Hormone receptors in initially excised versus recurrent intracranial meningiomas

Intracranial meningiomas from 51 surgical patients consecutively treated during an 18-month period were evaluated for the presence of receptors to progesterone and estrogen. Thirty-eight patients underwent initial resection during this time and 13 underwent reoperation for recurrent disease. With positivity defined as receptor levels greater than 10 fmol/mg of cytosol protein, 84% of all the meningiomas were positive for progesterone receptors, whereas only 33% were positive for estrogen receptors. Among the recurrent meningiomas, 92% showed evidence of progesterone receptors and 54% of estrogen receptors; these figures were not significantly different from the corresponding incidence of 82% and 26%, respectively, among the initially excised tumors. However, the mean concentration of progesterone receptors in the recurrent tumor group was significantly higher when compared to the concentration in the initially excised group (p < 0.02). Twenty meningiomas (39%) were considered to be radiation-induced, since they were removed from patients who had received scalp irradiation during childhood. The incidence and concentration of receptors in the radiation-induced tumors were generally comparable to those in the spontaneous meningiomas. This study confirms previous reports of a high incidence of hormone receptors, mainly for progesterone, in meningiomas. In addition, it shows that in recurrent meningiomas these receptors persist and even increase. The results therefore support hormone treatment for nonresectable meningiomas, especially at recurrence.

Meningioma presenting at a site of a previously aspirated brain abscess

We report the case of a meningioma which developed in the parieto-occipital lobe at the site where a brain abscess had been aspirated 9 years previously. There was no history of head trauma. To the best of our knowledge this is the first reported case of a meningioma associated and possibly aetiologically related to a previous inflammatory process in the absence of head trauma. The association of chronic inflammation and the subsequent development of a meningioma is discussed.

The association of carcinoma of the breast with meningioma

The unique association between carcinoma of the breast and meningioma was previously described. We report herein an additional series of ten instances representing such an association and review the relevant literature. Surgeons should be aware of the possible relationship between these two conditions. Lesions of the central nervous system in patients with carcinoma of the breast should not be labeled as metastases unless benign, resectable, intracranial lesions have been ruled out by proper investigations.

Radiation-induced schwannomas

The histopathology and clinical course of three patients with schwannomas of the brain and high cervical cord after therapeutic irradiation for intracranial malignancy and for ringworm of the scalp are described. Earlier reports in the literature indicated that radiation of the scalp may induce tumors in the head and neck. It is therefore suggested that therapeutic irradiation in these instances was a causative factor in the genesis of these tumors.

Intracranial meningiomas presenting with epistaxis--case report and literature review

This paper reports a case of the extracranial extension of meningioma from the anterior cranial fossa to the nasal cavity which presented clinically with epistaxis. On rare occasions, the initial manifestation of olfactory groove meningioma is through ENT symptoms. Both the surgical approach and the relevant literature are reviewed.

Radiation-induced cerebral meningioma: a recognizable entity

The authors retrospectively analyzed the clinical and histopathological findings in 201 patients with intracranial meningiomas operated on in the period 1978 to 1982. Forty-three of the patients (21.4%) had at some previous time received radiation treatment to their scalp, the majority for tinea capitis. The findings in these 43 irradiated patients were compared with those in the 158 non-irradiated patients. Several distinctive clinical and histological features were identified in the irradiated group, which suggest that radiation-induced meningiomas can be defined as a separate nosological subgroup. The use of irradiation in large numbers of children with tinea capitis in the era prior to the availability of griseofulvin may be responsible for a significantly increased incidence of intracranial meningiomas.