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Ahmed N, Ferini G, Haque M, Umana GE, Scalia G, Chaurasia B, Vats A, Rahman A. Primary Intraosseous Osteolytic Meningioma with Aggressive Clinical Behaviour: Clinico-Pathologic Correlation and Proposed New Clinical Classification. Life (Basel) 2022; 12:life12040548. [PMID: 35455037 PMCID: PMC9025523 DOI: 10.3390/life12040548] [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: 12/31/2021] [Revised: 03/16/2022] [Accepted: 04/02/2022] [Indexed: 11/29/2022] Open
Abstract
(1) Introduction: Primary intraosseous osteolytic meningiomas (PIOM) are non-dural-based tumors predominantly presenting an osteolytic component with or without hyperostotic reactions. They are a subset of primary extradural meningiomas (PEM). In this study, we present a peculiar case with a systematic literature review and propose a new classification considering the limitations of previous classification systems. (2) Materials and Methods: Using a systematic search protocol in Google Scholar, PubMed, and Scopus databases, we extracted all case studies on PIOM published from inception to December 2020. A 46-year-old female patient form Dhaka, Bangladesh, was also described. The search protocol was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. (3) Results: Here, we present a 46-year-old female patient with PIOM who successfully underwent bifrontal craniotomy and gross total removal (GTR) of the tumor. At 6-month follow-up, no tumor recurrence was shown. Including our new case, 55 total cases from 47 articles were included in the analysis. PIOMs were in closer frequency among males (56.4%) and females (43.6%). The most common tumor location was the frontal and parietal calvarium, most commonly in the frontal bone (29.1%). Surgical resection was the predominant modality of treatment (87.3%); only 1.8% of patients were treated with radiotherapy, and 5.4% received a combination of surgery and radiotherapy. Gross total resection (GTR) was achieved in 80% of cases. Extracranial extension was reported in 41.8% of cases, dural invasion in 47.3%, and recurrence in 7.3%. Whole-body 68 Ga-DOTATOC PET/CT has also been reported as a useful tool both for differential diagnosis, radiotherapy contouring, and follow-up. Current treatments such as hydroxyurea and bevacizumab have variable success rates. We have also suggested a new classification which would provide a simple common ground for further research in this field. (4) Conclusions: Surgical resection, especially GTR, is the treatment of choice for PIOM, with a high GTR rate and low risk of complications and mortality. More research is needed on the differential diagnosis and specific treatment of PIOM.
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Affiliation(s)
- Nazmin Ahmed
- Department of Neurosurgery, Ibrahim Cardiac Hospital and Research Institute (A Centre for Cardiovascular, Neuroscience and Organ Transplant Units), Shahbag, Dhaka 1000, Bangladesh;
| | - Gianluca Ferini
- Department of Radiation Oncology, REM Radioterapia srl, 95029 Catania, Italy;
| | - Moududul Haque
- Department of Neurosurgery, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka 1000, Bangladesh; (M.H.); (A.R.)
| | - Giuseppe Emmanuele Umana
- Trauma Center, Gamma Knife Center, Department of Neurosurgery, Cannizzaro Hospital, 95100 Catania, Italy
- Correspondence:
| | - Gianluca Scalia
- Department of Neurosurgery, Highly Specialized Hospital and of National Importance “Garibaldi”, 95126 Catania, Italy;
| | - Bipin Chaurasia
- Department of Neurosurgery, Neurosurgery Clinic, Birgunj 44300, Nepal;
| | - Atul Vats
- Neurosurgery Department, James Cook University Hospital, Middlesbrough TS4 3BW, UK;
| | - Asifur Rahman
- Department of Neurosurgery, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka 1000, Bangladesh; (M.H.); (A.R.)
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Omofoye OA, Huynh T, Jhun R, Ashfaque H, Cronk K. Primary intraosseous meningioma of the calvarium: A systematic review. Clin Neurol Neurosurg 2020; 199:106283. [PMID: 33069929 DOI: 10.1016/j.clineuro.2020.106283] [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: 07/06/2020] [Revised: 09/23/2020] [Accepted: 10/04/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Primary intraosseous meningiomas (PIM) of calvarial origin are a small subset of meningiomas that arise from and occur within the calvarial bone. Its definition is often confused with other forms of non-dural based intracranial meningiomas, which has made previously published retrospective reviews heterogenous, non-specific and sometimes inaccurate. We present a systematic review of calvarial PIM. METHODS Using a systematic search protocol that included databases such as PubMed, Web of Science and Embase, we extracted all human studies on PIM published from inception to December 2017. This systematic review includes case reports and retrospective reviews that specifically described PIM. RESULTS On review of 166 articles identified with the systematic search protocol, 69 articles were analyzed. These comprised of 64 case reports, 1 case series and 4 retrospective reviews. 111 patients with PIM of calvarial origin were analyzed, 58 % of which were females and 42 % males. The mean patient age was 51 years and the frontal bone was the most common tumor location, occurring in 26.1 % of the cases. Surgical resection was the predominant modality of treatment in 97.2 % of the cases, and gross total resection was achieved in 84 % of cases that reported extent of resection. There were no recurrences for grade I meningiomas. However, all grade III meningiomas recurred and 33.3 % of grade II meningiomas showed recurrence with a mean postoperative follow-up interval of 20 months. Statistical analysis using Fisher's exact test showed the recurrence rate to be strongly associated with WHO tumor grade (p-value <0.001). CONCLUSION There is statistically significant increased recurrence rate for calvarial PIM of higher grades, and we recommend close follow-up in those cases. Surgical resection remains the overwhelming treatment of choice for calvarial PIM, and it has a high gross total resection rate and low risk of complications and mortality.
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Affiliation(s)
- Oluwaseun A Omofoye
- Boston Medical Center, Department of Neurosurgery, 725 Albany Street 7c, Boston, MA, 02118, USA.
| | - Trong Huynh
- Boston Medical Center, Department of Neurosurgery, 725 Albany Street 7c, Boston, MA, 02118, USA.
| | - Ray Jhun
- Boston University School of Medicine, 72 East Concord Street, Boston, MA, 02118, USA.
| | - Hasan Ashfaque
- Boston Medical Center, Department of Neurosurgery, 725 Albany Street 7c, Boston, MA, 02118, USA.
| | - Katharine Cronk
- Boston Medical Center, Department of Neurosurgery, 725 Albany Street 7c, Boston, MA, 02118, USA.
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Kwon SM, Ko Y, Bang SS. Primary intraosseous osteolytic meningioma: a case report and review of the literature. BMC Neurol 2019; 19:176. [PMID: 31337352 PMCID: PMC6647308 DOI: 10.1186/s12883-019-1392-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 07/03/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Primary intraosseous meningioma is a subset of extradural meningioma that arises in the bone, and only a few cases have been reported to date. CASE PRESENTATION An 80-year-old man presented with decreased hearing on the right side accompanied by a disturbance of balance 10 months prior to admission. Magnetic resonance imaging revealed an 8 × 7 cm osteolytic mass in the right posterior fossa related to the petrous bone, with extension to the cervical region. During surgery, the tumor was found to be located extradurally, with no invasion of the dura. The tumor was removed entirely, apart from a small portion around the jugular foramen to avoid lower cranial nerve injury. CONCLUSION The final diagnosis was primary intraosseous osteolytic meningioma with atypical pathology. Here, we report a rare case of an osteolytic skull lesion in the skull base not invading the dura and with extensive bone destruction.
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Affiliation(s)
- Sae Min Kwon
- Departments of Neurosurgery, College of Medicine, Hanyang University, 17 Haengdang-dong, Seongdong-gu, 133-792, Seoul, Republic of Korea.,Department of Neurosurgery, Keimyung University School of Medicine, 1095 Dalgubeol-daero, Dalseo-gu, Daegu, 42601, Republic of Korea
| | - Yong Ko
- Departments of Neurosurgery, College of Medicine, Hanyang University, 17 Haengdang-dong, Seongdong-gu, 133-792, Seoul, Republic of Korea.
| | - Seong Sik Bang
- Departments of Pathology, College of Medicine, Hanyang University, 17 Haengdang-dong, Seongdong-gu, 133-792, Seoul, Republic of Korea
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Tauziede-Espariat A, Parfait B, Besnard A, Lacombe J, Pallud J, Tazi S, Puget S, Lot G, Terris B, Cohen J, Vidaud M, Figarella-Branger D, Monnien F, Polivka M, Adle-Biassette H, Varlet P. Loss of SMARCE1 expression is a specific diagnostic marker of clear cell meningioma: a comprehensive immunophenotypical and molecular analysis. Brain Pathol 2017; 28:466-474. [PMID: 28474749 DOI: 10.1111/bpa.12524] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 04/28/2017] [Indexed: 01/01/2023] Open
Abstract
Clear cell meningioma (CCM) is a rare grade II histopathological subtype that usually occurs in young patients and displays high recurrence rate. Germline SMARCE1 mutations have been described in hereditary forms of this disease and more recently in small syndromic and sporadic CCM series. The diagnostic value of SMARCE1 in distinguishing between CCM and other meningioma variants has not been yet established. The aim of our study was to investigate the status of SMARCE1 in a series of CCMs and its morphological mimickers. We compared the performance of an anti-SMARCE1 antibody and the molecular analysis of the SMARCE1 gene in a retrospective multicenter series of CCMs. All CCMs lossed SMARCE1 immunoexpression. Bi-allelic inactivating events were found by NGS-based sequencing in all of these cases, except for one, which was incompletely explored, but had a wild-type sequence. We then validated the anti-SMARCE1 antibody specificity by analyzing additional 305 pediatric and adult meningiomas of various subtypes and 15 non-meningioma clear cell tumors by SMARCE1 immunohistochemistry. A nuclear immunostaining was preserved in all other meningioma variants, as well as non-meningioma clear cell tumors. In conclusion, our series showed, for the first time, that SMARCE1 immunostaining is a highly sensitive biomarker for CCM, useful as a routine diagnostic biomarker.
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Affiliation(s)
| | - Béatrice Parfait
- Department of Genetic and Molecular Biology, Cochin Hospital, AP-HP, 75014, Paris, France
| | - Aurore Besnard
- Department of Neuropathology, Sainte-Anne Hospital, 75014, Paris, France
| | - Joëlle Lacombe
- Department of Neuropathology, Sainte-Anne Hospital, 75014, Paris, France
| | - Johan Pallud
- Department of Neurosurgery, Sainte-Anne Hospital, 75014, Paris, France
| | - Sanaa Tazi
- Department of Neurosurgery, Mondor Hospital, 94010, Créteil, France
| | - Stéphanie Puget
- Department of Pediatric Neurosurgery, Necker University Hospital, University Paris Descartes, Sorbonne Paris Cité, 75015, Paris, France
| | - Guillaume Lot
- Department of Neurosurgery, Rothschild Foundation, 75019, Paris, France
| | - Benoît Terris
- Department of Pathology, Cochin Hospital, AP-HP, 75014, Paris, France
| | - Joëlle Cohen
- Department of Genetic and Molecular Biology, Cochin Hospital, AP-HP, 75014, Paris, France
| | - Michel Vidaud
- Department of Genetic and Molecular Biology, Cochin Hospital, AP-HP, 75014, Paris, France
| | - Dominique Figarella-Branger
- INSERM, CRO2, La Timone Hospital, Department of Anatomopathology and Neuropathology, Aix-Marseille Univ, APHM, 13385, Marseille, France
| | - Franck Monnien
- Department of Pathology, Jean Minjoz Hospital, 25000, Besançon, France
| | - Marc Polivka
- Department of Pathology, Lariboisière Hospital, APHP, 75475, Paris, France
| | | | - Pascale Varlet
- Department of Neuropathology, Sainte-Anne Hospital, 75014, Paris, France
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