Clinical characteristics and therapeutic strategies of atypical meningioma

Background Atypical meningioma accounts for about 4.7% to 7.2% of all kinds of meningiomas, which is invasive with a relatively high recurrence and mortality. The objective of this study was to investigate the clinical manifestations and therapeutic strategies of atypical meningioma.

Surgical treatment of elderly patients with primary osteolytic atypical meningioma:a case report and review of the literature

Background: Elderly patients with primary intracranial osteolytic and externally growing atypical meningiomas are rare and easy to be misdiagnosed. Recently, a patient with an atypical meningioma was treated in our department and analyzed the case by reviewing the historical literature.Case presentation: We describe a 63-year-old female with primary intracranial osteolytic atypical meningioma at our neurosurgery department, and retrospectively reviewed previous literatures about its diagnosis, surgical treatment,pathological results, and clinical outcome. Simpson grade I resection was accomplished through a pterional approach.First-stage skull reconstruction was performed, and the patient underwent an uneventful recovery.Conclusions: The final diagnosis of the primary osteolytic atypical meningioma is dependent on a pathological examination. First-stage skull reconstruction could avoid a secondary lesion and improve the patient's quality of life.

Radical treatment strategies improve the long-term outcome of recurrent atypical meningiomas

Background Atypical meningioma is one of the rare subtypes of meningioma, which is lacking of optimal consensus on treatment strategies. This study aimed to investigate the radical treatment strategies to improve the long-term outcome of recurrent atypical meningiomas. Methods The prognostic factors including the age and gender of patients; the location, histology, recurrence pattern and mitotic cell rate of the tumors; and the resection extents, surgical strategies and adjuvant therapies of 15 cases of recurrent atypical meningiomas were analyzed retrospectively. Results The age and gender of patients were not associated with tumor recurrence. However, high recurrence rates and poor prognosis for atypical meningiomas were associated with the high mitotic cell rate, failure to achieve Simpson grade Ⅰ-Ⅱ resection, and without the dura and bone flap replacement intraoperatively. Post-operative radiotherapy improved the outcomes of tumors in patients after the second surgery. Conclusion Radical treatment strategies such as dura and bone flap replacements and radiotherapy should be considered in patients diagnosed with atypical meningiomas.

Dynamic Contrast-Enhanced Perfusion MR Imaging Measurements of Endothelial Permeability: Differentiation between Atypical and Typical Meningiomas

BACKGROUND: AND PURPOSE: The measurement of relative cerebral blood volume (rCBV) and the volume transfer constant (K(trans)) by means of dynamic contrast-enhanced (DCE) perfusion MR imaging (pMRI) can be useful in characterizing brain tumors. The purpose of our study was to evaluate the utility of these measurements in differentiating typical meningiomas and atypical meningiomas. METHODS: Fifteen patients with pathologically confirmed typical meningiomas and seven with atypical meningiomas underwent conventional imaging and DCE pMRI before resection.rCBV measurements were calculated by using standard intravascular

The Evaluation of Efficacy and Side Effects of Radiotherapy in Cerebral Meningiomas

Aims: The current study aimed to evaluate the efficacy, side effects of radiotherapy and factors influencing treatment outcome in patients received radiotherapy for cerebral meningiomas. Methods and Material: In the last two decades, a total of 35 patients with cerebral meningioma who received radiotherapy in our clinic were evaluated statistically in terms of survival, toxicity and prognostic factors. The records of patients diagnosed with cerebral meningioma who underwent postoperative radiotherapy were retrospectively analyzed. Statistical analysis used: Statistical comparisons were made using IBM SPSS v24.0. Kaplan-Meier method was used to compare survival times. Results: Five of the patients had grade I meningioma showing recurrence, 18 were grade II meningioma and 12 were grade III meningioma. Patients were treated with 54 or 60 Gy adjuvant radiotherapy with 2 Gy daily fractions according to histopathological grade and operation type. Three and five-year overall survival rates were 56% and 40%, respectively and median overall survival was 36 months. Progression was observed in 15 of the 35 patients included in the study. Three and five-year progression-free survival (PFS) rates of the patients were 56% and 50%, respectively. There was a statistically significant correlation between histopathological grade and overall survival among patients. However;no statistical difference found in overall survival of patients in terms of tumor location, operation type and age. Conclusions: In the treatment of cerebral meningiomas, changes in radiotherapy dose and field designs can be predicted according to the tumor grade and operation type. In addition, it is thought that large scale studies are needed to determine prognostic factors more meticulously.