Metastases to cranial base meningiomas. Clinical presentations and surgical outcomes. Literature overview

Tumour-to-meningioma metastasis (TTMM) is an uncommon phenomenon, however repeatedly found in the literature. Meningiomas occur to be the most frequent target of metastatic expansion of systemic cancers. Meningiomas often vary in symptoms and treatment, and this largely depends on the tumour location. Due to their variable locations, they can be classified as convexity meningiomas, which includes falcine and parasagittal tumours, and cranial base, which includes tumours located in the olfactory groove, sphenoid wing, petrous bone and other cranial base locations. The aim of this study was to analyse all data regarding metastases to cranial base meningiomas. We performed a literature search to locate all cases of metastases to cranial base meningiomas in PubMed and Medline databases using the following key words: metastasis to meningioma, meningioma metastasis, and cranial base meningioma. We collected patient and cancer parameters, exact meningioma location and clinical presentations including characteristics which may suggest TTMM. We found 100 articles describing 111 patients of metastasis to cranial base meningioma. Among these articles, 55 cases (49.55%) included metastases to non-skull base meningiomas. In 24 cases (21.62%), the location of meningioma was not precisely described or other data were unavailable, in particular histopathological examination. The most common location of TTMM was sphenoid wing, which was found in 9 patients. The other locations included cerebellopontine angle in 5 patients, and tuberculum sellae in 3 cases. 81.25% cases of TTMM were reported in women, and the most common cancer origins were the breast (28.3%), lung (18.7%), kidney (9.38%) and prostate (9.38%). In two cases the metastatic origin was unclear, and in 15.6% of cases the patients were in remission for more than 1 year. In 78.1% of cases patients presented focal deficits, followed by increased intracranial pressure, and seizures. In almost one-third of cases, TTMM first appeared from a previously unknown cancer. Rapid clinical presentation of cranial nerve palsies may suggest the dual nature of intracranial pathology. The metastasis to cranial base meningioma should be suspected in patients with oncological background, regardless of meningioma parameters or cancer status.

Claudin 6 is associated with a short survival and a short recurrent free interval in non-small cell lung carcinoma

We investigated the expression of claudin 6 in non-small-cell lung carcinomas (NSCLC) by immunohistochemistry. Samples of 164 patients with NSCLC were studied by immunohistochemistry. Claudin 6 was expressed in 42 % of cases. Its expression was significantly more frequent in adeno- than in squamous cell carcinoma (p = 0.002). There was no association between the TNM status and claudin 6 expression. Claudin 6 associated with a poor prognosis of the patients and with a short recurrence-free interval (p = 0.002, p < 0.001). The association with survival had independent prognostic value (p = 0.011). The results show that claudin 6 can be regarded as a marker of poor prognosis in lung cancer. This is different to some other cancers, such as breast and cervical carcinoma suggesting that claudin 6 probably induces other cellular pathways in neoplastic lung cells than in those tumors. In lung cancer, adenocarcinomas were most abundantly positive indicating a higher linkage of claudin 6 to glandular differentiation.

The relationship of tumour-associated macrophages (CD68, CD163, CD11c) and cancer stem cell (CD44) markers with prognostic parameters in breast carcinomas

INTRODUCTION

In invasive breast cancer (IBC), tumour-associated macrophages and cancer stem cells in the tumour microenvironment are thought to be associated with poor prognosis, tumour growth, and metastasis.

MATERIAL AND METHODS

In this study, we evaluated the relationship of CD68, CD163, CD11c, and CD44 expressions in the tumour microenvironment of IBC with prognostic parameters by immunohistochemical method.

RESULTS

A correlation was found between high histological grade, oestrogen receptor/ progesterone receptor negativity, and high Ki-67 index in IBC, and the number of CD68-, CD163-, and CD11c-positive macrophages in the tumour microenvironment. In addition, in the tumour microenvironment, a correlation was found between IBC-specific subtypes and CD68, luminal A subtype relative to luminal B and CD163, HER2 score 3 cases, and CD11c-positive macrophage count. It was observed that CD44 expression in the tumour in IBC was not associated with the parameters examined. In addition, a high-level linear correlation was found between CD68- and CD163- and CD11c-positive macrophage counts. Tumour-associated macrophages in the tumour microenvironment in IBC may be a novel prognostic factor and an alternative avenue for targeted therapies.

CONCLUSIONS

The fact that CD44 positivity in the tumour is not associated with prognostic parameters will contribute to the literature in this direction.