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Toader C, Covache-Busuioc RA, Bratu BG, Glavan LA, Popa AA, Ciurea AV. Successful Surgical Treatment of a Giant Intraventricular Meningioma: A Case Report and Literature Review. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:560. [PMID: 38674205 PMCID: PMC11052000 DOI: 10.3390/medicina60040560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 03/24/2024] [Accepted: 03/28/2024] [Indexed: 04/28/2024]
Abstract
In our study, we document the case of a 48-year-old patient who presented at our clinic with various neurological disturbances. Magnetic Resonance Imaging revealed the presence of an intraventricular meningioma located in the body of the left lateral ventricle measuring 60 mm in diameter. This tumor was classified as a giant meningioma, accompanied by a significant amount of digitiform-type edema. A surgical procedure was conducted, resulting in a gross total resection of the tumor. Histopathological analysis identified the tumor as a fibrous meningioma. Postoperative assessments, as well as follow-ups conducted at 3 months and 1 year post-surgery, indicated considerable neurological improvement. The patient exhibited a remission of hemiparesis and gait disturbances along with a marginal improvement in the status of expressive aphasia. This case report underscores the significance of achieving total and safe resection of the tumor and includes an analysis of various cases from the literature, particularly focusing on those that describe minimally invasive surgical approaches and highlight the benefits of radiosurgery in the treatment of giant intraventricular meningiomas.
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Affiliation(s)
- Corneliu Toader
- Department of Neurosurgery “Carol Davila”, University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.T.); (B.-G.B.); (L.A.G.); (A.A.P.); (A.V.C.)
- Department of Neurosurgery, National Institute of Neurology and Neurovascular Diseases, 077160 Bucharest, Romania
| | - Razvan-Adrian Covache-Busuioc
- Department of Neurosurgery “Carol Davila”, University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.T.); (B.-G.B.); (L.A.G.); (A.A.P.); (A.V.C.)
| | - Bogdan-Gabriel Bratu
- Department of Neurosurgery “Carol Davila”, University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.T.); (B.-G.B.); (L.A.G.); (A.A.P.); (A.V.C.)
| | - Luca Andrei Glavan
- Department of Neurosurgery “Carol Davila”, University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.T.); (B.-G.B.); (L.A.G.); (A.A.P.); (A.V.C.)
| | - Andrei Adrian Popa
- Department of Neurosurgery “Carol Davila”, University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.T.); (B.-G.B.); (L.A.G.); (A.A.P.); (A.V.C.)
| | - Alexandru Vlad Ciurea
- Department of Neurosurgery “Carol Davila”, University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.T.); (B.-G.B.); (L.A.G.); (A.A.P.); (A.V.C.)
- Department of Neurosurgery, Sanador Clinical Hospital, 010991 Bucharest, Romania
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Umekawa M, Shinya Y, Hasegawa H, Katano A, Saito N. Primary Stereotactic Radiosurgery Provides Favorable Tumor Control for Intraventricular Meningioma: A Retrospective Analysis. J Clin Med 2023; 12:jcm12031068. [PMID: 36769714 PMCID: PMC9918074 DOI: 10.3390/jcm12031068] [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: 12/08/2022] [Revised: 01/19/2023] [Accepted: 01/24/2023] [Indexed: 01/31/2023] Open
Abstract
The surgical resection of intraventricular meningiomas (IVMs) remains challenging because of their anatomically deep locations and proximity to vital structures, resulting in non-negligible morbidity and mortality rates. Stereotactic radiosurgery (SRS) is a safe and effective treatment option, providing durable tumor control for benign brain tumors, but its outcomes for IVMs have rarely been reported. Therefore, the goal of the present study was to evaluate the SRS outcomes for IVMs at our institution. This retrospective observational study included 11 patients with 12 IVMs with a median follow-up period of 52 months (range, 3-353 months) treated with SRS using the Leksell Gamma Knife. Nine (75%) tumors were located in the trigone of the lateral ventricle, two (17%) in the body of the lateral ventricle, and one (8%) in the third ventricle. Tumor control was achieved in all cases, and seven (55%) decreased in size. Post-SRS perifocal edema was observed in four (37%; three asymptomatic and one symptomatic but transient) patients, all of which were resolved by the last follow-up. SRS appears to provide safe and excellent tumor control for IVMs. A longer follow-up with a larger number of cases is desired for a more solid conclusion.
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Affiliation(s)
- Motoyuki Umekawa
- Department of Neurosurgery, The University of Tokyo Hospital, Tokyo 113-8655, Japan
- Correspondence: ; Tel.: +81-3-5800-8853
| | - Yuki Shinya
- Department of Neurosurgery, The University of Tokyo Hospital, Tokyo 113-8655, Japan
| | - Hirotaka Hasegawa
- Department of Neurosurgery, The University of Tokyo Hospital, Tokyo 113-8655, Japan
| | - Atsuto Katano
- Department of Radiology, The University of Tokyo Hospital, Tokyo 113-8655, Japan
| | - Nobuhito Saito
- Department of Neurosurgery, The University of Tokyo Hospital, Tokyo 113-8655, Japan
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Cao D, Ou Y, Chen X, Guo Z, Chen Y, Chen J. Clinical outcomes after microsurgical resection of giant lateral ventricular meningiomas. Neurosurg Rev 2023; 46:33. [PMID: 36607461 DOI: 10.1007/s10143-022-01932-y] [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: 05/30/2022] [Revised: 10/13/2022] [Accepted: 12/21/2022] [Indexed: 01/07/2023]
Abstract
Giant lateral ventricular meningiomas (LVMs), with the largest diameter of at least 5 cm, form a distinct subset. The incidence of giant LVMs is considered to be relatively low. Here, we evaluated clinical characteristics, and clinical outcomes after microsurgical resection, especially functional outcomes and morbidity of giant LVMs. We retrospectively reviewed 49 patients with LVMs, including 18 giant LVMs from 2012 to 2020. And we analyzed clinical, histopathological, surgical, and outcome data at our institution. Giant LVMs were most commonly present in the fourth decade of patients with the male-to-female ratio of 1:2. The most common subtypes were transitional and fibrous. Most lesions were resected via the temporal or parieto-occipital approach in our series. The median volume of blood loss was higher in the giant group (900 vs. 600 ml, p = 0.02). Meanwhile, the median length of hospital stay was prolonged for giant LVMs (20.5 vs. 16.0 days, p < 0.01). The proportion of discharged functional deterioration was higher in giant LVMs (38.9% vs. 6.5%, p = 0.02). However, there was no statistical significance between functional deterioration and tumor size at long-term follow-up (p = 0.28). Giant LVMs patients suffered from neurological and regional complications more commonly, particularly from a postoperative hematoma (4/18 vs. 1/31), and hydrocephalus (2/18 vs. 0/31). Patients with giant LVMs had a high incidence of immediate functional deterioration after microsurgery, and there was no difference in functional deterioration between the giant and non-giant LVMS during long-term follow-up. Microsurgery entails a higher complication rate in giant LVMs. We need to pay special attention to preventing postoperative hematoma and hydrocephalus.
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Affiliation(s)
- Dan Cao
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Yibo Ou
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Xu Chen
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Zhengqian Guo
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Yong Chen
- Department of Neurosurgery Intensive Care Unit, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Jian Chen
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.
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Chen Y, Tian S, Wang J, Liang Z, Wang B, Zhao Y, Ma J. Lateral ventricle meningiomas in children: clinicopathological and neuroradiological features. Childs Nerv Syst 2023; 39:151-158. [PMID: 36316483 DOI: 10.1007/s00381-022-05680-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 09/15/2022] [Indexed: 11/07/2022]
Abstract
PURPOSE Lateral ventricle meningiomas (LVM) in children are very rare. The current research is mostly limited to adults, and there are very few related studies on children. The purpose of this study was to analyze the clinicopathological and imaging features of lateral ventricle meningiomas in children. METHODS A retrospective analysis of five children with pathologically confirmed lateral ventricle meningioma was performed, and we collected clinical data, including clinicopathological data, treatment prognosis data, and imaging features (including tumor location, signal intensity, enhancement degree, intratumoral cyst, calcification, peritumoral edema, and associated hydrocephalus). RESULTS Among the 5 patients with LVM, 4 were male and 1 was female with an average age of 7.6 years (range 2 to 12 years). All CT scans showed slight hyperintensity or isodensity, and only 1 patient had calcification. Two patients demonstrated cyst changes. Four patients had varying degrees of peritumoral edema. The average tumor volume was 164.1 cm3 (1.4-314.9 cm3). All 5 patients with LVM were iso- or hypointense on T1WI. The T2WI signals had no obvious features. Four patients had a high signal on DWI (80%). The contrast-enhanced signals were mostly homogeneously strong (80%). MRI showed hydrocephalus in 3 patients. All patients underwent gross total resection, and they were followed up regularly after the operation. The average follow-up time was 47.4 months. No recurrence was found in any of the children. All patients were pathologically confirmed to have meningiomas, and WHO grades were all grade I. CONCLUSION Lateral ventricle meningiomas in children are very rare, and the imaging manifestations of the tumor have certain characteristics, but the clinical diagnosis is still difficult, and the diagnosis still requires pathological analysis.
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Affiliation(s)
- Yufan Chen
- Department of Pediatric Neurosurgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Shuaiwei Tian
- Department of Pediatric Neurosurgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Jiajia Wang
- Department of Pediatric Neurosurgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Zhuangzhuang Liang
- Department of Pediatric Neurosurgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Baocheng Wang
- Department of Pediatric Neurosurgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Yang Zhao
- Department of Pediatric Neurosurgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.
| | - Jie Ma
- Department of Pediatric Neurosurgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.
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Design Model of Cultural and Creative Products Using User Perception Demand Mining. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:6339184. [PMID: 36045971 PMCID: PMC9420601 DOI: 10.1155/2022/6339184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/05/2022] [Accepted: 07/07/2022] [Indexed: 11/20/2022]
Abstract
People are becoming more and more aware of the value of design throughout a product's entire life cycle as a result of the fierce competition for industrial products that exists today. The life of a product involves its design, manufacture, sale, and use, and how well these links are managed determines the product's positioning in terms of value in the eyes of consumers. The key to the functional integration of the design is monitoring the entire process and applying the user's emotional needs. A useful tool for assessing users' emotional needs is the perceptual image of a product. An artificial intelligence-driven method for product perceptual design is proposed, and its efficacy is demonstrated by the design of an optometer. This method addresses the issues of incomplete measurement and insufficient sample collection in the traditional users' perceptual cognition measurement. The findings demonstrate that extracting users' perceptual cognition through text mining can assist designers in better understanding users' perceptual needs, resulting in designed products that are more likely to meet users' expectations for satisfaction. A design approach that can increase users' psychological acceptance of products and boost their competitiveness is the perceptual design method, which combines human and artificial intelligence.
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Liu J, Zhao K, Wang J, Shu K. Clinical features and long-term outcomes of pediatric meningiomas. Childs Nerv Syst 2021; 37:3041-3047. [PMID: 34292388 DOI: 10.1007/s00381-021-05296-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 07/14/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Pediatric meningiomas are relatively rare and have atypical clinical features compared to adults. The purpose of this work is to report our 15-year experience in the management of pediatric meningiomas and assess their clinical characteristics, pathological features, and prognostic factors. METHODS A total of 40 children (age ≤ 15 years) who were diagnosed as pediatric meningiomas were enrolled in this study. Patient information including clinical presentation, gender, age at time of diagnosis, histopathological features, tumor location, tumor volume, treatment methods, and follow-up data were extracted and analyzed. RESULTS The mean age at diagnosis was 10.78 ± 3.50 years (range 2-15 years) in 40 patients with a male to female ratio of 1:1.11. Headache, epilepsy, visual disturbance, and limb weakness are common clinical manifestations. Two patients had multiple intracranial meningiomas. Fourteen (33.3%) of pediatric meningiomas were high grade meningiomas. Seven patients (17.5%) were treated with STR, while GTR was achieved in 33 patients (82.5%). The mean follow-up period was 82.1 months (range 9-173 months). Recurrence occurred in 9 patients (22.5%), and 5 patients (12.5%) passed away. CONCLUSION The incidence of pediatric meningiomas increases with advancing age. In pediatric patients, the percentage of high-grade tumors is higher than adults. Younger children were more likely to have high-grade meningiomas, while patients with tumors located in skull base or parasagittal/falx tend to have low-grade meningiomas. The WHO grade III meningiomas were significantly correlated with poor prognosis. Adjuvant radiotherapy after surgery can improve prognosis and may be a potential treatment strategy in children with malignant meningiomas.
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Affiliation(s)
- Jingdian Liu
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Kai Zhao
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Junwen Wang
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| | - Kai Shu
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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Teng H, Liu Z, Yan O, He W, Jie D, Qie Y, Xu J. Lateral Ventricular Meningiomas: Clinical Features, Radiological Findings and Long-Term Outcomes. Cancer Manag Res 2021; 13:6089-6099. [PMID: 34377027 PMCID: PMC8349535 DOI: 10.2147/cmar.s320651] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 07/22/2021] [Indexed: 02/05/2023] Open
Abstract
Purpose Lateral ventricle meningioma (LVM) is a rare type of intracranial meningioma, which has been rarely studied. It has different clinical features, imaging features, and long-term results from other locations. This study investigated the epidemiology, clinical characteristics and prognosis of LVM and comprehensively describes its characteristics. Methods This article analyzes the LVMs that were diagnosed pathologically in West China hospital between January 1, 2009 and July 1 2020. Demographic information, imaging characteristics and prognostic factors are discussed. Data analysis was performed using SPSS 23.0 and R version 3.5.3. Results We collected 7202 meningiomas and 195 LVMs (136 females; median age, 46 years; range, 5–81 years) were included in this study. Gross total resection was completed in 189 patients. The OS rate was 93.8%, and the recurrence rate was 5.2%. Multivariate regression analysis showed that sex (P = 0.01) and tumor size (P = 0.018) were related to WHO grade. Postoperative KPS (P = 0.003) was associated with OS. WHO grade (P = 0.025), extent of tumor resection (P < 0.001), and hospital day (P=0.028) were associated with recurrence. Conclusion LVMs require long-term follow-up, individualized treatment, and follow-up strategies to be formulated according to the relevant risk factors.
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Affiliation(s)
- Haibo Teng
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Zhiyong Liu
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Ouying Yan
- Department of Radiation Oncology, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, People's Republic of China
| | - Wenbo He
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Danyang Jie
- Department of Neurosurgery, West China School of Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Yuanwei Qie
- Health Management Center, West-China Fourth Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Jianguo Xu
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
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Malignant intraventricular meningioma: literature review and case report. Neurosurg Rev 2021; 45:151-166. [PMID: 34159472 DOI: 10.1007/s10143-021-01585-3] [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: 04/18/2021] [Revised: 05/19/2021] [Accepted: 06/10/2021] [Indexed: 10/21/2022]
Abstract
Malignant intraventricular meningiomas (IVMs) are very rare with only a few reported cases. A midline search up to December 2020 selected 40 articles for a total of 65 patients. The inclusion criteria were series and case reports in English language, as well as papers written in other languages, but with abstracts written in English. Malignant IVMs at the first diagnosis (group A, 50 patients) and those with anaplastic transformation from previous WHO grades I and II tumors (group B, 15 patients) were separately analyzed. The unique personal case among 1285 meningiomas (0.078%) is also added. Malignant IVMs mainly occur in women (61%) with a median age of 45 years and are mainly located in the lateral ventricle (93%) and trigonal region (74%), with no cases in the fourth ventricle. Irregular borders (80%), heterogeneous enhancement (83%), and perilesional edema (76%) are the most frequent radiological findings. The histology was mainly pure anaplastic (85%), whereas papillary (7%), rhabdoid (5%), and mixed forms (3%) are very rare. The CSF spread was found in 60% of the cases. The prognosis is very dismal, with an overall median survival of 17.5 months after surgery for the anaplastic forms. Malignant IVMs at initial diagnosis (group A) show better overall survival (25 months) than those occurring from anaplastic transformation of lower grade tumors (group B) (10.1 months).
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Sood R, Singh A, Karthigeyan M, Gupta K, Salunke P. Customising the surgical management for intraventricular meningiomas - 'one size doesn't fit all'. Br J Neurosurg 2021; 35:633-638. [PMID: 34148479 DOI: 10.1080/02688697.2021.1940858] [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: 10/21/2022]
Abstract
BACKGROUND Intraventricular meningiomas are uncommon and gross total resection is the recommended treatment. However, total resection may not always be possible, especially in locations in which the lesions are adherent to veins and neural structures. We share our experience with intraventricular meningiomas, focusing on the management strategies and outcomes. PATIENTS AND METHODS We describe the data of 7 patients with intraventricular meningiomas operated at our institute over the last 9 years. Three patients had a third ventricular tumor of which two had lesions straddling across the foramen of Monro. The remaining 4 patients had trigonal mass. The clinico-radiological features, management strategies and outcomes have been elaborated with a mean follow-up of 57 months. RESULTS The common clinical presentations were raised intracranial pressure symptoms, visual field defects and memory deficits. One patient had multiple meningiomas. Total excision was achieved in all except in 2 patients in whom the lesion straddled across the foramen of Monro with dense adhesions to veins and neural structures. Staged resection was required in one patient with a large trigonal mass. All patients had a low-grade lesion. The tumor recurred in one patient (post-pregnancy) after partial resection. All the patients improved neurologically, and none had added deficits. CONCLUSIONS Gross total resection of intraventricular meningiomas although desirable may not be possible in certain cases in which the risks outweigh the benefits. These tumors often are of low histological grade and the treatment strategies should be individualized. Regular follow-up is warranted as these tumors may recur despite a low histological grade.
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Affiliation(s)
- Ridhi Sood
- Department of Histopathology, PGIMER, Chandigarh, India
| | | | | | - Kirti Gupta
- Department of Histopathology, PGIMER, Chandigarh, India
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Tsurubuchi T, Matsuda M, Muroi A, Sakamoto N, Ishikawa E, Matsumura A. An Aggressive Extension of Dumbbell-Type Pediatric Skull Base Meningioma: A Case Report with Review of the Literature. World Neurosurg 2020; 139:535-547. [PMID: 32371076 DOI: 10.1016/j.wneu.2020.04.152] [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: 01/14/2020] [Revised: 04/18/2020] [Accepted: 04/20/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Pediatric meningiomas account for less than 2% of pediatric brain tumors. Pediatric clear cell meningiomas (CCMs) occurring in the posterior fossa are particularly rare. Therapeutic strategies differ among the previous pediatric CCM case reports. Therefore, to clarify the clinical features of pediatric CCMs, we report a rare case of dumbbell-type pediatric CCM and a corresponding literature review. CASE DESCRIPTION A 7-year-old boy with complaints of headache, left facial palsy, dysarthria, and left-sided ataxic gait was emergently admitted to our hospital. His consciousness level was slight stupor, with Glasgow Coma Scale score 3-5-6, and he showed left ptosis, dysarthria, and ataxias of the left trunk and extremities. Magnetic resonance imaging (MRI) scan showed acute obstructive hydrocephalus because of the tumor's compression of the brainstem. The dumbbell-shaped tumor extended from the lateral wall of the cavernous sinus, through the left Meckel's cave, to the cerebellopontine angle. Physical examination and perioperative MRI scan showed no evidence regarding neurofibromatosis type I or II. The tumor was removed in a 2-staged operation. Postoperative proton therapy was done to treat some residual tumors. One year after postoperative proton therapy, there is no recurrence, and apart from left corneal and facial hypesthesia, he is healthy. CONCLUSIONS We reported a rare case of pediatric skull base-type CCM with huge extension originating from the anteromedial wall of Meckel's cave firmly adhered to the cavernous sinus wall to the posterior fossa that was successfully treated with surgery and postoperative proton therapy. CCM has a high recurrence rate; therefore, careful prolonged follow-up is needed.
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Affiliation(s)
- Takao Tsurubuchi
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
| | - Masahide Matsuda
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Ai Muroi
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Noriaki Sakamoto
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; Department of Diagnostic Pathology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Eiichi Ishikawa
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Akira Matsumura
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
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Jamilson Araújo Pereira B, Nogueira de Almeida A, Henrique Pires de Aguiar P, Silva Paiva W, Jacobsen Teixeira M, Kazue Nagahashi Marie S. Comprehensive analysis of meningioma in the first two decades of life: A systematic review. Neurochirurgie 2019; 66:36-40. [PMID: 31809786 DOI: 10.1016/j.neuchi.2019.10.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 10/19/2019] [Accepted: 10/20/2019] [Indexed: 12/22/2022]
Abstract
PURPOSE To evaluate the relationship between meningioma histological subtype and tumor site in under-20 year-olds. METHODS A review of the literature on meningioma during the first 2 decades of life was carried out through a Medline search up to February 2019. To evaluate the adult population, a cross-sectional study was conducted on patients operated on between 2000 and 2014 in a single institution. Exclusion criteria comprised: series reports and papers that lacked detailed description of clinical findings, neuroimaging confirmation of tumor location, and/or at least 5 years' follow-up. RESULTS One hundred and seven manuscripts were included, for 365 under-20 year-old patients: 200 male, and 164 female. Histopathology found 197 cases (53.9%) of WHO grade I meningioma, with predominance of meningothelial (41.1%) and transitional (30.9%) subtypes; 123 (33.7%) grade II, and 45 (12.3%) grade III. For 65 (18.25%) of the 356 cases, recurrence was documented, with only 24 deaths (6.7%). CONCLUSION Meningioma in this population presented 2 differences compared to the adult population: male predominance, and high incidence of atypical meningioma. Surgery was the primary treatment. Adjuvant radiotherapy is controversial in the literature.
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Affiliation(s)
- B Jamilson Araújo Pereira
- Departamento de Neurologia do Hospital das Clínicas da Universidade de São Paulo, SP, Brazil; Departmento de Neurologia, Laboratório de biologia cellular e molecular LIM15, Escola de Medicina, Universidade de São Paulo, São Paulo, Brazil.
| | - A Nogueira de Almeida
- Departamento de Neurologia do Hospital das Clínicas da Universidade de São Paulo, SP, Brazil; Divisão de Neurocirurgia Funcional IPQ. Hospital das Clínicas da Universidade de São Paulo, SP, Brazil
| | | | - W Silva Paiva
- Departamento de Neurologia do Hospital das Clínicas da Universidade de São Paulo, SP, Brazil
| | - M Jacobsen Teixeira
- Departamento de Neurologia do Hospital das Clínicas da Universidade de São Paulo, SP, Brazil
| | - S Kazue Nagahashi Marie
- Departamento de Neurologia do Hospital das Clínicas da Universidade de São Paulo, SP, Brazil
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Management of pediatric CNS meningiomas: CCHE-57357 experience in 39 cases. Childs Nerv Syst 2019; 35:1323-1331. [PMID: 31127346 DOI: 10.1007/s00381-019-04156-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 04/14/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Our aim is to present our experience in the management of pediatric meningiomas in the largest referral center in Egypt for pediatric tumors focusing on variables including clinical picture, anatomic location, histopathology, treatment strategies, and outcome together with their possible correlation to prognosis. METHODS We retrospectively reviewed the medical records of 39 pediatric patients who were treated for CNS meningiomas in Children's Cancer Hospital-Egypt (CCHE-57357) 2007-2017. RESULTS The prevalence of pediatric meningioma was 1.42%. Four cases had type 2 neurofibromatosis (NFII). The mean age was 8.19 years. The presence of NFII was associated with challenging multiple lesions, older age of presentation and poorer prognosis and functional outcome. Convexity was the commonest location. Gross total resection (GTR) was achieved in 28 cases, subtotal resection (STR) in 8 cases, and biopsy was decided in 3 patients. Histopathological examination revealed WHO grade I in 16 patients and higher grades in 23 patients (59%). The 5-year overall survival (OS) rate was 87.8% while the 5-years event-free survival (EFS) rate was 85.6%. Tumor location, histopathology, and clinical presentation were not statistically correlated to prognosis. CONCLUSIONS Pediatric CNS meningiomas are uncommon pediatric tumors but of an aggressive clinical and pathological behaviors as compared to adult meningiomas. The presence of NFII is associated with a poorer prognosis and functional outcomes. Although being challenging, the maximum and safe surgical excision should be exercised even in recurrent cases in order to achieve the best outcome. Adjuvant radiotherapy provides good tumor control for inoperable residual atypical or anaplastic meningiomas.
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Chen C, Lv L, Hu Y, Yin S, Zhou P, Jiang S. Clinical features, surgical management, and long-term prognosis of intraventricular meningiomas: A large series of 89 patients at a single institution. Medicine (Baltimore) 2019; 98:e15334. [PMID: 31008991 PMCID: PMC6494377 DOI: 10.1097/md.0000000000015334] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Intraventricular meningiomas are rather rare and only represent a small proportion of all intracranial meningiomas. Data are still limited toward this peculiar entity and surgical resection remains challenging for neurosurgeons. The purpose of present study is to demonstrate clinical features, surgical treatment, and potential risk factors determined long-term prognosis of intraventricular meningiomas.A total of 89 surgically treated and histopathologically confirmed intraventricular meningiomas were identified in our institution from 2008 to 2018. Clinical features, neuroimaging findings, surgical records, and prognosis data were extracted and reviewed retrospectively. Group comparison and recurrence-free survival analysis were performed.Female predominance was well established with a sex radio of 2.1:1. Raised intracranial pressure and decline of visual acuity were 2 chief symptoms that patients generally complained of. Preoperative magnetic resonance imaging (MRI) scans were performed in all patients and there was a trend toward lateral ventricular meningiomas were larger in size than others (P = .07). Superior parietal lobule and temporal approach were widely adopted and lateral/4th ventricular meningiomas were more easily to acquire total tumor resection as compared with 3rd ventricular meningiomas (P = .03). After an average follow-up of 57.3 months, 6 patients experienced recurrence of disease in our series. Individuals with subtotal resection (P < .001) and higher World Health Organization classification (P = .001) were more prone to relapse.Intraventricular meningiomas presented with a wide variety of symptoms. Surgery remained 1st treatment of choice and optimal surgical approach should be planned individually based on preoperative MRI evaluation. Patients underwent subtotal tumor resection and with malignant tumor nature should be carefully monitored during follow-up.
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Jiang Y, Lv L, Li J, Ma W, Chen C, Zhou P, Jiang S. Clinical features, radiological findings, and treatment outcomes of high-grade lateral ventricular meningiomas: a report of 26 cases. Neurosurg Rev 2019; 43:565-573. [PMID: 30649647 DOI: 10.1007/s10143-019-01078-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Revised: 12/25/2018] [Accepted: 01/08/2019] [Indexed: 02/05/2023]
Abstract
High-grade meningiomas in ventricles are rare, where most published series only include a few patients. A retrospective analysis was performed on the clinical features, radiological findings, and treatment outcomes of 26 patients with high-grade meningiomas in lateral ventricles who were surgically treated in our hospital between July 2008 and July 2016. A female predilection (female/male = 1.4:1) was observed with a mean age of 42.4 years. Headache and/or vomiting (65.3%) were the most common initial symptom, and with symptom duration time ranging between 7 days and 5 years (mean 8.5 months). The lateral ventricle trigone area was the most common site (80.7%). Twenty-two patients (84.6%) obtained gross total resection. The 2007 WHO classification was used to classify 22 (84.6%) meningiomas as grade II and the remaining four tumors were graded III. These tumors accounted for a recurrence rate of 38.5% (10 of 26 patients) and a mortality rate of 11.5% (3 deaths) during the follow-up periods. The recurrence rate after the gross total resection was 27.3% (6 of 22 patients). Radiotherapy was administered as an adjuvant treatment in 12 patients (46.2%) after surgery. There were 4 recurrences out of the 12 patients who received radiotherapy and 6 of the 14 patients relapsed without radiotherapy (p = 0.58). The subtotal resection was considered a risk factor for recurrence. The postoperative radiotherapy seemed to have little significance for the high-grade meningiomas in the lateral ventricles. Long-term follow-up is required, regardless of the resection grade, and reoperation is feasible for patients with recurrence.
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Affiliation(s)
- Yong Jiang
- Department of Neurosurgery, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, China
| | - Liang Lv
- Department of Neurosurgery, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, China
| | - Jiuhong Li
- Department of Neurosurgery, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, China
| | - Weichao Ma
- Department of Neurosurgery, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, China
| | - Cheng Chen
- Department of Neurosurgery, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, China
| | - Peizhi Zhou
- Department of Neurosurgery, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, China
| | - Shu Jiang
- Department of Neurosurgery, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, China.
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Chen H, Lai R, Tang X, Liu Z, Xu J. Lateral Intraventricular Anaplastic Meningioma: A Series of 5 Patients at a Single Institution and Literature Review. World Neurosurg 2018; 131:e1-e11. [PMID: 30500581 DOI: 10.1016/j.wneu.2018.11.184] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 11/17/2018] [Accepted: 11/19/2018] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Lateral intraventricular anaplastic meningiomas (LIAMs) are rare lesions. The aim of this study is to clarify clinical and radiologic characteristics and the optimal treatment strategies of LIAMs with long-term follow-up. METHODS From September 2008 to September 2017, 5 patients with LIAM were enrolled in our study. The clinical profiles, radiologic features, treatment strategies, and outcomes were retrospectively analyzed. RESULTS Five patients (all female; mean age, 48.8 years; range, 33-61 years) were included in this study. The most frequent symptoms were those related to increased intracranial pressure. Mean duration of symptoms was 6.7 months (range, 2 weeks-2 years). The average tumor size was 4.98 cm at the maximal diameter (range, 3.0-6.2 cm). All were confirmed with a diagnosis of anaplastic meningioma. Gross total resection was achieved in all 5 patients. All patients experienced improvement of symptoms. Recurrence and progression were identified in only 2 patients. At the last follow-up, the mean recurrence-free survival was 13 months (range, 7-21 months) and the mean overall survival was 16.25 months (range, 8-21 months). One patient was lost to follow-up. CONCLUSIONS Female and right trigone area predominance were found in our case series. Shorter duration of symptoms, irregular tumor shape, peritumoral edema, and heterogeneous enhancement may indicate an aggressive feature. Maximal safe resection followed by radiation therapy may be the best strategy for patients with LIAM. Long-term clinical follow-up and serial imaging are recommended.
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Affiliation(s)
- Hongxu Chen
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China
| | - Rui Lai
- Department of Anesthesiology, People's Hospital of Deyang City, Deyang, Sichuan, P.R. China
| | - Xinpu Tang
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China
| | - Zhiyong Liu
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China
| | - Jianguo Xu
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China.
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Pereira BJA, de Almeida AN, Paiva WS, de Aguiar PHP, Teixeira MJ, Marie SKN. Natural history of intraventricular meningiomas: systematic review. Neurosurg Rev 2018; 43:513-523. [PMID: 30112665 DOI: 10.1007/s10143-018-1019-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 07/23/2018] [Accepted: 08/02/2018] [Indexed: 02/06/2023]
Abstract
Review the data published on the subject to create a more comprehensive natural history of intraventricular meningiomas (IVMs). A Medline search up to March 2018 using "intraventricular meningioma" returned 98 papers. As a first selection step, we adopted the following inclusion criteria: series and case reports about IVMs, as well as papers written in other languages, but abstracts written in English were evaluated. Six hundred eighty-one tumors were evaluated from 98 papers. The majority of the tumors were located in the lateral ventricles (602-88.4%), fourth ventricle (59-8.7%), and third ventricle (20-2.9%). These tumors accounted for a mortality rate of 4.0% (25 deaths) and a recurrence rate of 5.3% (26 recurrences). The majority of the tumors were grade I (89.8%) and consisted of the following subtypes: fibrous, 39.7% (n = 171); transitional, 22.0% (n = 95); meningothelial, 18.6% (n = 80); angiomatosus, 3.2% (n = 14); psammomatous, 2.6% (n = 11); and others, 13.9% (n = 60). Forty-five patients (7.4%) presented with grade II (GII) tumors, and 17 patients (2.8%) presented with grade III (GIII) tumors. These tumors follow the histopathological distribution of meningiomas in general, with the exception of the higher prevalence of the fibrous subtype, possibly due to its embryonic origin. Recurrence and mortality were lower than in other localizations likely due to a complete surgical resection rate than in the convexity and skull base, which suggests that GTR is the gold standard for the management of IVMs.
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Affiliation(s)
- Benedito Jamilson Araújo Pereira
- Departamento de Neurologia da Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil. .,699 Edifício Paulista Paradise Life, Rua Martiniano de Carvalho, Apto 1150, Bela Vista, Brazil.
| | - Antônio Nogueira de Almeida
- Divisão de Neurocirurgia Funcional IPQ, Hospital das Clínicas da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Wellingson Silva Paiva
- Departamento de Neurologia da Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | | | - Manoel Jacobsen Teixeira
- Departamento de Neurologia da Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
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