RESUMEN

Meningiomas and their WHO histological diagnostic criteria is complex, especially for grade 2 tumors presenting a interobserver discordance as high as 12.2%. The 2016 edition of the WHO Classification of CNS tumors recommended brain invasion as a stand-alone grading criterion for diagnosing an atypical grade 2 meningioma (AM). To provide an overview of the classification of 2016 WHO impact on the natural history of atypical meningioma (AM) relative to previous classification. To achieve this goal, we selected articles from the period 2017-2024 in Medline search on atypical meningiomas and analyzed them after following the following criteria: 1) reports with confirmed histopathological diagnosis according to WHO 2016 and or 2021 criteria; 2) series and case reports; 3) detailed and individualized clinical outcomes for AM; and 4) papers written in English; after that a total of 3445 patients reported in 67 manuscripts from worldwide centers from 2017 to March 2024 were analyzed. The patient's age at the time of surgery ranged from 1 month to 97 years (mean 52.28 ± 18.7 years). The most common tumor site was the convexity, accounting for 67.8%, followed by the skull base in 30.6%, ventricle in 1%, and spine in 0.6%; Gross total resection (GTR) was performed in 71.25% and subtotal resection (STR) in 28.75%; 1021 patients (29.63%) underwent adjuvant radiotherapy, and 22 patients (0.6%) were treated with adjuvant chemotherapy; tumor recurrence was reported in 1221 patients (35.44%) and 859 deaths (24.93%). 1) AM prevalence in females; 2) AM age distribution similar to the distribution of meningiomas in general; 3) AM recurrence rate of 35.44%, despite the high rate of GTR, which was higher than previously reported; 4) deepening knowledge in molecular mechanism of tumor progression will provide alternative therapeutic approaches for AM.

Asunto(s)

Neoplasias Meníngeas , Meningioma , Organización Mundial de la Salud , Humanos , Meningioma/patología , Meningioma/terapia , Neoplasias Meníngeas/patología , Neoplasias Meníngeas/terapia , Persona de Mediana Edad , Femenino , Masculino , Adulto , Anciano , Neoplasias del Sistema Nervioso Central/patología , Neoplasias del Sistema Nervioso Central/terapia , Anciano de 80 o más Años , Adolescente

RESUMEN

BACKGROUND: The Simpson grading scale assumes dural resection (grade I) is more effective against recurrence than coagulation (grade II). However, the results of recent studies have raised doubts about this effectiveness in spinal meningiomas. Therefore, we aimed to perform a meta-analysis comparing outcomes between Simpson grades I and II in spinal meningiomas. METHODS: According to the PRISMA statement, we systematically searched PubMed, EMBASE, and Web of Science for studies involving patients with spinal meningiomas who underwent Simpson grades I, II, III, or IV. Outcomes were radiological tumor recurrence, postoperative neurological deficits, and procedure-related complications. RESULTS: We included 54 studies with a total of 3334 patients. Simpson grades I, II, III, and IV were performed in 674 (20%), 2205 (66%), 254 (8%), and 201 (6%) patients, respectively. The follow-up ranged from 9 to 192 months, and 95.4% of all tumors were WHO grade 1. There was no difference in radiological tumor recurrence (OR 0.80, 95% CI: 0.46-1.36, P = 0.41; I2 = 0%), postoperative neurological deficits (OR 0.74, 95% CI: 0.32-1.75, P = 0.50; I2 = 0%) or procedure-related complications (OR 2.22, 95% CI: 0.80-6.13, P = 0.12; I2 = 3%) between Simpson grades I and II. Furthermore, no significant difference in postoperative neurological deficits or procedure-related complications was detected when comparing all Simpson's to each other. However, radiological tumor recurrences in Simpson I and II were significantly lower than in III and IV, with Simpson III outperforming IV (OR 0.19, 95% CI: 0.09-0.40, P < 0.01; I2 = 0%). CONCLUSION: Simpson grade I is not more effective than grade II in any outcome, although both are superior to III and IV in tumor recurrence. Our results might suggest that dural coagulation is preferable over resection when the latter carries a higher risk of complications.

Asunto(s)

Duramadre , Neoplasias Meníngeas , Meningioma , Humanos , Meningioma/cirugía , Meningioma/patología , Neoplasias Meníngeas/cirugía , Neoplasias Meníngeas/patología , Duramadre/cirugía , Duramadre/patología , Recurrencia Local de Neoplasia/cirugía , Procedimientos Neuroquirúrgicos/métodos , Resultado del Tratamiento , Complicaciones Posoperatorias/etiología

RESUMEN

This article discusses a rare case of coexistent meningiomas and Primary familial brain calcification (PFBC). PFBC is a neurodegenerative disease characterized by brain calcifications and a variety of neuropsychiatric symptoms and signs, with pathogenic variants in specific genes. The study explores the potential link between PFBC and meningiomas, highlighting shared features like intralesional calcifications and common genes such as MEA6. The article also revisits PFBC patients developing other brain tumors, particularly gliomas, emphasizing the intersection of oncogenes like PDGFB and PDGFRB in both calcifications and tumor progression. In recent investigations, attention has extended beyond brain tumors to breast cancer metastasis, unveiling a noteworthy connection. These findings suggest a broader connection between brain calcifications and tumors, encouraging a reevaluation of therapeutic approaches for PFBC.

Asunto(s)

Neoplasias Encefálicas , Calcinosis , Meningioma , Humanos , Calcinosis/genética , Calcinosis/patología , Meningioma/genética , Meningioma/patología , Neoplasias Encefálicas/genética , Neoplasias Encefálicas/patología , Neoplasias Encefálicas/metabolismo , Femenino , Neoplasias Meníngeas/genética , Neoplasias Meníngeas/patología , Encefalopatías/genética , Encefalopatías/patología , Encefalopatías/metabolismo

RESUMEN

INTRODUCTION: Meningiomas are the most common primary brain and central nervous system tumors, accounting for approximately 40% of these tumors. The most important exams for the radiological study of meningiomas are computed tomography (CT) and magnetic resonance imaging (MRI). We aimed to analyze the radiological features of patients with meningioma related to the simultaneous presence of bilateral macronodular adrenocortical disease (BMAD), with or without pathogenic variants of ARMC5. METHODS: This study included 10 patients who were diagnosed with BMAD. All of them had a radiological diagnosis of expansive brain lesions suggestive of meningioma. All patients underwent brain MRI and a neuroradiolgist analyzed the following parameters: number, site and size of lesions; presence of calcification, edema and bone involvement. RESULTS AND DISCUSSION: Eight patients presented with germline variants of ARMC5; the other 2, did not. The most significant result was the incidence of multiple meningiomas, which was 50% in BMAD patients, whereas the average incidence described thus far is lower than 10%. Considering location, the 22 tumors in the BMAD patients were 5 convexity tumors (22.7%), and 17 skull base tumors (77.2%), the opposite proportion of patients without BMAD. A total of 40.9% of the tumors had calcification, 9% had cerebral edema and 40.9% had bone invasion due to hyperostosis. The literature describes meningioma calcification in 25% of patients, bone invasion by tumor hyperostosis in 20%, and cerebral edema in approximately 60%. CONCLUSION: Relevant results were found considering the rate of multiple meningiomas and tumor location. This finding reinforces the need for further research into the neurological effects caused by genetic variants of ARMC5 in patients with BMAD.

Asunto(s)

Imagen por Resonancia Magnética , Neoplasias Meníngeas , Meningioma , Humanos , Meningioma/genética , Meningioma/diagnóstico por imagen , Meningioma/patología , Femenino , Masculino , Neoplasias Meníngeas/genética , Neoplasias Meníngeas/diagnóstico por imagen , Neoplasias Meníngeas/patología , Persona de Mediana Edad , Adulto , Anciano , Tomografía Computarizada por Rayos X , Proteínas del Dominio Armadillo

RESUMEN

Presurgical embolization (PE) has emerged as an interesting strategy to help turn brain tumor resection more amenable. This study aims to systematically review the safety and effectiveness of Onyx™ PE in meningioma resection. We followed Cochrane Collaboration and PRISMA for systematic review and meta-analysis, querying PUBMED, Cochrane Library, Web of Science, and Embase databases. Major complications were defined as other artery occlusion, visual deficits due to PE, or non temporary nerve damage, while minor included transitory conditions and others without clinical implications. A total of 186 patients were included, in which 120 were WHO grade I (80%), II (16%), and III (4%). Patient baseline characteristics and complications were distributed in groups without or with individual patient data analysis. Individual Patient Data Meta-Analysis (IPDMA) was performed on the last category, comprising 51 meningiomas that underwent Onyx™ PE. Among available data, 70%, 17%, and 13% were WHO grade I, II, and III, respectively. Considering all studies, tumor characteristics regarding grade underscored a certain homogeneity. Complications occurred at a rate of 9% (95% CI, 4 to 14%; I2 = 35%), with the rate of major complications significantly lower at only 1% (95% CI, 0 to 3%; I2 = 32%), whereas of minor complications was 7% (95% CI, 3 to 10%; I2 = 0%). Mean surgery blood loss was 668.7 (95% CI, 534.9 to 835.8; I2 = 0%) in IPDMA. Onyx™ PE is promising for safer surgical meningioma resection, despite limitations. Further studies are required to validate efficacy, enhance patient selection, and refine techniques.

Asunto(s)

Meningioma , Procedimientos Neuroquirúrgicos , Humanos , Craneotomía , Neoplasias Meníngeas/cirugía , Neoplasias Meníngeas/patología , Meningioma/cirugía , Meningioma/patología , Procedimientos Neuroquirúrgicos/métodos , Cuidados Preoperatorios/métodos

RESUMEN

Intracranial tumors occurring in specific brain regions, such as the cerebellopontine angle, may be associated with cranial nerve dysfunction and dysphagia in humans and animals. Although dysphagia is a known risk factor for pneumonia, only postoperative pneumonia has been investigated in veterinary medicine. This study aimed to describe the clinical and pathological features of dogs with untreated intracranial meningiomas and concomitant pneumonia. Data from post-mortem examination registries from 2011 to 2021 were used (n=23). The frequency of pneumonia and other characteristics were compared between dogs with meningiomas in the ventral rhombencephalon region (VR group; n=13) and those with meningiomas in other intracranial sites (OIS group; n=10). The frequency of pneumonia was higher in the VR group than in the OIS group (n=5 vs. n=0; P=0.039). Plaque-like lesions were also more common in the VR group than in the OIS group (P=0.012). Dogs with concomitant pneumonia had cerebellopontine angle (n=3) and basilar meningiomas (n=2), mainly plaque-like lesions extending to or from other brain areas. In dogs with concomitant pneumonia, meningiomas had invasive (n=5) and compressive (n=3) growth behaviors and nerve roots involved in the swallowing process were frequently affected. Microscopically, these meningiomas were classified as atypical (n=4) and meningiomas (n=1). The reported clinical signs included anorexia (n=3), adipsia (n=1), and dysphagia (n=1). Our findings suggest untreated dogs with ventral rhombencephalon meningiomas may develop cranial nerve damage and aspiration pneumonia.

---

Tumores intracranianos que ocorrem em regiões específicas do cérebro, como o ângulo ponto-cerebelar, podem estar associados à disfunção de nervos cranianos e disfagia em humanos e animais. Embora a disfagia seja um conhecido fator de risco para pneumonia, apenas a pneumonia pós-operatória tem sido investigada na medicina veterinária. Este estudo teve como objetivo descrever as características clínicas e patológicas de cães com meningiomas intracranianos não tratados e pneumonia concomitante. Foram utilizados dados de registros de necropsias de 2011 a 2021. A frequência de pneumonia e outras características foram comparadas entre cães com meningiomas na região do rombencéfalo ventral (grupo VR; n=13) e aqueles com meningiomas em outros sítios intracranianos (grupo OIS; n=10). A frequência de pneumonia foi maior no grupo VR do que no grupo OIS (n=5 vs. n=0; P=0,039). Lesões tipo placa também foram mais comuns no grupo VR do que no grupo OIS (P=0,012). Cães com pneumonia concomitante apresentaram meningiomas no ângulo ponto-cerebelar (n=3) e região basilar (n=2), predominantemente lesões em forma de placa que se estendem de ou para outras áreas do cérebro. Em cães com pneumonia concomitante, os meningiomas apresentaram comportamentos de crescimento invasivo (n=5) e compressivo (n=3) e as raízes nervosas envolvidas no processo de deglutição foram frequentemente afetadas. Microscopicamente, esses meningiomas foram classificados como atípicos (n=4) e papilar (n=1). Os sinais clínicos relatados incluíram anorexia (n=3), adipsia (n=1) e disfagia (n=1). Nossos achados sugerem que cães com meningiomas no rombencéfalo ventral, não tratados, podem desenvolver lesão em nervos cranianos e pneumonia aspirativa.

Asunto(s)

Animales , Perros , Neumonía/diagnóstico , Neumonía/patología , Neumonía/veterinaria , Enfermedades de los Perros , Meningioma/patología , Meningioma/veterinaria , Meningioma/epidemiología , Rombencéfalo , Trastornos de Deglución/veterinaria

RESUMEN

Introduction: Primary melanocytic tumors originating from CNS melanocytes are rare, with a low incidence of 0.7 cases per 10 million annually. This study focuses on primary leptomeningeal melanocytomas, emphasizing their epidemiology, clinical characteristics, and diagnostic challenges. Despite their infrequency, these tumors warrant attention due to their unique features and potential for local recurrence. Case Report: A 32-year-old female presented with syncope and seizures, leading to the discovery of two left-sided supratentorial lesions initially misidentified as convexity meningiomas. Detailed imaging suggested meningioma-like features, but intraoperative findings revealed unexpected hyperpigmented lesions. Histopathological examination, supported by immunohistochemistry, confirmed primary leptomeningeal melanocytoma. The surgical approach and subsequent management are discussed. Discussion: The discussion emphasizes challenges in diagnosing primary leptomeningeal melanocytomas. Treatment debates, especially regarding adjuvant radiotherapy, are explored. Recurrence risks stress the importance of vigilant follow-up, advocating for complete surgical resection as the primary approach. The rarity of supratentorial cases adds complexity to diagnosis, necessitating a multidisciplinary approach. Insights from this case contribute to understanding and managing primary leptomeningeal melanocytomas, addressing challenges in differentiation from more common tumors and prompting ongoing research for refined diagnostics and optimized treatments. Conclusion: This study contributes insights into primary leptomeningeal melanocytomas, highlighting their rarity in supratentorial regions. The case underscores the importance of a multidisciplinary approach, incorporating clinical, radiological, and histopathological expertise for accurate diagnosis and tailored management. Ongoing research is crucial to refine treatment strategies, enhance prognostic precision, and improve outcomes for individuals with this uncommon CNS neoplasm.

Asunto(s)

Melanoma , Neoplasias Meníngeas , Meningioma , Nevo Pigmentado , Neoplasias Cutáneas , Neoplasias Supratentoriales , Femenino , Adulto , Humanos , Meningioma/diagnóstico , Meningioma/cirugía , Meningioma/patología , Melanoma/diagnóstico , Melanoma/cirugía , Melanoma/patología , Neoplasias Meníngeas/diagnóstico , Neoplasias Meníngeas/cirugía , Neoplasias Meníngeas/patología , Melanocitos , Nevo Pigmentado/patología , Neoplasias Supratentoriales/patología , Neoplasias Cutáneas/patología , Imagen por Resonancia Magnética

RESUMEN

Primary intracranial malignant fibrous histiocytoma (MFH), or myxofibrosarcoma, is an extremely rare condition, with only a few cases reported in the literature. We report a case of a dural-based myxofibrosarcoma in a previously healthy 42-year-old man that was initially presumed to be an atypical meningioma. The findings based on conventional and advanced magnetic resonance sequences, including diffusion-weighted imaging, perfusion weighted imaging and proton magnetic resonance spectroscopy, as well as histopathological aspects, are discussed.

Asunto(s)

Neoplasias Encefálicas , Histiocitoma Fibroso Maligno , Neoplasias Meníngeas , Meningioma , Adulto , Neoplasias Encefálicas/diagnóstico por imagen , Histiocitoma Fibroso Maligno/diagnóstico por imagen , Humanos , Imagen por Resonancia Magnética/métodos , Masculino , Neoplasias Meníngeas/diagnóstico por imagen , Neoplasias Meníngeas/patología , Meningioma/diagnóstico por imagen , Meningioma/patología

Asunto(s)

Neoplasias de las Glándulas Suprarrenales/patología , Neoplasias Colorrectales Hereditarias sin Poliposis/patología , Meningioma/patología , Neoplasias Primarias Múltiples/patología , Feocromocitoma/patología , Adulto , Humanos , Masculino , Metástasis de la Neoplasia

RESUMEN

Meningiomas (MGMs) are currently classified into grades I, II, and III. High-grade tumors are correlated with decreased survival rates and increased recurrence rates. The current grading classification is based on histological criteria and determined only after surgical tumor sampling. This study aimed to identify plasma metabolic alterations in meningiomas of different grades, which would aid surgeons in predefining the ideal surgical strategy. Plasma samples were collected from 51 patients with meningioma and classified into low-grade (LG) (grade I; n = 43), and high-grade (HG) samples (grade II, n = 5; grade III, n = 3). An untargeted metabolomic approach was used to analyze plasma metabolites. Statistical analyses were performed to select differential biomarkers among HG and LG groups. Metabolites were identified using tandem mass spectrometry along with database verification. Five and four differential biomarkers were identified for HG and LG meningiomas, respectively. To evaluate the potential of HG MGM metabolites to differentiate between HG and LG tumors, a receiving operating characteristic curve was constructed, which revealed an area under the curve of 95.7%. This indicates that the five HG MGM metabolites represent metabolic alterations that can differentiate between LG and HG meningiomas. These metabolites may indicate tumor grade even before the appearance of histological features.

Asunto(s)

Neoplasias Meníngeas , Meningioma , Humanos , Meningioma/patología , Neoplasias Meníngeas/patología , Clasificación del Tumor , Estudios Retrospectivos

RESUMEN

BACKGROUND: Elevated preoperative lactate levels have been reported in patients admitted for resection of brain tumors. As histologic type and tumor grade have also been linked to lactate concentration, we hypothesized that preoperative lactate concentration in patients with brain tumors may be associated with tumor proliferation. We describe the relationship between preoperative plasma lactate levels, and the cell proliferation marker Ki-67 in brain tumor surgery. METHODS: In this cross-sectional study, records of patients who underwent craniotomy between June 2017 and February 2018 at our Hospital were reviewed to select glioma and meningioma cases in which lactate concentrations in plasma and degree of cell proliferation were registered. Bivariable and linear regression analyses were used to assess the association between lactate concentrations and the Ki-67 Index. RESULTS: Lactate concentrations in plasma and Ki-67 Index were available in 55 patients. Meningioma cases had a mean concentration of 1.2 (0.1) mmol/L compared to diffuse astrocytic and oligodendroglial tumors cases with 1.7 (0.1) mmol/L (P<0.01). Both variables had a low positive correlation in meningiomas (Spearman's r, 0.29; 95% CI, -0.10-0.61; P=0.13) and a high correlation in gliomas (Spearman's r, 0.64; 95% CI, 0.33-0.82; P<0.01). The pooled analysis showed a high correlation index (Spearman's r, 0.61; 95% CI, 0.40-0.76; P<0.01). A linear regression model showed that the Ki-67 Index explained 43% of the variation in lactate (P<0.01). CONCLUSIONS: Brain tumors with higher rates of cell proliferation have higher plasma lactate levels. In this scenario, lactate concentrations may not only reflect systemic perfusion.

Asunto(s)

Neoplasias Encefálicas , Glioma , Neoplasias Meníngeas , Meningioma , Neoplasias Encefálicas/patología , Neoplasias Encefálicas/cirugía , Estudios Transversales , Glioma/patología , Glioma/cirugía , Humanos , Antígeno Ki-67/metabolismo , Ácido Láctico , Neoplasias Meníngeas/patología , Neoplasias Meníngeas/cirugía , Meningioma/patología , Meningioma/cirugía

RESUMEN

OBJECTIVE: Determine the histopathological and clinical characteristics of patients diagnosed with meningiomas and to establish the frequency of these tumors in the pediatric population Mexican. Determine the NF1/2 frequency in meningioma pediatric. METHODS: Samples from the histopathology file were reviewed, and from the complete clinical file the following patient data was reviewed: age, gender, diagnosis, diagnosis year, surgical resection, location, tumor size, symptoms, and family background. The frequency of NF1/2 in pediatric meningioma was reviewed in literature. RESULTS: Forty-four de novo cases were collected from pediatric patients; 19 were female patients and 25 males. The most frequent histological subtype was transitional meningioma. Of all the cases, 75% had a supratentorial localization and 20% had an extramedullary intrarachidian localization. Some clinical manifestations included seizures, paresis, headache, and visual disturbances. CONCLUSION: There is a low incidence of meningiomas in the pediatric population, more than 70% are Grade I, and they have supratentorial localization.

Asunto(s)

Meningioma , Adolescente , Niño , Preescolar , Femenino , Humanos , Masculino , Neoplasias Meníngeas/diagnóstico , Neoplasias Meníngeas/epidemiología , Neoplasias Meníngeas/patología , Meningioma/diagnóstico , Meningioma/epidemiología , Meningioma/patología , México/epidemiología , Clasificación del Tumor , Prevalencia , Estudios Retrospectivos , Adulto Joven

RESUMEN

Pediatricmeningiomas are rare and account for only 2.2% of the central nervous system (CNS) tumors. In this age group, they aremore frequently located in atypical sites, such as, mainly, the ventricular system, with a frequency of 8.8 to 13.6%. Adding this to the fact that the angiomatous subtype constitutes only 2.1% of allmeningiomas, the rarity of the case reported here is corroborated. We report a 17-year-old female patient diagnosed with intraventricular angiomatous meningioma; she underwent surgical resection of the tumor in the body and frontal horn of the right lateral ventricle, and there were no neurological sequelae. With a follow-up of 26 months, there was no recurrence and the patient had clinical stability. Intraventricular tumors usually have slow growth and reach a considerable size until they cause symptoms and then are diagnosed. In addition, the deep location of the tumor and its proximity to eloquent areas make these tumors a neurosurgical challenge. The angiomatous subtype, due to the presence of hypervascularization (consisting of > 50% of vascular components), may, in some cases, hinder surgical resection as well as be erroneously diagnosed. However, surgical treatment aimed at total resection of the lesion remains the conduct of choice in the case reported here, especially in patients in the first two decades of life, in which the use of radiation is avoided. Specifically when it comes to the surgery, we chose a transcalosal approach that allows a good transoperative visualization of the lesion when located in the body and frontal horn of the lateral ventricle.

Asunto(s)

Humanos , Femenino , Adolescente , Ventrículos Laterales/cirugía , Neoplasias Meníngeas/cirugía , Meningioma/cirugía , Resultado del Tratamiento , Neoplasias Meníngeas/diagnóstico por imagen , Meningioma/patología , Meningioma/diagnóstico por imagen

RESUMEN

Sarcoidosis is a systemic disease characterized by granulomatous inflammation. Pulmonary and lymphatic granulomatous involvement are common.We present a rare case report of involvement of the central nervous system affecting the ocular region and mimicking optic nerve sheath meningioma. We report the case of a 79-year-old female patient with progressive visual impairment with an evolution of 4 years. Amagnetic resonance imaging scan of the cranium with gadolinium and intense homogeneous contrast enhancement revealed an expansive lesion in the right optic nerve, at the height of the optic canal. The patient was submitted to the neurosurgical approach with lesion biopsy, which showed sarcoidosis of the central nervous system. Due to the rarity of central nervous system involvement, the diagnosis of this pathologymay unfortunately be postponed. The present article aims to elucidate this pathology as a differential diagnosis of retro-orbital tumors.

Asunto(s)

Humanos , Femenino , Anciano , Sarcoidosis/diagnóstico , Neoplasias del Nervio Óptico/cirugía , Neoplasias Meníngeas/cirugía , Meningioma/cirugía , Fosa Craneal Anterior/cirugía , Diagnóstico Diferencial , Neoplasias Meníngeas/diagnóstico por imagen , Meningioma/patología , Meningioma/diagnóstico por imagen

RESUMEN

Anaplastic or malignant meningiomas that are classified as World Health Organization (WHO) grade III account for less than 1% of all meningiomas diagnosed. Despite the aggressive course, distant metastases are a rarity, occurring in only 0.1% to 0.2% of cases. We report the case of a 56-year-old woman who presented with parasagittal benign meningioma that underwent malignant transformation along with metastasis into the right orbitosphenoid region. The clinical, radiological, and histopathological aspects are highlighted, with an emphasis on the natural history of meningiomas.

Asunto(s)

Humanos , Femenino , Persona de Mediana Edad , Seno Sagital Superior/cirugía , Neoplasias Meníngeas/cirugía , Meningioma/patología , Metástasis de la Neoplasia , Seno Sagital Superior/patología , Neoplasias Meníngeas/patología , Meningioma/cirugía , Meningioma/diagnóstico por imagen

RESUMEN

OBJECTIVE: To determine the epidemiology of the localization and histological type of meningiomas in the Mexican population and the distribution of the different histological patterns and their relationship to tumor localization and patient demographics. METHODS: A retrospective analysis was performed in 5 hospitals in Mexico from 2009 to 2019. For qualitative variables, mean values were compared using Pearson χ2 test for the correlation between location and histological pattern as well as the clinical presentation and the patient's sex. Student t test was performed for age and its correlation with location and histology. RESULTS: Analysis of 179 patients revealed significant differences in histopathological pattern, patient sex, and tumor location. No significant differences were found for age or clinical presentation in association with any specific histological pattern. CONCLUSIONS: There was a correlation between the histology of the 15 histopathological varieties of meningiomas and the predilection site of appearance as well as certain demographic aspects, such as sex. This study lays the foundation for future studies in Mexico on the differentiation and typing of meningiomas regardless of the histological grade to which they belong, as the exact behavior of these tumors, including grade I tumors, remains unknown to date.

Asunto(s)

Neoplasias Meníngeas/patología , Meningioma/patología , Adulto , Anciano , Femenino , Humanos , Masculino , Neoplasias Meníngeas/epidemiología , Meningioma/epidemiología , México/epidemiología , Persona de Mediana Edad , Estudios Retrospectivos , Organización Mundial de la Salud

RESUMEN

The systematic adoption of the histopathologic criteria provided by the 2016 update of the WHO classification of brain tumors has markedly increased the relative proportion of atypical and anaplastic meningiomas. These tumors exhibit a much greater recurrence rate compared to benign meningiomas, which negatively impacts survival. In recent years, the publication of numerous retrospective case series, yet no randomized controlled trials, on the impact of radiation therapy in non-benign meningioma, has yielded conflicting evidence. At present, maximum safe resection, including the dural attachment, is the preferred primary treatment modality for all types of meningiomas. Adjuvant radiotherapy is currently recommended for subtotally resected grade II and for all grade III meningiomas. However, in grade II meningiomas achieving complete resection, close radiologic and clinical observation is a feasible option. Despite the great amount of non-benign meningiomas available and eligible for trials, there is a striking lack of prospective studies testing adjuvant therapies against observation for this subset of patients. An updated and systematic literature review is provided on the effectiveness and indications of radiotherapy on grade II and III meningiomas.

Asunto(s)

Neoplasias Meníngeas/radioterapia , Meningioma/radioterapia , Recurrencia Local de Neoplasia/radioterapia , Radioterapia Adyuvante , Humanos , Neoplasias Meníngeas/clasificación , Neoplasias Meníngeas/patología , Neoplasias Meníngeas/cirugía , Meningioma/clasificación , Meningioma/patología , Meningioma/cirugía , Clasificación del Tumor , Recurrencia Local de Neoplasia/patología , Recurrencia Local de Neoplasia/cirugía , Estudios Prospectivos , Organización Mundial de la Salud

RESUMEN

Meningiomas are among the most common primary tumors of the central nervous system (CNS) and originate from the arachnoid or meningothelial cells of the meninges. Surgery is the first option of treatment, but depending on the location and invasion patterns, complete removal of the tumor is not always feasible. Reports indicate many differences in meningiomas from male versus female patients; for example, incidence is higher in females, whereas males usually develop the malignant and more aggressive type. With this as motivation, we used shotgun proteomics to compare the proteomic profile of grade I meningioma biopsies of male and female patients. Our results listed several differentially abundant proteins between the two groups; some examples are S100-A4 and proteins involved in RNA splicing events. For males, we identified enriched pathways for cell-matrix organization and for females, pathways related to RNA transporting and processing. We believe our findings contribute to the understanding of the molecular differences between grade I meningiomas of female and male patients.

Asunto(s)

Biomarcadores de Tumor/análisis , Neoplasias Meníngeas/diagnóstico , Meninges/patología , Meningioma/diagnóstico , Anciano , Anciano de 80 o más Años , Biomarcadores de Tumor/metabolismo , Biopsia , Conjuntos de Datos como Asunto , Femenino , Humanos , Masculino , Neoplasias Meníngeas/patología , Meningioma/patología , Persona de Mediana Edad , Clasificación del Tumor , Proteómica , Factores Sexuales , Transducción de Señal

RESUMEN

Objective To describe our surgical techniques, analyze their safety and their postoperative outcomes for foramen magnum tumors (FMTs). Methods From 1986 to 2014, 34 patients with FMTs underwent surgeries using either the lateral suboccipital approach, standard midline suboccipital craniotomy, or the far lateral approach, depending on the anatomic location of the lesions. Results In the present series, there were 22 (64.7%) female and 12 (35.2%)male patients. The age of the patients ranged from12 to 63 years old.We observed 1 operativemortality (2.9%). A total of 28 patients (82.3%) achieved a score of 4 or 5 in the Glasgow Outcome Scale (GOS). Gross total resection (GTR) was obtained in 22 (64.7%) patients. After the surgery, 9 (26%) patients developed lower cranial nerve dysfunction (LCNd) weakness. The follow-up varied from 1 to 24 years (mean: 13.2 years). Conclusion Themajority of tumors located in the FMcan be safely and efficiently removed usingeither thelateral suboccipital approach, standardmiddlelinesuboccipital craniotomy, or the far lateral approach, depending on the anatomic location of the lesions.

Asunto(s)

Procedimientos Neuroquirúrgicos/métodos , Foramen Magno/cirugía , Neoplasias Meníngeas/cirugía , Meningioma/cirugía , Registros Médicos , Estudios Retrospectivos , Resultado del Tratamiento , Craneotomía/métodos , Foramen Magno/anomalías , Foramen Magno/fisiopatología , Meningioma/patología

RESUMEN

Introduction Meningiomas are the most common primary intracranial tumors, accounting for up to 35% of the neoplasms in this category. Approximately 10­20% of these neoplasms are histologically atypical, and the lymphoplasmacyte-rich meningioma (LPM) corresponds to a very rare subtype of meningioma that is characterized histopathologically by massive infiltrates of inflammatory cells. The case described in the present study is the sixth case of an intraventricular LPM found in the literature and the first case considering the location in the third ventricle. Case Description A 21-year-old male without previous comorbidities sought medical attention due to visual impairment (complaining of intermittent visual blur) for 2 months. A magnetic resonance imaging of the brain confirmed the presence of a well-delimited solid mass in the third ventricle of 3.0 2.3 cmwith a cystic component that extended itself inferiorly and distorted the visual pathway anatomy. Neurosurgeons decided to access the lesion using an interhemispheric transcallosal approach with a transforaminal access, and the lesion was resected completely. The patient has an ambulatorial endocrinological follow-up and is neurologically stable 6 months after the procedure. No new visual deficits were noted. Conclusion Lymphoplasmacyte-rich meningioma is a very rare intracranial tumor, and the involvement of the third ventricle make this case unique.

Asunto(s)

Humanos , Masculino , Adulto , Tercer Ventrículo/cirugía , Tercer Ventrículo/patología , Neoplasias Meníngeas/cirugía , Meningioma/cirugía , Neoplasias Meníngeas/patología , Neoplasias Meníngeas/diagnóstico por imagen , Meningioma/patología , Meningioma/diagnóstico por imagen