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Song X, Li Z. Coexistence of meningioma and craniofacial fibrous dysplasia: a case series of clinicopathological study and literature review. Orphanet J Rare Dis 2024; 19:30. [PMID: 38287340 PMCID: PMC10826192 DOI: 10.1186/s13023-024-03032-0] [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: 11/03/2022] [Accepted: 01/19/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND The co-existence of meningioma and craniofacial fibrous dysplasia (CFD) is rare. Due to the similar radiological characteristics, it is challenging to differentiate such co-existence from solitary hyperostotic meningioma resulting in a dilemma of prompt diagnosis and appropriate intervention. METHOD We conducted a retrospective review of the data from 21 patients with concomitant meningioma and CFD who were treated at Beijing Tiantan Hospital from 2003 to 2021. We summarized their clinicopathological features and performed a comprehensive literature review. Additionally, we tested the characteristic pathogenic variants in exon 8 and 9 of GNAS gene and the expression of corresponding α-subunit of the stimulatory G protein (Gαs) related to CFD to explore the potential interactions between these two diseases. RESULTS The cohort comprised 4 men and 17 women (mean age, 45.14 years). CFD most commonly involved the sphenoid bone (n = 10) and meningiomas were predominantly located at the skull base (n = 12). Surgical treatment was performed in 4 CFD lesions and 14 meningiomas. Simpson grade I-II resection was achieved in 12 out of the 14 resected meningiomas and almost all of them were classified as WHO I grade (n = 13). The mean follow-up duration was 56.89 months and recurrence was noticed in 2 cases. Genetic study was conducted in 7 tumor specimens and immunohistochemistry was accomplished in 8 samples showing that though GNAS variant was not detected, Gαs protein were positively expressed in different degrees. CONCLUSIONS We presented an uncommon case series of co-diagnosed meningioma and CFD and provided a detailed description of its clinicopathological features, treatment strategy and prognosis. Although a definite causative relationship had not been established, possible genetic or environmental interplay between these two diseases could not be excluded. It was challenging to initiate prompt diagnosis and appropriate treatment for concomitant meningioma and CFD because of its similar radiological manifestations to meningioma with reactive hyperostosis. Personalized and multi-disciplinary management strategies should be adopted for the co-existence of meningioma and CFD.
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Affiliation(s)
- Xiaowen Song
- Department of Radiology, Center of Interventional Radiology and Vascular Surgery, Zhongda Hospital, Medical School, Southeast University, Nanjing, 210009, Jiangsu Province, China
- Basic Medicine Research and Innovation Center of Ministry of Education, Zhongda Hospital, Southeast University, Nanjing, 210009, Jiangsu Province, China
| | - Zhi Li
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.
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Fan YH, Li Z. Coexistence of craniopharyngioma and cranial fibrous dysplasia: a case series of clinicopathological study. Orphanet J Rare Dis 2022; 17:126. [PMID: 35303908 PMCID: PMC8932149 DOI: 10.1186/s13023-022-02281-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 03/07/2022] [Indexed: 11/15/2022] Open
Abstract
Background Craniopharyngioma (CP) and cranial fibrous dysplasia (CFD) are rare embryonic benign cranial diseases that most commonly present during childhood or adolescence. The coexistence of CP and CFD is extremely rare and has not yet been reported. Methods We retrospectively reviewed the data of five patients with concomitant CP and CFD treated at Beijing Tiantan Hospital from January 2003 to January 2021 and summarized their clinicopathological features, treatment modalities, and outcomes. We also performed a comprehensive literature review, tested the patients for characteristic GNAS gene mutations related to CFD, and tested the CP specimens for corresponding Gsα protein to explore the potential connection leading to the coexistence of CP and CFD. Results The cohort comprised four men and one woman (median age, 39 years). The symptoms mainly included headache, dizziness, fatigue, polyuria/polydipsia, hypogonadism, and blurred vision. CFD most commonly involved the sphenoid bone (n = 4). Four patients underwent surgery to remove the CP (one trans-sphenoidal and three transcranial resections); complete and subtotal resection were achieved in two patients, respectively. The tumor subtype was adamantinomatous in three patients and unknown in one. The common postoperative complications were panhypopituitarism, diabetes insipidus, and hypothyroidism. The mean follow-up duration was 57.2 months. Two patients required postoperative hormone replacement therapy. Three patients underwent genetic study of the tumor specimens; GNAS mutations were not detected, but these patients were positive for Gsα protein. Conclusions Although a definite causative relationship has not been proved, the coexistence of CP and CFD means that potential interplay or an atypical fibrous dysplasia course as uncommon manifestations of CP cannot be excluded. It is more challenging to initiate prompt diagnosis and appropriate treatment for concomitant CP and CFD than for solitary CP because of skull base deformations. Current management strategies are aimed at surgical treating the CP and regularly monitoring the CFD. Supplementary Information The online version contains supplementary material available at 10.1186/s13023-022-02281-1.
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Affiliation(s)
- Yang-Hua Fan
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No.119, the South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Zhi Li
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No.119, the South Fourth Ring West Road, Fengtai District, Beijing, 100070, China.
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Song X, Li Z. Co-existing of craniofacial fibrous dysplasia and cerebrovascular diseases: a series of 22 cases and review of the literature. Orphanet J Rare Dis 2021; 16:471. [PMID: 34736485 PMCID: PMC8567608 DOI: 10.1186/s13023-021-02102-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 10/24/2021] [Indexed: 01/11/2023] Open
Abstract
Background Craniofacial fibrous dysplasia is a fairly rare condition. Some literature have reported a few patients with craniofacial fibrous dysplasia suffering from vascular abnormalities. This study aimed to describe the possible coexistence of craniofacial fibrous dysplasia and cerebrovascular diseases for the first time. Method We retrospectively reviewed the 1175 patients with craniofacial fibrous dysplasia in Beijing Tiantan Hospital and the information of the 22 patients coexisted with cerebrovascular diseases were described. In addition, we performed a systematic review for cases of craniofacial fibrous dysplasia with vascular abnormalities. Result 22 out of 1175 patients (1.9%) were diagnosed with craniofacial fibrous dysplasia and cerebrovascular diseases including 9 intracranial aneurysms, 4 venous malformations, 2 arteriovenous malformations, 1 moyamoya disease, 2 intracranial venous stenosis and 4 cerebral ischemia with a mean age of 38.18 years old. Only 2 patients were managed surgically for craniofacial fibrous dysplasia and 6 patients were treated with neurosurgery for cerebrovascular diseases. 8 patients were closely followed and only 1 patient’s symptoms worsened. Conclusion Craniofacial fibrous dysplasia might cause constriction of the intracranial vessels and alteration of the overall hemodynamics of the intracranial vasculature resulting in various cerebrovascular diseases. Multimodal screening and examinations seems reasonable for patients with craniofacial fibrous dysplasia for throughout treatment and prognosis evaluations.
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Affiliation(s)
- Xiaowen Song
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No 119, Nansihuan xilu, Beijing, 100070, China.,China National Research Center for Neurological Disease, Beijing, China
| | - Zhi Li
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No 119, Nansihuan xilu, Beijing, 100070, China. .,China National Research Center for Neurological Disease, Beijing, China.
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Sharma V, Kedia R, Mohapatra I, Banerjee AD. Coexisting Vestibular Schwannoma with Fibrous Dysplasia: A Rare Occurrence. Asian J Neurosurg 2019; 14:1295-1297. [PMID: 31903382 PMCID: PMC6896621 DOI: 10.4103/ajns.ajns_73_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Coexisting vestibular schwannoma (VS) with fibrous dysplasia is extremely rare. Here, we represent the case of a 48-year-old female with coexisting VS and fibrous dysplasia of overlying occipital bone. After proper evaluation, the patient underwent surgery and microscopic total excision of the right cerebellopontine angle lesion was achieved. However, during surgery, bone work was extremely tedious and exposure to reach up to lesion was difficult. To the best of our knowledge, this is the first reported case of coexisting fibrous dysplasia of overlying bone and VS as histopathological diagnosis.
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Affiliation(s)
- Vikas Sharma
- Department of Neurosurgery, Institute of Neurosciences, Medanta the Medicity, Gurgaon, Haryana, India
| | - Rishabh Kedia
- Department of Neurosurgery, Institute of Neurosciences, Medanta the Medicity, Gurgaon, Haryana, India
| | - Ishani Mohapatra
- Department of Pathology, Medanta the Medicity, Gurgaon, Haryana, India
| | - Anirban Deep Banerjee
- Department of Neurosurgery, Institute of Neurosciences, Medanta the Medicity, Gurgaon, Haryana, India
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Tao X, Wang K, Dong J, Hou Z, Wu Z, Zhang J, Liu B. Clinical, Radiologic, and Pathologic Features of 56 Cases of Intracranial Lymphoplasmacyte-Rich Meningioma. World Neurosurg 2017; 106:152-164. [PMID: 28673887 DOI: 10.1016/j.wneu.2017.06.143] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Revised: 06/20/2017] [Accepted: 06/24/2017] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Intracranial lymphoplasmacyte-rich meningioma (LPRM) is rarely reported because of its extremely low incidence, and current understanding of this disease is poor. We analyzed the incidence and clinical, radiologic, pathologic, and prognostic features of intracranial LPRMs. METHODS Approximately 10,908 intracranial meningiomas were surgically resected in Beijing Tiantan Hospital between June 2009 and November 2016. All pathologically proven LPRM cases were identified. Statistical analysis was performed to determine which parameters were associated with prognoses and tumor resection. RESULTS LPRMs accounted for approximately 0.51% of intracranial meningiomas (56 of 10,908). Patients with LPRM had a mean age of 44.6 years and there was no significant gender preference (28 male and 28 female). Gross total resection was achieved in 45 cases, subtotal resection in 9 cases, and partial resection in 2 cases. At discharge, Karnofsky Performance Scale scores and neurologic function improved in 42 cases (75.0%) and worsened in 14 cases (25.0%). At the 41.5 months median follow-up (range, 5-97 months), 5 patients had tumor recurrence, and the 3-year and 5-year progression-free survival rates were 94.6% and 92.9%, respectively. One patient died of tumor recurrence. At the latest follow-up, Karnofsky Performance Scale scores improved in 48 cases (85.7%), worsened in 7 cases (12.5%), and 1 patient died (1.8%). Univariate analysis showed that the extent of tumor resection and tumors located in the skull base were significantly associated with short-term outcomes. Skull base location was significantly associated with increased risk of worse long-term outcomes. Tumor size ≥45 mm, poorly defined tumor border, and skull base location significantly limited the extent of tumor resection. CONCLUSIONS Intracranial LPRM is a rare subtype of meningioma with no gender difference and low recurrence. Long-term survival is expected, although tumors located in the skull base and bone destruction are independent risk factors of poor long-term outcomes. Microsurgical treatment of skull base LPRM remains a formidable challenge because of poorly defined borders and critical neurovascular structure encasement. Radical tumor resection, which induces severe neurologic deficits, is unnecessary.
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Affiliation(s)
- Xiaogang Tao
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
| | - Kun Wang
- Department of Neurosurgery, Qingdao Huangdao District People's Hospital, Qingdao, Shandong Province, China
| | - Jinqian Dong
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
| | - Zonggang Hou
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
| | - Zhen Wu
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
| | - Junting Zhang
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
| | - Baiyun Liu
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China; Department of Neurotrauma, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China; Nerve Injury and Repair Center of Beijing Institute for Brain Disorders, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China; Beijing Key Laboratory of Central Nervous System Injury, Beijing, China.
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Kanno H, Nishihara H, Hara K, Ozaki Y, Itoh T, Kimura T, Tanino M, Tanaka S. A case of lymphoplasmacyte-rich meningioma of the jugular foramen. Brain Tumor Pathol 2011; 28:341-5. [DOI: 10.1007/s10014-011-0048-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2011] [Accepted: 06/03/2011] [Indexed: 10/18/2022]
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Alves RV, Souza AR, Silva ADS, Cardim VLN, Godoy R. Co-existing fibrous dysplasia and meningothelial meningioma. ARQUIVOS DE NEURO-PSIQUIATRIA 2009; 67:699-700. [PMID: 19722054 DOI: 10.1590/s0004-282x2009000400025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Raphael Vicente Alves
- Neurosurgery Unit and Plastic Surgery Unit, Hospital São Joaquim, Real e Benemérita Beneficência Portuguesa de São Paulo, São Paulo, SP, Brazil.
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