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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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Crea A, Grimod G, Scalia G, Verlotta M, Mazzeo L, Rossi G, Mattavelli D, Rampinelli V, Luzzi S, Spena G. Fronto-orbito-ethmoidal intradiploic meningiomas: A case study with systematic review. Surg Neurol Int 2021; 12:485. [PMID: 34754535 PMCID: PMC8571263 DOI: 10.25259/sni_386_2021] [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: 04/19/2021] [Accepted: 09/08/2021] [Indexed: 10/26/2022] Open
Abstract
Background Primary intradiploic meningiomas, extra-axial tumors arising primarily in the skull, are rare. The authors reported a complex case of intradiploic intraosseous metaplastic meningioma of the left medial wall and orbital roof with the left frontal sinus invasion and left ethmoidal body bone substitution. The authors also conducted a systematic review concerning diagnosis and management of patients affected by purely calvarial intradiploic meningiomas along with a focus on fronto-orbito-ethmoidal ones. Methods A literature search was conducted using PubMed and Scopus databases according to preferred reporting items for systematic reviews and meta-analysis statement and with the following Mesh terms: Intradiploic, intraosseous, calvarial, and meningioma. Eligibility criteria were limited by the nature of existing literature on intradiploic meningiomas, consisting of only case series, and case reports. Results A total of 128 published studies were identified through our search. 41 studies were included in this systematic review, 59 patients with a female/male ratio of 1.2/1. The mean age of the patients is of 47.69 years (range 3-84 years). Only seven out of 59 patients (11.9%) presented a complex intradiploic meningioma located in fronto-orbito-ethmoidal region like our case. In almost all patients, a gross-total resection was performed (96.6%) and only in two patients (3.4%) a subtotal resection was achieved. Conclusion The authors shared this successfully treated case to add to the overall clinical experience in the management of this rare subtype tumor, with the hope that more studies are conducted to further address the mechanism of intradiploic meningiomas development.
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Affiliation(s)
- Antonio Crea
- Department of Neuroscience, Neurosurgery Unit, Alessandro Manzoni Hospital, Lecco, Italy
| | - Gianluca Grimod
- Department of Neuroscience, Neurosurgery Unit, Alessandro Manzoni Hospital, Lecco, Italy
| | - Gianluca Scalia
- Department of Neurosurgery, Highly Specialized Hospital of National Importance "Garibaldi", Catania, Italy
| | - Mariarosaria Verlotta
- Department of Neuroscience, Neurosurgery Unit, Alessandro Manzoni Hospital, Lecco, Italy
| | - Lucio Mazzeo
- Department of Neuroscience, Neurosurgery Unit, Alessandro Manzoni Hospital, Lecco, Italy
| | - Giorgio Rossi
- Department of Oncology, Pathological Anatomy and Histology Unit, Alessandro Manzoni Hospital, Lecco, Italy
| | - Davide Mattavelli
- Department of Surgical Specialties, Radiological Sciences and Public Health, Unit of Otorhinolaryngology - Head and neck Surgery, Piazza del Mercato, Brescia, Italy
| | - Vittorio Rampinelli
- Department of Surgical Specialties, Radiological Sciences and Public Health, Unit of Otorhinolaryngology - Head and neck Surgery, Piazza del Mercato, Brescia, Italy
| | - Sabino Luzzi
- Department of Neurosurgery, IRCCS Fondazione Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Giannantonio Spena
- Department of Neuroscience, Neurosurgery Unit, Alessandro Manzoni Hospital, Lecco, Italy
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