derived icaritin exerts anti-glioblastoma effects by positively modulating estrogen receptor β. Exp Ther Med 2020; 19:2841-2850. [PMID: 32256768 PMCID: PMC7086240 DOI: 10.3892/etm.2020.8571] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 10/02/2019] [Indexed: 12/14/2022] Open
Abstract
Glioblastoma is the most common malignancy of the central nervous system, and patients typically have a poor prognosis. Previous studies indicate a gender bias in the development of glioblastoma; women are at a lower risk compared with men, suggesting that estrogen may confer protective effects. Icaritin, a prenylflavonoid derivative from a Chinese herb of the Epimedium genus, selectively regulates the estrogen receptor (ER) and possesses anti-cancer properties. The aim of the present study was to investigate the protective effects of icaritin on glioblastoma and its underlying mechanisms, with a particular focus on its association with the ER. The results demonstrated that icaritin inhibited the growth of C6 and U87-MG glioblastoma cells in a dose- and time-dependent manner. At a concentration of 12.5 µM, icaritin induced apoptosis, which was characterized by the increased expression of the cleaved forms of caspases 3, 7, 8 and 9 and poly (ADP-ribose) polymerase, downregulation of BCL2 apoptosis regulator and upregulation of BCL2-associated X, apoptosis regulator expression. Additionally, icaritin inhibited the migration of C6 and U87-MG cells. The protein expression levels of matrix metalloproteinase (MMP)-2 and MMP-9 were also downregulated following icaritin treatment. Furthermore, icaritin treatment increased the expression of estrogen receptor (ER)β and the phosphatase and tensin (PTEN) homolog oncoprotein, thus reducing the expression of downstream targets of PTEN; protein kinase B (Akt) and phosphorylated Akt. Subsequent experiments demonstrated that icaritin cooperates with 17β-estradiol to inhibit the growth of glioblastoma cells, and the inhibition of ERβ with the ERβ-specific antagonist ICI 182,780, attenuated the anti-glioblastoma effects of icaritin. In conclusion, the results of the present study demonstrate that the anti-glioblastoma effects of icaritin may be mediated by its modulation of ERβ.
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Affiliation(s)
- Xiaowen Li
- Department of Pharmacology, College of Pharmacy, Guilin Medical University, Guilin, Guangxi 541004, P.R. China
| | - Weiwei Zhang
- Department of Medical Oncology, The Affiliated Yantai Yuhuangding Hospital, Medical College of Qingdao University, Yantai, Shandong 264000, P.R. China
| | - Lingli Liang
- Department of Pharmacology, College of Pharmacy, Guilin Medical University, Guilin, Guangxi 541004, P.R. China
| | - Xiaoqun Duan
- Department of Pharmacology, College of Pharmacy, Guilin Medical University, Guilin, Guangxi 541004, P.R. China
| | - Jianzhi Deng
- Guangxi Key Laboratory of Embedded Technology and Intelligent System, Guilin University of Technology, Guilin, Guangxi 541004, P.R. China
| | - Yuehan Zhou
- Department of Pharmacology, College of Pharmacy, Guilin Medical University, Guilin, Guangxi 541004, P.R. China
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Chen T, Jiang B, Zheng Y, She D, Zhang H, Xing Z, Cao D. Differentiating intracranial solitary fibrous tumor/hemangiopericytoma from meningioma using diffusion-weighted imaging and susceptibility-weighted imaging. Neuroradiology 2019; 62:175-184. [DOI: 10.1007/s00234-019-02307-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 10/15/2019] [Indexed: 12/11/2022]
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Kamenova M, Guzman R, Soleman J. Demographics and outcome of histologically confirmed intracranial meningiomas. CLINICAL AND TRANSLATIONAL NEUROSCIENCE 2019. [DOI: 10.1177/2514183x19894945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective: Meningiomas represent the most common intracranial extraaxial neoplasia in adults, accounting for a third of all diagnosed primary tumors of the brain. Despite decades of research, relatively little data on demographics of meningiomas exist. The aim of our study was to undertake an analysis of demographics and outcome of patients who underwent meningioma surgery over an 8-year time period at our institution. Methods: We reviewed 187 consecutive patients with histologically confirmed meningioma. Demographic data, tumor location and side, surgical resection grade, and histopathological and radiological data were collected and assessed for all patients. Furthermore, recurrence, morbidity, and mortality were evaluated. Results: Of the 187 consecutive patients undergoing meningioma resection over a period of 8 years, 131 (70.1%) were women ( p < 0.001). Meningiomas were classified as World Health Organization (WHO) grade I, grade II, and grade III in 66.8%, 31.0%, and 2.1%, of the cases, respectively ( p < 0.001). MIB-1 proliferation index was <1 in 7.5%, 1–5 in 52.9%, 6–10 in 22.4%, >10 in 11.8% of the lesions ( p < 0.001). In 82.4% of the cases, gross total resection was achieved. Recurrence occurred in 23 patients (12.3%), while overall morbidity and mortality rate was 41.2% and 7.7%, respectively. Conclusion: Based on our results, women are more than twice as likely to be affected, and the peak age is between 60 years and 70 years. Recurrence rate in our cohort was relatively low when compared to the data in the literature. The diagnosis of WHO grade II meningiomas, 31% in our cohort, is increasing since the 2007 WHO criteria have been published.
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Affiliation(s)
- Maria Kamenova
- Department of Neurosurgery, University Hospital of Basel, Basel, Switzerland
| | - Raphael Guzman
- Department of Neurosurgery, University Hospital of Basel, Basel, Switzerland
| | - Jehuda Soleman
- Department of Neurosurgery, University Hospital of Basel, Basel, Switzerland
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Shankar JJS, Hodgson L, Sinha N. Diffusion weighted imaging may help differentiate intracranial hemangiopericytoma from meningioma. J Neuroradiol 2019; 46:263-267. [DOI: 10.1016/j.neurad.2018.11.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 10/29/2018] [Accepted: 11/15/2018] [Indexed: 11/25/2022]
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The Role of Particle Therapy for the Treatment of Skull Base Tumors and Tumors of the Central Nervous System (CNS). Top Magn Reson Imaging 2019; 28:49-61. [PMID: 31022048 DOI: 10.1097/rmr.0000000000000197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Radiation therapy (RT) is a mainstay in the interdisciplinary treatment of brain tumors of the skull base and brain. Technical innovations during the past 2 decades have allowed for increasingly precise treatment with better sparing of adjacent healthy tissues to prevent treatment-related side effects that influence patients' quality of life. Particle therapy with protons and charged ions offer favorable kinetics with sharp dose deposition in a well-defined depth (Bragg-Peak) and a steep radiation fall-off beyond that maximum. This review highlights the role of particle therapy in the management of primary brain tumors and tumors of the skull base.
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The association between preoperative edema and postoperative cognitive functioning and health-related quality of life in WHO grade I meningioma patients. Acta Neurochir (Wien) 2019; 161:579-588. [PMID: 30756243 PMCID: PMC6407739 DOI: 10.1007/s00701-019-03819-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 01/23/2019] [Indexed: 10/28/2022]
Abstract
BACKGROUND Studies on the associations between preoperative cerebral edema, cognitive functioning, and health-related quality of life (HRQOL) in WHO grade I meningioma patients are virtually lacking. We studied the association between preoperative cerebral edema on postoperative cognitive functioning and HRQOL 6 months postoperatively in WHO grade I meningioma patients. METHODS Twenty-one consecutive WHO grade I meningioma patients, who underwent surgery, were matched individually for age, gender, and educational level to healthy controls. Tumor and edema volume were assessed on preoperative T1- and T2-weighted MRI images, respectively. At least 5 months postoperatively, functional status, cognitive functioning, and HRQOL, using a cognitive test battery and the Short-Form Health Survey (SF-36), were determined. The correlation between preoperative tumor and cerebral edema volume with postoperative cognitive functioning and HRQOL was investigated using Kendall's tau coefficients. RESULTS Compared to healthy controls, patients had lower verbal memory capacity (p = .012), whereas HRQOL was similar to matched healthy controls. In all cognitive domains, postoperative functioning was much lower in patients with preoperative cerebral edema than in those without. There were significant correlations between preoperative cerebral edema and tumor volume and postoperative cognitive functioning. Preoperative cerebral edema and/or tumor volume were not associated with HRQOL. CONCLUSIONS Our results suggest that WHO grade I meningioma patients with larger volumes of preoperative cerebral edema are more at risk of experiencing limitations in longer-term cognitive functioning than patients with no or less edema preoperatively. This is an important knowledge for neurologists and neurosurgeons treating patients with a meningioma. More studies regarding the effect of peritumoral edema on cognitive functioning in meningioma patients are necessary.
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Rahatli FK, Donmez FY, Kesim C, Haberal KM, Turnaoglu H, Agildere AM. Can unenhanced brain magnetic resonance imaging be used in routine follow up of meningiomas to avoid gadolinium deposition in brain? Clin Imaging 2019; 53:155-161. [DOI: 10.1016/j.clinimag.2018.10.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 10/01/2018] [Accepted: 10/12/2018] [Indexed: 11/17/2022]
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Fadelalla M, Kanodia AK, Brunton J, Singh K, Torgersen A, Sammler E, Smith C, Mowle D, White P, Hossain-Ibrahim K. An unusual case of a grade I meningioma with perineural spread. Br J Neurosurg 2018:1-4. [PMID: 30450991 DOI: 10.1080/02688697.2018.1530730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
A 39-year-old lady with worsening intermittent diplopia and headaches was diagnosed with a WHO Grade I Meningothelial Meningioma with highly unusual perineural spread on imaging, making this the first reported case of this behaviour. Complete surgical resection was deemed too great a risk and the patient remains under observation. The process of perineural spread is not restricted to more aggressive brain tumours.
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Affiliation(s)
| | | | - John Brunton
- b Department of Radiology , NHS Tayside , Dundee , United Kingdom
| | - Kirit Singh
- a Department of Neurosurgery , NHS Tayside , Dundee , United Kingdom
| | - Antonia Torgersen
- c Department of Neuropathology , NHS Lothian , Edinburgh , United Kingdom
| | - Esther Sammler
- d Department of Neurology , NHS Tayside , Dundee , United Kingdom
| | - Colin Smith
- c Department of Neuropathology , NHS Lothian , Edinburgh , United Kingdom
| | - David Mowle
- a Department of Neurosurgery , NHS Tayside , Dundee , United Kingdom
| | - Paul White
- e Department of ENT , NHS Tayside , Dundee , United Kingdom
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Kreßner M, Arlt F, Riepl W, Meixensberger J. Prognostic factors of microsurgical treatment of intracranial meningiomas - A multivariate analysis. PLoS One 2018; 13:e0202520. [PMID: 30325925 PMCID: PMC6191082 DOI: 10.1371/journal.pone.0202520] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 08/03/2018] [Indexed: 01/01/2023] Open
Abstract
Objective Peri- and postoperative time course of meningioma patients who had undergone surgical treatment was evaluated to determine prognostic factors of neurological outcome by focusing on preoperative parameters. Material and methods A retrospective monocenter analysis was performed including patients who were operated in the Department of Neurosurgery, University Hospital Leipzig, from 2009 to 2015. Data from all patients with histologically confirmed diagnosis of intracranial meningioma treated microsurgically were included in the study. The individual characteristics of the patients, meningiomas and Karnofsky Performance scores (KPS) were analyzed by multivariate tests. Results Two hundred ninety-four patients with a median age of 61 years (range: 17–89) were included. Preoperative KPS (p < 0.001), skull base as tumor origin and tumor size (p < 0.05) proved to be significantly strong prognostic factors of KPS deterioration one year postoperative by multivariate analysis. According to uni- and bivariate analysis, the following prognostic factors could also be found: preoperative mass displacement, preexisting recurrence and presence of preoperative symptoms. In this study, age had no significant influence on deterioration in patient health state, measured by KPS, one year postoperative. Conclusion Patients generally obtained an improvement in KPS score after microsurgical treatment. The knowledge of prognostic factors can be very helpful in the decision-making process for meningioma treatment of the elderly, particularly to estimate the postoperative outcome and quality of life.
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Affiliation(s)
- Maika Kreßner
- Department of Neurosurgery, University Hospital Leipzig, Leipzig, Germany
| | - Felix Arlt
- Department of Neurosurgery, University Hospital Leipzig, Leipzig, Germany
| | - Wolf Riepl
- Social Science Research, Dresden, Germany
| | - Jürgen Meixensberger
- Department of Neurosurgery, University Hospital Leipzig, Leipzig, Germany
- * E-mail:
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Turan Y, Yılmaz T. İntrakranial Menenjioma Olgularının Değerlendirilmesi: 72 Hastanın Analizi. DICLE MEDICAL JOURNAL 2018. [DOI: 10.5798/dicletip.419310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Liang Y, Wang C, Chen A, Zhu L, Zhang J, Jiang P, Yue Q, De G. Immunohistochemistry analysis of Pygo2 expression in central nervous system tumors. J Cell Commun Signal 2018; 13:75-84. [PMID: 29978348 DOI: 10.1007/s12079-018-0476-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 06/26/2018] [Indexed: 11/30/2022] Open
Abstract
Pygo2 as a Wnt signaling pathway component has been detected in multiple cancer types. In this study, we identified Pygo2 expression features by immunohistochemistry in 73 central nervous system tumor specimens, in comparison with 14 normal brain tissues and surrounding non-tumorous tissues of tumor. Our study indicated that 59% of the patient tumor specimens exhibited positive Pygo2-staining and increases intensity with the grade of malignancy, especially for WHO grade III and IV gliomas, was observed high level expression, compared with normal brain tissues. Five out of nine WHO grade III anaplastic astrocytomas and seven out of nine WHO grade IV glioblastomas showed Pygo2-positive staining. The analysis of Pygo2 gene expression by quantitative real-time PCR of additional ten fresh patient samples yielded similar results. Further studies performed with stable cell lines in vitro demonstrated that Pygo2 render cells higher proliferation rate, migration and anchorage-independent colony-forming ability in soft agar. Taken together, our studies suggest an important role of Pygo2 in brain tumor progression.
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Affiliation(s)
- Yi Liang
- Laboratory Medicine College, Guangdong Medical University, Guangdong, People's Republic of China
| | - Chaoxi Wang
- Laboratory Medicine College, Guangdong Medical University, Guangdong, People's Republic of China
| | - Apeng Chen
- Department of Neurological Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lei Zhu
- State Key Laboratory of Oncogenes and Related Genes, Shanghai Cancer Institute, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Jie Zhang
- Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, People's Republic of China
| | - Pucha Jiang
- Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, People's Republic of China
| | - Qiaoxin Yue
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China
| | - Gejing De
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China.
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Pollak L, Walach N, Gur R, Schiffer J. Meningiomas after Radiotherapy for Tinea Capitis - Still No History. TUMORI JOURNAL 2018; 84:65-8. [PMID: 9619718 DOI: 10.1177/030089169808400114] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aims and background To review the clinical, radiological and histological findings of 19 patients with radiation-induced intracranial meningiomas treated at our neurosurgical department between 1981 and 1996. Method The records of 18 patients with intracranial meningiomas who underwent low-dose radiation for tinea capitis in childhood, and of one patient irradiated for pituitary adenoma, were analyzed in respect of the previously reported features of postradiation meningiomas. Results The mean age of the patients with low-dose radiation-induced meningiomas was 58 years and the mean shortest onset latency was 48 years. The male to female ratio was 1.1:1. Forty-seven percent of patients presented with mental changes and/or focal neurological signs, 21% with signs of increased intracranial pressure and 26% with seizures. Calvarial location of the meningiomas was found in 54% of patients and in one patient the tumor arose from the skull base. Multiple tumors were present in 15% of patients and 29% of the meningiomas displayed malignant features on histological examination. A significantly lower meningioma recurrence rate was found in our series compared to the recurrence rate in the reported series of postradiation meningiomas. Five patients had a history of a second neoplasm other than meningioma. Conclusion Our series of low-dose radiation-induced meningiomas represents one of the largest of its kind in the English literature. The patients did not differ substantially in sex ratio, tumor localization, multiplicity and histological features from the previously reported postradiation meningioma patients, except for the significantly lower tumor recurrence rate. It would seem that over the next years we will be further witnessing the deleterious effects of low-dose radiation administered in childhood.
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Affiliation(s)
- L Pollak
- Department of Neurosurgery, Assaf Harofeh Medical Center, Zerifin, Israel
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Plesker R, Bleyer M, Mätz-Rensing K. Spontaneous meningioma in a pig-tailed macaque ( Macaca nemestrina). Primate Biol 2018; 5:7-13. [PMID: 32110712 PMCID: PMC7041523 DOI: 10.5194/pb-5-7-2018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 03/12/2018] [Indexed: 12/02/2022] Open
Abstract
We present a case of spontaneous meningioma in a female pig-tailed macaque (Macaca nemestrina) more than 24 years old. Clinically, the monkey displayed slow, weak, and insecure movements and poor vision. A tumorous mass was present at the floor of the cranial vault extending from the optic chiasm towards the foramen magnum. It compressed adjacent parts of the brain, infiltrated the sphenoidal and occipital bone, and showed transcranial expansion into the pharyngeal area. Histologically, the tumor was consistent with a meningioma displaying mostly meningothelial and some microcystic components. Since only six cases of meningiomas in nonhuman primates have been reported so far and only two of these meningiomas have been described in detail, the findings of each case should be reported to expand the knowledge base of this type of tumor. In addition, this is the first description of a meningioma in pig-tailed macaques.
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Affiliation(s)
| | - Martina Bleyer
- Pathology Unit, German Primate Center, Göttingen, 37077, Germany
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Factors Associated with Recurrence of Intracranial Meningiomas After Surgical Resection: A Retrospective Single-Center Study. INT J GERONTOL 2018. [DOI: 10.1016/j.ijge.2017.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Abstract
Meningiomas originate in the central nervous system and are the most common intracranial benign tumor. However, although rarely, they can develop extracranially. Primary extracranial meningiomas are frequently misdiagnosed, resulting in inappropriate clinical management. The most common sites of extracranial meningiomas include the skull, scalp, orbit, nose, paranasal sinuses, middle ear, neck, and skin. A 77-year-old woman presented with a mass on her left eyebrow. Computed tomography revealed an enhancing soft tissue mass in the left frontal area. The differential diagnoses included benign and malignant tumors. The patient underwent surgical excision by a direct approach, with dissection through the galea plane. Histological examination showed tumor cells arranged in sheets or whorls, with occasional psammoma bodies. The margins were free of tumor. The mass measured 2.1 × 1.1 × 2 cm, and was diagnosed as an extracranial meningioma. The patient had no recurrence 1 year later. Extracranial meningiomas are rare; nonetheless, ectopic meningioma should be considered in the differential diagnosis of any mass lesion in the eyebrow region.
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Montibeller GR, Schackmann B, Urbschat S, Oertel JMK. Effect of granulocyte colony–stimulating factor on the cochlear nuclei after creation of a partial nerve lesion: an experimental study in rats. J Neurosurg 2018; 128:296-303. [DOI: 10.3171/2016.10.jns161109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVEThe risk of injury of the cochlear nerve during angle (CPA) surgery is high. Granulocyte colony–stimulating factor (G-CSF) has been found in various experimental models of peripheral and CNS injury to have a neuroprotective effect by inhibiting apoptosis and inflammation. However, to the authors' knowledge, the influence of G-CSF on cochlear nerve regeneration has not been reported. This study investigated the neuroprotective effect of G-CSF after a partial cochlear nerve lesion in rats.METHODSA lesion of the right cochlear nerve in adult male Sprague-Dawley rats was created using a water-jet dissector with a pressure of 8 bar. In the first group (G-CSF-post), G-CSF was administrated on Days 1, 3, and 5 after the surgery. The second group (G-CSF-pre/post) was treated with G-CSF 1 day before and 1, 3, and 5 days after applying the nerve injury. The control group received sodium chloride after nerve injury at the various time points. Brainstem auditory evoked potentials (BAEPs) were measured directly before and after nerve injury and on Days 1 and 7 to evaluate the acoustic function of the cochlear nerve. The animals were sacrificed 1 week after the operation, and their brains were fixed in formalin. Nissl staining of the cochlear nuclei was performed, and histological sections were analyzed with a light microscope and an image-processing program. The numbers of neurons in the cochlear nuclei were assessed.RESULTSThe values for Waves 2 and 4 of the BAEPs decreased abruptly in all 3 groups in the direct postoperative measurement. Although the amplitude in the control group did not recover, it increased in both treatment groups. According to 2-way ANOVA, groups treated with G-CSF had a significant increase in BAEP Wave II amplitudes on the right side (p = 0.0401) after the applied cochlear nerve injury. With respect to Wave IV, a trend toward better recovery in the G-CSF groups was found, but this difference did not reach statistical significance. In the histological analysis, higher numbers of neurons were found in the G-CSF groups. In the statistical analysis, the difference in the numbers of neurons between the control and G-CSF-post groups reached significance (p = 0.0086). The difference in the numbers of neurons between the control and G-CSF-pre/post groups and between the G-CSF-post and G-CSF-pre/post groups did not reach statistical significance.CONCLUSIONSThe use of G-CSF improved the function of the eighth cranial nerve and protected cochlear nucleus cells from destruction after a controlled partial injury of the nerve. These findings might be relevant for surgery that involves CPA tumors. The use of G-CSF in patients with a lesion in the CPA might improve postoperative outcomes.
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Mukherjee D, Hu JL, Chu RM. Isolated Extracranial Intraosseous Metastasis of an Intracranial Meningioma following Bevacizumab Therapy: Case Report and Review of the Literature. Asian J Neurosurg 2018; 13:98-101. [PMID: 29492134 PMCID: PMC5820909 DOI: 10.4103/1793-5482.185057] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Meningiomas account for a significant proportion of all primary intracranial tumors; distant metastasis is quite rare. We report a patient with resected, atypical meningioma. The patient's clinical course over 5 years included two craniotomies, a course of radiation, and a shortened course of bevacizumab. Only 5 months after starting bevacizumab, the patient developed an isolated left clavicular pathological fracture attributable to metastatic anaplastic meningioma. This constitutes the first report of meningioma with isolated extracranial intraosseous metastasis in the modern English literature and highlights concerns associated with the use of anti-angiogenic agents in promoting more invasive tumor phenotypes upon disease recurrence.
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Affiliation(s)
- Debraj Mukherjee
- Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Jethro L Hu
- Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Ray M Chu
- Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
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Abstract
RATIONALE Meningiomas are mostly regarded as benign tumors histologically,accounting for 13% to 26% of all primary intracranial tumors.It is testified that multiple meningiomas occur in <10% of cases.A case of concurrent grades I and II in the same patient in our hospital was described. PATIENT CONCERN A 66-year-old man who was experiencing headache and weakening in the left limbs, which gradually improved.Then, the myodynamia of left limb was weakening to level 3 and the muscular tension of left limbwas too strong for 1 year. Finally the man was admitted to our department of neurosurgery. DIAGNOSES According the symptoms, signs and imaging data the patient. The 2 masses was diagnosed as the meningioma.Finally the histological examination showed the meningioma located in the right parietal lobe was diagnosed as fibrous meningioma,WHOgrade I, whereas meningioma reaching to the skull as atypical meningioma, WHO grade II. INTERVENTIONS The 2 masses including the invaded dura mater,parietal skull, and adjacent subcutaneous tissue were excised wholly In the process of surgery. OUTCOMES There is no sign caused by recurrent tumor. within the half year.The physical of the patient is good LESSONS:: The patient with multicentric meningiomas should keep follow-up closely in case the meningiomas show the malignant characteristics.
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Affiliation(s)
| | | | - Tong Wang
- Department of Neurosurgery, The Third Hospital of MianYang, Sichuan, China
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Grossbach AJ, Mahaney KB, Menezes AH. Pediatric meningiomas: 65-year experience at a single institution. J Neurosurg Pediatr 2017; 20:42-50. [PMID: 28474981 DOI: 10.3171/2017.2.peds16497] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Meningiomas are relatively common, typically benign neoplasms in adults; however, they are relatively rare in the pediatric population. Pediatric meningiomas behave very differently from their adult counterparts, tending to have more malignant histological subtypes and recur more frequently. The authors of this paper investigate the risk factors, pathological subtypes, and recurrence rates of pediatric meningiomas. METHODS A retrospective chart review was conducted at the University of Iowa to identify patients 20 years old and younger with meningiomas in the period from 1948 to 2015. RESULTS Sixty-seven meningiomas in 39 patients were identified. Eight patients had neurofibromatosis, 2 had a family history of meningioma, and 3 had prior radiation exposure. Twelve (31%) of the 39 patients had WHO Grade II or III lesions, and 15 (38%) had recurrent lesions after resection. CONCLUSIONS Pediatric meningiomas should be considered for early treatment and diligent follow-up.
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Affiliation(s)
- Andrew J Grossbach
- Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa; and
| | - Kelly B Mahaney
- Department of Neurosurgery, University of Virginia, Charlottesville, Virginia
| | - Arnold H Menezes
- Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa; and
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Zweckberger K, Hallek E, Vogt L, Giese H, Schick U, Unterberg AW. Prospective analysis of neuropsychological deficits following resection of benign skull base meningiomas. J Neurosurg 2017; 127:1242-1248. [PMID: 28186454 DOI: 10.3171/2016.10.jns161936] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Resection of skull base tumors is challenging. The introduction of alternative treatment options, such as radiotherapy, has sparked discussion regarding outcome in terms of quality of life and neuropsychological deficits. So far, however, no prospective data are available on this topic. METHODS A total of 58 patients with skull base meningiomas who underwent surgery for the first time were enrolled in this prospective single-center trial. The average age of the patients was 56.4 ± 12.5 years. Seventy-nine percent of the tumors were located within the anterior skull base. Neurological examinations and neuropsychological testing were performed at 3 time points: 1 day prior to surgery (T1), 3-5 months after surgery (T2), and 9-12 months after surgery (T3). The average follow-up duration was 13.8 months. Neuropsychological assessment consisted of quality of life, depression and anxiety, verbal learning and memory, cognitive speed, attention and concentration, figural memory, and visual-motor speed. RESULTS Following surgery, 23% of patients showed transient neurological deficits and 12% showed permanent new neurological deficits with varying grades of manifestation. Postoperative quality of life, however, remained stable and was slightly improved at follow-up examinations at T3 (60.6 ± 21.5 vs 63.6 ± 24.1 points), and there was no observed effect on anxiety and depression. Long-term verbal memory, working memory, and executive functioning were slightly affected within the first months following surgery and appeared to be the most vulnerable to impairment by the tumor or the resection but were stable or improved in the majority of patients at long-term follow-up examinations after 1 year. CONCLUSIONS This report describes the first prospective study of neuropsychological outcomes following resection of skull base meningiomas and, as such, contributes to a better understanding of postoperative impairment in these patients. Despite deterioration in a minority of patients on subscales of the measures used, the majority demonstrated stable or improved outcome at follow-up assessments.
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Messerer M, Richoz B, Cossu G, Dhermain F, Hottinger A, Parker F, Levivier M, Daniel R. Recent advances in the management of atypical meningiomas. Neurochirurgie 2016; 62:213-22. [DOI: 10.1016/j.neuchi.2016.02.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 01/17/2016] [Accepted: 02/26/2016] [Indexed: 11/26/2022]
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Moussa WMM, Mohamed MAA. Prophylactic use of anticoagulation and hemodilution for the prevention of venous thromboembolic events following meningioma surgery. Clin Neurol Neurosurg 2016; 144:1-6. [DOI: 10.1016/j.clineuro.2016.02.040] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 02/23/2016] [Accepted: 02/28/2016] [Indexed: 11/28/2022]
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Lin Q, Ling F, Xu G. Invasive benign meningioma: Clinical characteristics, surgical strategies and outcomes from a single neurosurgical institute. Exp Ther Med 2016; 11:2537-2540. [PMID: 27284345 DOI: 10.3892/etm.2016.3223] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Accepted: 02/18/2016] [Indexed: 12/26/2022] Open
Abstract
The aim of the present study was to improve the prognosis for patients with invasive benign meningioma by increasing the precision of pre-operative evaluation and refining the surgical resection strategy. A retrospective review of all the cases of invasive benign meningioma admitted to a single institute from 2005 to 2010 was conducted. The clinical characteristics, magnetic resonance imaging (MRI) findings, refined surgical strategies and outcomes were summarized and analyzed. There were 19 cases of invasive benign meningioma among 254 cases of meningioma. Of the earliest 4 cases, a traditional extra-capsular surgical removal approach was applied, which resulted in permanent neurological deficits for all cases. A modified surgical strategy combining intra- and extra-capsular resection techniques was employed for the subsequent 15 cases, which lead to mild neurological impairment in only 1 case. Pre-operative recognition of this unique sub-type of meningioma maybe facilitated by its typical MRI study findings, and the combination of intra- and extra-capsular resection techniques may be of critical importance in achieving complete tumor removal while maintaining intact neurological functions.
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Affiliation(s)
- Qingtang Lin
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing 100054, P.R. China
| | - Feng Ling
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing 100054, P.R. China
| | - Geng Xu
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing 100054, P.R. China
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Fonkem E, Dandashi JA, Stroberg E, Garrett D, Harris FS, El Nihum IM, Cooper J, Dayawansa S, Huang JH. A retrospective analysis of meningioma in Central Texas. J Epidemiol Glob Health 2016; 6:87-93. [PMID: 26851351 PMCID: PMC7320443 DOI: 10.1016/j.jegh.2016.01.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 01/06/2016] [Accepted: 01/13/2016] [Indexed: 11/25/2022] Open
Abstract
Documented meningioma cases in Central Texas (USA) from 1976 to 2013 were studied utilizing the Scott & White Brain Tumor Registry. All the cases examined were histologically diagnosed as meningiomas. Of the 372 cases, most were benign tumors (p < 0.05). A majority of the patients were females (p < 0.05). Elderly individuals (>45 years of age) superseded the younger patients in meningioma incidence (p < 0.05). Previous data regarding meningioma epidemiology in Texas showed a higher incidence in black patients when compared to white patients. By contrast, this study’s findings of Central Texas meningioma demographics show increased incidence of meningiomas in white patients (p < 0.05). This interesting find in meningioma prevalence warrants further investigation with a larger sample size, in order to establish validity and further parse out possible causes of meningioma development among white individuals.
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Affiliation(s)
- Ekokobe Fonkem
- Department of Neurosurgery, Baylor Scott & White Healthcare, Temple, TX, USA
| | - Jad A Dandashi
- College of Medicine, Texas A&M Health Science Center, Temple, TX, USA
| | - Edana Stroberg
- Department of Pathology, Baylor Scott & White Healthcare, Temple, TX, USA
| | - David Garrett
- Department of Neurosurgery, Baylor Scott & White Healthcare, Temple, TX, USA
| | - Frank S Harris
- Department of Neurosurgery, Baylor Scott & White Healthcare, Temple, TX, USA; College of Medicine, Texas A&M Health Science Center, Temple, TX, USA; Department of Pathology, Baylor Scott & White Healthcare, Temple, TX, USA
| | - Ibrahim M El Nihum
- Department of Neurosurgery, Baylor Scott & White Healthcare, Temple, TX, USA
| | - James Cooper
- Department of Neurosurgery, Baylor Scott & White Healthcare, Temple, TX, USA
| | - Samantha Dayawansa
- Department of Neurosurgery, Baylor Scott & White Healthcare, Temple, TX, USA.
| | - Jason H Huang
- Department of Neurosurgery, Baylor Scott & White Healthcare, Temple, TX, USA; College of Medicine, Texas A&M Health Science Center, Temple, TX, USA
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