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Ren L, Hua L, Bao Z, Deng J, Wang D, Chen J, Chen H, Juratli TA, Wakimoto H, Gong Y. Distinct clinical outcome of microcystic meningioma as a WHO grade 1 meningioma subtype. J Neurooncol 2023; 161:193-202. [PMID: 35612696 DOI: 10.1007/s11060-022-04034-3] [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] [Received: 04/28/2022] [Accepted: 05/11/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To evaluate the clinicopathological characteristics, radiology, and long-term outcomes of microcystic meningiomas (MM) and compare it with other subtypes of meningiomas managed at a single neurosurgical center. METHODS A total of 87 consecutive patients who underwent surgical resection and were diagnosed as MM between 2005 and 2016 were enrolled for analysis. Clinicopathological, radiology, and prognostic information was collected and analyzed. Progression free survival (PFS) was compared with 659 patients with other subtypes of WHO grade 1 meningiomas and 167 patients with atypical meningiomas treated during the same period. RESULTS Fifty six females and 31 males with MM were analyzed. Peri-tumor brain edema was frequent on T2 WI (85%).12 patients (13.8%) experienced tumor progression during the mean follow-up of 101.66 ± 40.92 months. The median PFS was unavailable, and the 5, 10, and 15 year progression-free rates were 96.9%, 84.0%, and 73.9%, respectively. Univariate COX analysis demonstrated skull base location and higher Ki-67 index as significant negative prognostic factors for PFS (P < 0.05); multivariate analysis identified tumor location and Ki-67 index as independent factors (P < 0.01), as well. Of note, the PFS of MM was worse than other WHO grade 1 subtypes (P < 0.001), but better than atypical meningiomas (P < 0.001), and the PFS differences were retained even when the analysis was limited to the patients receiving GTR (P < 0.05). CONCLUSION The PFS of MM was worse than other WHO grade 1 subtypes and better than atypical meningiomas. Skull base location and higher Ki-67 index were independent negative prognostic factors in MM.
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Affiliation(s)
- Leihao Ren
- Department of Neurosurgery, Shanghai Medical College, Huashan Hospital, Fudan University, 12# Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China.,Institute of Neurosurgery, Fudan University, 12# Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China.,Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Fudan University, 12# Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China
| | - Lingyang Hua
- Department of Neurosurgery, Shanghai Medical College, Huashan Hospital, Fudan University, 12# Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China.,Institute of Neurosurgery, Fudan University, 12# Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China.,Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Fudan University, 12# Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China
| | - Zhongyuan Bao
- Department of Neurosurgery, The Affiliated Wuxi No. 2 People's Hospital of Nanjing Medical University, Wuxi, China
| | - Jiaojiao Deng
- Department of Neurosurgery, Shanghai Medical College, Huashan Hospital, Fudan University, 12# Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China.,Institute of Neurosurgery, Fudan University, 12# Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China.,Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Fudan University, 12# Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China
| | - Daijun Wang
- Department of Neurosurgery, Shanghai Medical College, Huashan Hospital, Fudan University, 12# Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China.,Institute of Neurosurgery, Fudan University, 12# Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China.,Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Fudan University, 12# Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China
| | - Jiawei Chen
- Department of Neurosurgery, Shanghai Medical College, Huashan Hospital, Fudan University, 12# Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China.,Institute of Neurosurgery, Fudan University, 12# Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China.,Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Fudan University, 12# Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China
| | - Hong Chen
- Department of Pathology, Shanghai Medical College, Huashan Hospital, Fudan University, Shanghai, China
| | - Tareq A Juratli
- Department of Neurosurgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - Hiroaki Wakimoto
- Department of Neurosurgery, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - Ye Gong
- Department of Neurosurgery, Shanghai Medical College, Huashan Hospital, Fudan University, 12# Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China. .,Institute of Neurosurgery, Fudan University, 12# Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China. .,Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Fudan University, 12# Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China. .,Department of Critical Care Medicine, Shanghai Medical College, Huashan Hospital, Fudan University, 12# Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China.
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Kulanthaivelu K, Lanka V, Chandran C, Nandeesh BN, Tiwari S, Mahadevan A, Prasad C, Saini J, Bhat MD, Chakrabarti D, Pruthi N, Vazhayil V, Sadashiva N, Srinivas D. Microcystic Meningiomas: MRI-Pathologic Correlation. J Neuroimaging 2020; 30:704-718. [PMID: 32521093 DOI: 10.1111/jon.12743] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 05/26/2020] [Accepted: 05/26/2020] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND AND PURPOSE Microcystic meningiomas (MM) are a distinctive, rare subtype of Grade I meningiomas with limited radiological descriptions. We intend to identify unique imaging phenotypes and seek radiopathological correlations. METHODS Retrospective analysis of histopathologically proven MM was undertaken. Clinicodemographic profiles, imaging, and histopathological characteristics were recorded. Spearman rank correlations among radiological and pathological attributes were performed. RESULTS Twenty-eight cases were analyzed (mean age = 45.5 years; M:F = 1:1.54; mean volume = 50.1 mL; supratentorial n = 27). Most lesions were markedly T2 hyperintense (higher than peritumoral brain edema-a unique finding) (89.3%) and showed invariable diffusion restriction, severe peritumoral brain edema (edema index >2 in 64.3%), a "storiform" pattern on T2-weighted images (T2WI) (75%), reticular pattern on postcontrast T1 (78.6%)/diffusion-weighted images (DWI) (65.4%), hyperperfusion, T1 hypointensity (84.6%), and absence of blooming on susceptibility-weighted image (80.9%). Storiform/reticular morphology correlated with large cysts on histopathology (ρ = .56; P = .005753). Lesion dimension positively correlated with reticular morphology on imaging (ρ = .59; P = .001173), higher flow voids (ρ = .65; P = .00027), and greater microcystic changes on histopathology (ρ = .51; P = .006778). Peritumoral brain edema was higher for lesions demonstrating greater angiomatous component (ρ = .46; P = .014451). CONCLUSIONS We have elucidated varied neuroimaging features and highlighted pathological substrates of crucial imaging findings of MM. MM ought to be considered as an imaging possibility in an extra-axial lesion with a marked hypodensity on noncontrast computed tomography, markedly T2-hyperintense/T1-hypointense signal, and a storiform/reticular pattern on T2W/GdT1w//DWI.
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Affiliation(s)
- Karthik Kulanthaivelu
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Vivek Lanka
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Chitra Chandran
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Bevinhalli N Nandeesh
- Department of Neuropathology, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Sarbesh Tiwari
- Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences Jodhpur, Jodhpur, India
| | - Anita Mahadevan
- Department of Neuropathology, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Chandrajit Prasad
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Jitender Saini
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Maya D Bhat
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Dhritiman Chakrabarti
- Department of Neuroanaesthesia and Neurocritical care, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Nupur Pruthi
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Vikas Vazhayil
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Nishanth Sadashiva
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Dwarakanath Srinivas
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, India
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3
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Jacobo JA, Mamani R, Jimenez SM, Avendaño J, Nuñez S. Microcystic meningioma associated with other meningioma subtypes: A diagnostic challenge, report of two cases. INTERDISCIPLINARY NEUROSURGERY 2020. [DOI: 10.1016/j.inat.2019.100548] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Xiaoai K, Qing Z, Lei H, Junlin Z. Differentiating microcystic meningioma from atypical meningioma using diffusion-weighted imaging. Neuroradiology 2020; 62:601-607. [PMID: 31996968 DOI: 10.1007/s00234-020-02374-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 01/20/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE Microcystic meningioma (MCM) appears similar to atypical meningioma(AM) as per conventional diagnostic imaging. However, considering their different recurrence rate and prognosis, accurate differential diagnosis is essential for determine the appropriate treatment strategy. The aim of the study was to differentiate MCM from AM by diffusion-weighted imaging (DWI), in order to provide the basis for accurate preoperative diagnosis. METHODS The preoperative clinical data, conventional MRI and DWI data of 15 MCM and 30 AM cases were retrospectively analyzed. The average apparent diffusion coefficient (ADCmean), minimum ADC (ADCmin) and normalized ADC (nADC) between MCM and AM were compared using two sample t-tests. The value of ADCmean, ADCmin and nADC in the differential diagnosis of MCM and AM were calculated by the receiver operating curve (ROC) analysis. RESULTS The ADCmean (1.06 ± 0.10 vs 0.80 ± 0.11 × 10-3 mm2/s; P < 0.001), ADCmin (0.99 ± 0.10 vs 0.74 ± 0.12 × 10-3 mm2/s; P < 0.001) and nADC (1.45 ± 0.17 vs 1.07 ± 0.17; P < .0001) were significantly higher in MCM compared to AM. ADCmean of 0.91 × 10-3 mm2/s showed an optimum area under the ROC curve of 0.967 ± 0.022, and distinguished between MCM and AM with 86.67% sensitivity, 100% specificity and 88.89% accuracy. In addition, its positive and negative predictive values were 96.29% and 77.78% respectively. CONCLUSIONS DWI can differentially diagnose MCM and AM, and ADCmean is a potential quantitative tool that can improve preoperative diagnosis of both tumors.
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Affiliation(s)
- Ke Xiaoai
- Department of Radiology, Lanzhou University Second Hospital, Second Clinical School, Lanzhou University, Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, 730030, China
| | - Zhou Qing
- Department of Radiology, Lanzhou University Second Hospital, Second Clinical School, Lanzhou University, Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, 730030, China
| | - Han Lei
- Department of Radiology, Lanzhou University Second Hospital, Second Clinical School, Lanzhou University, Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, 730030, China
| | - Zhou Junlin
- Department of Radiology, Lanzhou University Second Hospital, Second Clinical School, Lanzhou University, Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, 730030, China.
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Tamada T, Enatsu R, Kikuchi N, Mikuni N. Meningioma mimicking an intraparenchymal cystic tumor. NAGOYA JOURNAL OF MEDICAL SCIENCE 2018; 80:431-434. [PMID: 30214093 PMCID: PMC6125649 DOI: 10.18999/nagjms.80.3.431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Meningiomas rarely exhibit cystic lesions with mural nodules, and may be misdiagnosed as intraparenchymal cystic tumors. We herein present a 64-year-old woman with a cystic lesion and enhancing mural nodule in the left temporal lobe accompanied by peritumoral brain edema. Differential diagnoses included low-grade gliomas, hemangioblastoma, and cystic meningioma. Gross total resection of the tumor was achieved through a temporal surgical approach. Intraoperative findings showed that the tumor was an extraparenchymal tumor. The cyst was covered by an extraparenchymal thin membrane and the cystic fluid was yellowish in color. The final result of the pathological examination was microcystic meningioma, WHO grade I. Although intraparenchymal tumors, such as hemangioblastoma, ganglioglioma, pilocytic astrocytoma, and pleomorphic xanthoastrocytoma, commonly display this MRI pattern, meningioma needs to be included in the differential diagnosis.
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Affiliation(s)
- Tomoaki Tamada
- Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Rei Enatsu
- Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Noriaki Kikuchi
- Department of Surgical Pathology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Nobuhiro Mikuni
- Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan
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Characteristic features and proposed classification in 69 cases of intracranial microcystic meningiomas. Neurosurg Rev 2018; 42:443-453. [PMID: 29721630 DOI: 10.1007/s10143-018-0982-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 03/16/2018] [Accepted: 04/25/2018] [Indexed: 10/17/2022]
Abstract
Microcystic meningioma (MM) is a rare subtype of intracranial meningiomas, with clinical and radiologic features not well characterized in the literature. Based on our experience, we propose a classification system of intracranial MMs. We reviewed the medical records, radiographic studies, and operative notes of a group of consecutive patients with intracranial MM. The mean age of the 69 patients was 46.8 ± 10.6 years (range, 21-75 years). Three types of intracranial MMs could be identified. Type 1 MMs presented as a solid lesion, hypointense or isointense on T1WI, hyperintense on T2WI, and homogeneous or heterogeneous enhancement, and were found in 43 patients (67.2%). Type 2 MMs represented signals similar to CSF both on T1WI and T2WI, and faint reticular enhancement with marginal enhancement, and these were found in 7 patients (10.9%). Type 3 MMs consisted of cystic-solid or cystic lesion and were found in 14 patients (21.9%). Significant differences were observed among the different types of MMs for the following variables: sex, presence of severe peritumoral brain edema (PTBE), and extent of tumor resection. Females were found in all of patients with type 2 MMs, but were only 35.7% of those with type 3 MMs (P = 0.018). Severe PTBEs were more common among patients with type 1 MMs (55.8%) than among those with type 2 (14.3%) and type 3 MMs (14.3%) (P = 0.007). Type 1 MMs (97.7%) were associated with a significantly higher rate of gross total resection compared with the other two types (71.4 and 78.6%) (P = 0.019). Total length of hospital stay after craniotomy ranged from 4 to 30 days (median, 8 days). There were no significant differences in progression-free survival among the three types of MMs (P = 0.788). The current classification identifies three distinct types of intracranial MM based on their radiological findings and growth patterns. The type 1 MMs are more commonly associated with severe PTBE. Type 2 and Type 3 MMs have a higher predilection towards parasaggital location with venous involvement and therefore have a lower rate of gross total resection.
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7
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Hussain NS, Moisi MD, Keogh B, McCullough BJ, Rostad S, Newell D, Gwinn R, Foltz G, Mayberg M, Aguedan B, Good V, Fouke SJ. Dynamic susceptibility contrast and dynamic contrast-enhanced MRI characteristics to distinguish microcystic meningiomas from traditional Grade I meningiomas and high-grade gliomas. J Neurosurg 2017; 126:1220-1226. [DOI: 10.3171/2016.3.jns14243] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE
Microcystic meningioma (MM) is a meningioma variant with a multicystic appearance that may mimic intrinsic primary brain tumors and other nonmeningiomatous tumor types. Dynamic susceptibility contrast (DSC) and dynamic contrast-enhanced (DCE) MRI techniques provide imaging parameters that can differentiate these tumors according to hemodynamic and permeability characteristics with the potential to aid in preoperative identification of tumor type.
METHODS
The medical data of 18 patients with a histopathological diagnosis of MM were identified through a retrospective review of procedures performed between 2008 and 2012; DSC imaging data were available for 12 patients and DCE imaging data for 6. A subcohort of 12 patients with Grade I meningiomas (i.e., of meningoepithelial subtype) and 54 patients with Grade IV primary gliomas (i.e., astrocytomas) was also included, and all preoperative imaging sequences were analyzed. Clinical variables including patient sex, age, and surgical blood loss were also included in the analysis. Images were acquired at both 1.5 and 3.0 T. The DSC images were acquired at a temporal resolution of either 1500 msec (3.0 T) or 2000 msec (1.5 T). In all cases, parameters including normalized cerebral blood volume (CBV) and transfer coefficient (kTrans) were calculated with region-of-interest analysis of enhancing tumor volume. The normalized CBV and kTrans data from the patient groups were analyzed with 1-way ANOVA, and post hoc statistical comparisons among groups were conducted with the Bonferroni adjustment.
RESULTS
Preoperative DSC imaging indicated mean (± SD) normalized CBVs of 5.7 ± 2.2 ml for WHO Grade I meningiomas of the meningoepithelial subtype (n = 12), 4.8 ± 1.8 ml for Grade IV astrocytomas (n = 54), and 12.3 ± 3.8 ml for Grade I meningiomas of the MM subtype (n = 12). The normalized CBV measured within the enhancing portion of the tumor was significantly higher in the MM subtype than in typical meningiomas and Grade IV astrocytomas (p < 0.001 for both). Preoperative DCE imaging indicated mean kTrans values of 0.49 ± 0.20 min−1 in Grade I meningiomas of the meningoepithelial subtype (n = 12), 0.27 ± 0.12 min−1 for Grade IV astrocytomas (n = 54), and 1.35 ± 0.74 min−1 for Grade I meningiomas of the MM subtype (n = 6). The kTrans was significantly higher in the MM variants than in the corresponding nonmicrocystic Grade 1 meningiomas and Grade IV astrocytomas (p < 0.001 for both). Intraoperative blood loss tended to increase with increased normalized CBV (R = 0.45, p = 0.085).
CONCLUSIONS
An enhancing cystic lesion with a normalized CBV greater than 10.3 ml or a kTrans greater than 0.88 min−1 should prompt radiologists and surgeons to consider the diagnosis of MM rather than traditional Grade I meningioma or high-grade glioma in planning surgical care. Higher normalized CBVs tend to be associated with increased intraoperative blood loss.
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Affiliation(s)
| | - Marc D. Moisi
- 1Swedish Neuroscience Institute, Swedish Medical Center, and
| | - Bart Keogh
- 1Swedish Neuroscience Institute, Swedish Medical Center, and
- 2Radia Inc. PS, Everett, Washington
| | - Brendan J. McCullough
- 1Swedish Neuroscience Institute, Swedish Medical Center, and
- 2Radia Inc. PS, Everett, Washington
| | - Steven Rostad
- 1Swedish Neuroscience Institute, Swedish Medical Center, and
- 3CellNetix Pathology and Laboratories, Seattle; and
| | - David Newell
- 1Swedish Neuroscience Institute, Swedish Medical Center, and
| | - Ryder Gwinn
- 1Swedish Neuroscience Institute, Swedish Medical Center, and
| | - Gregory Foltz
- 1Swedish Neuroscience Institute, Swedish Medical Center, and
| | - Marc Mayberg
- 1Swedish Neuroscience Institute, Swedish Medical Center, and
| | | | | | - Sarah J. Fouke
- 1Swedish Neuroscience Institute, Swedish Medical Center, and
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Boukobza M, Cebula H, Pop R, Kouakou F, Sadoun A, Coca HA, Polivka M, Diemidio P, Ganau M, George B, Froelich S, Proust F, Chibbaro S. Cystic meningioma: radiological, histological, and surgical particularities in 43 patients. Acta Neurochir (Wien) 2016; 158:1955-64. [PMID: 27510826 DOI: 10.1007/s00701-016-2898-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2016] [Accepted: 07/13/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND The presence of cysts is a rare occurrence for intracranial meningiomas in adults. We report our experience in a large consecutive series of cystic meningiomas. METHOD We prospectively collected data for a dedicated database of cystic meningioma cases between January 2004 and December 2011 in two tertiary neurosurgical centers. Studied data included preoperative imaging, surgical records, and pathology reports. RESULTS Among 1214 surgeries for intracranial meningioma, we identified 43 cases of cystic meningioma, corresponding to an incidence of 3.5 %. The most common localization was the hemispheric convexity (17/43 cases). Twenty-eight patients had intratumoral cysts, nine peritumoral, and five mixed intra and extratumoral. In 29 patients with available diffusion imaging, ADC coefficients were significantly lower in grade II-III tumors compared to grade I (p = 0.01). Complete resection of the cystic components was possible in 27/43 patients (63 %); partial resection in 4/43 (9 %); in 6/43 (14 %) cyst resection was not possible but multiple biopsies were performed from the cystic walls; in another 6/43 (14 %) the cystic wall was not identified during surgery. Cells with neoplastic features were identified within the cyst walls at pathology in 26/43 cases (60 %). All patients were followed-up for 24 months; long-term follow-up was available only in 32 patients for an average period of 49 months (range, 36-96 months). No recurrence requiring surgery was observed. CONCLUSIONS Cystic meningiomas are rare. Cells with neoplastic features are often identified within the cyst walls. Complete cyst resection is recommendable when considered technically feasible and safe.
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Affiliation(s)
- Monique Boukobza
- Department of Neuroradiology, Lariboisière University Hospital, Paris, France
| | - Helene Cebula
- Department of Neurosurgery, Hautepierre University Hospital, Strasbourg, France
| | - Raoul Pop
- Department of Interventional Neuroradiology UF6954, Hautepierre University Hospital, 1 Avenue Moliere, 67098, Strasbourg, France.
| | - Fulbert Kouakou
- Department of Neurosurgery, Hautepierre University Hospital, Strasbourg, France
| | - Amirouche Sadoun
- Department of Neurosurgery, Hautepierre University Hospital, Strasbourg, France
| | - Hugo Andres Coca
- Department of Neurosurgery, Hautepierre University Hospital, Strasbourg, France
| | - Marc Polivka
- Department of Histopathology, Lariboisière University Hospital, Paris, France
| | - Paolo Diemidio
- Department of Neurosurgery, Hautepierre University Hospital, Strasbourg, France
| | - Mario Ganau
- Department of Neurosurgery, Hautepierre University Hospital, Strasbourg, France
| | - Bernard George
- Department of Neurosurgery, Lariboisière University Hospital, Paris, France
| | - Sebastien Froelich
- Department of Neurosurgery, Lariboisière University Hospital, Paris, France
| | - Francois Proust
- Department of Neurosurgery, Hautepierre University Hospital, Strasbourg, France
| | - Salvatore Chibbaro
- Department of Neurosurgery, Hautepierre University Hospital, Strasbourg, France
- Department of Neurosurgery, Lariboisière University Hospital, Paris, France
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Terada Y, Toda H, Okumura R, Ikeda N, Yuba Y, Katayama T, Iwasaki K. Reticular Appearance on Gadolinium-enhanced T1- and Diffusion-weighted MRI, and Low Apparent Diffusion Coefficient Values in Microcystic Meningioma Cysts. Clin Neuroradiol 2016; 28:109-115. [DOI: 10.1007/s00062-016-0527-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 06/17/2016] [Indexed: 10/21/2022]
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10
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Wang P, Han S, Liu N, Yu C, Qi X, Zhu M, Zhang X, Wang LI, Yan C. Peritumoral cystic meningioma: A report of two cases and review of the literature. Exp Ther Med 2016; 11:904-908. [PMID: 26998010 DOI: 10.3892/etm.2016.2999] [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: 11/16/2014] [Accepted: 10/27/2015] [Indexed: 11/06/2022] Open
Abstract
The present study reported two cases of cystic meningioma. The clinical manifestations, magnetic resonance imaging (MRI) scan and histological aspects of the lesion and the associated cyst were examined. The classification of cystic meningioma was also discussed. The present study focused on the formation, diagnosis and management of the peritumoral cystic meningioma, and aimed to clarify certain contradictions in the literature concerning the formation of the peritumoral cyst meningioma: MRI alone is inadequate to determine the type of cystic meningioma, or to identify neoplastic cells on the cystic wall. In conclusion, surgical removal of the entire cyst is recommended in peritumoral cyst meningioma.
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Affiliation(s)
- Pengfei Wang
- Department of Neurosurgery, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing 100093, P.R. China
| | - Song Han
- Department of Neurosurgery, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing 100093, P.R. China
| | - Ning Liu
- Department of Neurosurgery, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing 100093, P.R. China
| | - Chunjiang Yu
- Department of Neurosurgery, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing 100093, P.R. China
| | - Xueling Qi
- Department of Pathology, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing 100093, P.R. China
| | - Mingwang Zhu
- Department of Radiation, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing 100093, P.R. China
| | - Xiangqian Zhang
- Department of Neurosurgery, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing 100093, P.R. China
| | - L I Wang
- Department of Neurosurgery, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing 100093, P.R. China
| | - Changxiang Yan
- Department of Neurosurgery, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing 100093, P.R. China
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