Surgically Difficult‑ to‑ Treat Meningiomas


Authors: M. Duba;  A. Mrlian;  E. Neuman;  J. Musil;  M. Smrčka
Authors‘ workplace: Neurochirurgická klinika LF MU a FN Brno
Published in: Cesk Slov Neurol N 2015; 78/111(1): 88-92
Category: Short Communication

Overview

Surgical treatment is still considered as the method of choice for the treatment of meningiomas. The goal of treatment is to completely surgically remove the tumor; complete excision often results in a permanent cure of the patient. The patient prognosis is mainly determined by the completeness of the resection but anatomical location and histological type of the tumor according to the WHO classification also play an important role. Some meningiomas, especially the skull base meningiomas, often involving large vessels and cranial nerves, as well as WHO grade III meningiomas are very difficult to treat. Patient general health status and internal comorbidities represent another very important factor. The authors describe the most common types of surgically difficult-to-treat meningiomas and describe their experience with surgical removal and additional treatment and surveillance of patients with these tumors.

Key words:
meningioma – surgery – resection

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manu­script met the ICMJE “uniform requirements” for biomedical papers.


Sources

1. Kane AJ, Sughrue ME, Rutkowski MJ, Shangari G, Fang S, McDermott MW et al. Anatomic location is a risk factor for atypical and malignant meningiomas. Cancer 2011; 117(6): 1272– 1278. doi: 10.1002/ cncr.25591.

2. Larjavaara S, Haapasalo H, Sankila R, Helén P, Auvinen A. Is the incidence of meningiomas underestimated? A regional survey. Br J Cancer 2008; 99(1): 182– 184.

3. Wiemels J, Wrensch M, Claus EB. Epidemiology and etiology of meningioma. J Neurooncol 2010; 99(3): 307– 314. doi: 10.1007/ s11060‑ 010‑ 0386‑ 3.

4. Perrot‑ Applanat M, Groyer‑ Picard MT, Kujas M. Immunocytochemical study of progesterone receptor in human meningioma. Acta Neurochir 1992; 115(1– 2): 20– 30.

5. Sughrue ME, Kane AJ, Shangari G, Rutkowski MJ, McDermott MW, Berger MS et al. The relevance of Simpson Grade I and II resection in modern neurosurgical treatment of World Health Organization Grade I meningiomas. J Neurosurg 2010; 113(5): 1029– 1035. doi: 10.3171/ 2010.3.JNS091971.

6. Palma L, Celli P, Franco C, Cervoni L, Cantore G. Long‑term prognosis for atypical and malignant meningiomas: a study of 71 surgical cases. Neurosurg Focus 1997; 2(4): 122– 126.

7. Pannullo SC, Fraser JF, Moliterno J, Cobb W, Stieg PE. Stereotactic radiosurgery: a meta‑analysis of current therapeutic applications in neuro‑oncologic disease. J Neurooncol 2011; 103(1): 1– 17. doi: 10.1007/ s11060‑ 010‑ 0360‑ 0.

8. Pollock BE, Stafford SL, Utter A, Giannini C, Schreiner SA. Stereotactic radiosurgery provides equivalent tumor control to Simpson Grade 1 resection for patients with small‑ to medium‑ size meningiomas. Int J Radiat Oncol Biol Phys 2003; 55(4): 1000– 1005.

9. Náhlovský J et al. Neurochirurgie. 1. vyd. Praha: Galén 2006.

10. Kozler P et al. Intrakraniální nádory. 1. vyd. Praha: Galén 2007.

11. Simpson D. The recurrence of intracranial meningiomas after surgical treatment. J Neurol Neurosurg Psychiatry 1957; 20(1): 22– 39.

12. Stafford S L, Perry A, Suman VJ, Meyer FB, Scheithauer BW, Lohse CM et al. Primarily resected meningiomas: outcome and prognostic factors in 581 Mayo clinic patients, 1978 through 1988. Mayo Clin Proc 1998; 73(10): 936– 942.

13. Schul DB, Wolf S, Krammer MJ, Landscheidt JF, Tomasino A, Lumenta CB. Meningioma surgery in the elderly: outcome and validation of 2 proposed grading scores systems. Neurosurgery 2012; 70(3): 555– 565. doi: 10.1227/ NEU.0b013e318233a99a.

14. Mirimanoff RO, Dosoretz DE, Linggood RM, Ojemann RG, Martuza RL. Meningioma: analysis of recurrence and progression following neurosurgical resection. J Neurosurg 1985; 62(1): 18– 24.

15. Jung HW, Yoo H, Paek SH, Choi KS. Long‑term outcome and growth rate of subtotally resected petroclival meningiomas: experience with 38 cases. Neurosurgery 2000; 46(3): 567– 574.

16. Kleihues P, Burger PD, Scheithauer BW. Histological typing of tumors of the central nervous system. World Health Organisation international histological classification of tumors. 1st ed. Berlin: Springer 1993: 33– 37.

17. Rohringer M, Sutherland GR, Louw DF, Sima AA. Incidence and clinicopathological features of meningioma. J Neurosurg 1989; 71(5): 665– 672.

18. Mahmood A, Caccamo DV, Tomecek FJ, Malik GM. Atypical and malignant meningiomas: a clinicopathological review. Neurosurgery 1993; 33(6): 955– 963.

19. Maier H, Ofner D, Hittmair A, Kitz K, Budka H. Classic, atypical, and anaplastic meningioma: three histopathological subtypes of clinical relevance. J Neurosurg 1997; 77(4): 616– 623.

20. Palma L, Celli P, Franco C, Cervoni L, Cantore G. Long‑term prognosis for atypical and malignant meningiomas: a study of 71 surgical cases. J Neurosurg 1997; 86(5): 793– 800.

21. Milosevic MF, Frost PJ, Laperriere NJ, Wong CS, Simpson WJ. Radiotherapy for atypical or malignant intracranial meningioma. Int J Radiat Oncol Biol Phys 1996; 34(4): 817– 822.

22. Dziuk TW, Woo S, Butler EB, Thornby J, Grossman R, Dennis WS et al. Malignant meningioma: an indication for initial aggressive surgery and adjuvant radiotherapy. J Neurooncol 1998; 37(2): 177– 188.

23. Goyal LK, Suh JH, Mohan DS, Prayson RA, Lee J, Barnett GH. Local control and overall survival in atypical meningioma: a retrospective study. Int J Radiat Oncol Biol Phys 2000; 46(1): 657– 661.

24. Jääskeläinen J, Haltia M, Servo A. Atypical and anaplastic meningiomas: radiology, surgery, radiotherapy and outcome. Surg Neurol 1986; 25(3): 233– 242.

25. McCarthy BJ, Davis FG, Freels S, Surawicz TS, Damek DM, Grutsch J et al. Factors associated with survival in patients with meningioma. J Neurosurg 1998; 88(5): 831– 839.

26. Perry A, Scheithauer BW, Stafford SL, Lohse CM, Wollan PC. “Malignancy” in meningiomas: a clinicopathologic study of 116 patients, with grading implications. Cancer 1999; 85(9): 2046– 2056.

27. Hsu DW, Pardo FS, Efird JT, Linggood RM, Hedley‑ Whyte ET. Prognostic significance of proliferative indices in meningiomas. J Neuropathol Exp Neurol 1994; 53(3): 247– 255.

28. Mesic JB, Hanks GE, Doggett RL. The value of radiation therapy as an adjuvant to surgery in intracranial meningiomas. Am J Clin Oncol 1986; 9(4): 337– 340.

29. Hakim R, Alexander E, Loeffler JS, Shrieve DC, Wen P, Fallon MP et al. Results of linear accelerator‑based radiosurgery for intracranial meningiomas. Neurosurgery 1998; 42(3): 446– 453.

30. Kondziolka D, Niranjan A, Lunsford LD, Flickinger JC. Stereotactic radiosurgery for meningiomas. Neurosurg Clin North Am 1999; 10(4): 317– 325.

31. Nutting C, Brada M, Brazil L, Sibtain A, Saran F, Westbury C et al. Radiotherapy in the treatment of benign meningioma of the skull base. J Neurosurg 1999; 90(5): 823– 827.

32. Debus J, Wuendrich M, Pirzkall A, Hoess A, Schlegel W, Zuna I et al. High efficacy of fractionated stereotactic radiotherapy of large base‑ of‑ skull meningiomas: long‑term results. J Clin Oncol 2001; 19(15): 547– 553.

33. Stafford SL, Pollock BE, Foote RL, Link MJ, Gorman DA, Schomberg PJ et al. Meningioma radiosurgery: tumor control, outcomes and complications among 190 consecutive patients. Neurosurgery 2001; 49(5): 1029– 1037.

34. Santacroce A, Walier M, Régis J, Liščák R, Motti E, Lind­quist C et al. Long‑term tumor control of benign intracranial meningiomas after radiosurgery in a series of 4,565 patients. Neurosurgery 2012; 70(1): 32– 39. doi: 10.1227/ NEU.0b013e31822d408a.

35. Kollová A, Liščák R, Šemnícká J, Simonová G, Vladyka V, Urgosík D et al. Dlhodobé výsledky liečby meningeómov Leksellovým gama nožom. Cesk Slov Neurol N 2010; 73/ 106(4): 415– 421.

36. Kollová A, Liscák R, Novotný J jr, Vladyka V, Simonová G, Janouskova L. Gamma knife surgery for benign meningioma. J Neurosurg 2007; 107(2): 325– 336.

37. Firsching RP, Fischer A, Peters R, Thun F, Klug N. Growth rate of incidental meningiomas. J Neurosurg 1990; 73(4): 545– 547.

38. Olivero WC, Lister JR, Elwood PW. The natural history and growth rate of asymp­tomatic meningiomas: a review of 60 patients. J Neurosurg 1995; 83(2): 222– 224.

39. Niiro M, Yatsushiro K, Nakamura K, Kawahara Y, Kuratsu J. Natural history of elderly patients with asymp­tomatic meningiomas. J Neurol Neurosurg Psychiatry 2000; 68(1) 25– 28.

40. Nakamura M, Roser F, Michel J, Jacobs C, Samii M. The natural history of incidental meningiomas. Neurosurgery 2003; 53(1): 62– 70.

41. Jääskeläinen J, Haltia M, Laasonen E, Wahlström T, Valtonen S. The growth rate of intracranial meningiomas and its relation to histology. An analysis of 43 patients. Surg Neurol 1985; 24(2): 165– 172.

42. Lee JH. Meningiomas: Dia­gnosis, Treatment, and Outcome. 1st ed. London (UK): Springer Science & Business Media 2009.

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Paediatric neurology Neurosurgery Neurology
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