WORLD HEALTH ORGANIZATION GRADES II AND III MENINGIOMAS ARE RARE IN THE CRANIAL BASE AND SPINE

Neurosurgery ◽  
2007 ◽  
Vol 61 (6) ◽  
pp. 1194-1198 ◽  
Author(s):  
Burak Sade ◽  
Ali Chahlavi ◽  
Ajit Krishnaney ◽  
Sean Nagel ◽  
Eugene Choi ◽  
...  
Keyword(s):  
World Health Organization ◽  
Tumor Location ◽  
Cranial Base ◽  
World Health ◽  
Spinal Tumors ◽  
Who Grade ◽  
Grade Ii ◽  
Spinal Meningiomas ◽  
Health Organization ◽  
Grade Iii

Abstract OBJECTIVE This study was undertaken to assess a possible relationship between the tumor location and the incidence of World Health Organization (WHO) Grades II and III meningiomas. METHODS A retrospective review of 794 consecutive patients who underwent meningioma resection between January 1991 and March 2004 was conducted. Among these, 47 patients (5.9%) with WHO Grade II meningiomas and 16 patients (2%) with Grade III meningiomas were further analyzed. Tumor location was assessed using preoperative magnetic resonance imaging scans and/or operative reports. Histological grading was done according to the WHO 2000 Classification scheme. RESULTS WHO Grade II tumors were found in eight out of 289 (2.8%) cranial base meningiomas and in zero spinal meningiomas, compared with 39 out of 429 (9.1%) non-cranial base meningiomas. Grade III histology was encountered in two (0.7%) cranial base tumors and in one out of 76 (1.3%) spinal tumors, compared with 13 (3%) non-cranial base tumors. The combined incidence of Grades II and III meningiomas was significantly lower in the cranial base (3.5%) and spinal (1.3%) locations compared with non-cranial base locations (12.1%) (P < 0.001). CONCLUSION WHO Grades II and III meningiomas occur far less frequently in the cranial base and spinal locations. Tumors arising from these locations may have different mechanisms of tumorigenesis and/or progression compared with meningiomas arising from other (non-cranial base) regions.

Stereotactic radiation treatment for recurrent nonbenign meningiomas

2007 ◽  
Vol 106 (5) ◽  
pp. 846-854 ◽  
Author(s):  
Carlos A. Mattozo ◽  
Antonio A. F. De Salles ◽  
Ivan A. Klement ◽  
Alessandra Gorgulho ◽  
David McArthur ◽  
...  
Keyword(s):  
Radiation Treatment ◽  
Progression Free Survival ◽  
Malignant Progression ◽  
World Health ◽  
Who Grade ◽  
Stereotactic Radiation ◽  
Grade Ii ◽  
Health Organization ◽  
Grade Iii

Object The authors analyzed the results of stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRT) for the treatment of recurrent meningiomas that were described at initial resection as showing aggressive, atypical, or malignant features (nonbenign). Methods Twenty-five patients who underwent SRS and/or SRT for nonbenign meningiomas between December 1992 and August 2004 were included. Thirteen of these patients underwent treatment for multiple primary or recurrent lesions. In all, 52 tumors were treated. All histological sections were reviewed and reclassified according to World Health Organization (WHO) 2000 guidelines as benign (Grade I), atypical (Grade II), or anaplastic (Grade III) meningiomas. The median follow-up period was 42 months. Seventeen (68%) of the cases were reclassified as follows: WHO Grade I (five cases), Grade II (11 cases), and Grade III (one case). Malignant progression occurred in eight cases (32%) during the follow-up period; these cases were considered as a separate group. The 3-year progression-free survival (PFS) rates for the Grades I, II, and III, and malignant progression groups were 100, 83, 0, and 11%, respectively (p < 0.001). In the Grade II group, the 3-year PFS rates for patients treated with SRS and SRT were 100 and 33%, respectively (p = 0.1). After initial treatment, 22 new tumors required treatment using SRS or SRT; 17 (77%) of them occurred inside the original resection cavity. Symptomatic edema developed in one patient (4%). Conclusions Stereotactic radiation treatment provided effective local control of “aggressive” Grade I and Grade II meningiomas, whereas Grade III lesions were associated with poor outcome. The outcome of cases in the malignant progression group was intermediate between that of the Grade II and Grade III groups, with the lesions showing a tendency toward malignancy.

scholarly journals Demographics and outcome of histologically confirmed intracranial meningiomas

2019 ◽  
Vol 3 (2) ◽  
pp. 2514183X1989494
Author(s):  
Maria Kamenova ◽  
Raphael Guzman ◽  
Jehuda Soleman
Keyword(s):  
Demographic Data ◽  
Tumor Location ◽  
Morbidity And Mortality ◽  
World Health ◽  
Proliferation Index ◽  
Who Grade ◽  
Primary Tumors ◽  
Radiological Data ◽  
Grade Ii ◽  
Health Organization

Objective: Meningiomas represent the most common intracranial extraaxial neoplasia in adults, accounting for a third of all diagnosed primary tumors of the brain. Despite decades of research, relatively little data on demographics of meningiomas exist. The aim of our study was to undertake an analysis of demographics and outcome of patients who underwent meningioma surgery over an 8-year time period at our institution. Methods: We reviewed 187 consecutive patients with histologically confirmed meningioma. Demographic data, tumor location and side, surgical resection grade, and histopathological and radiological data were collected and assessed for all patients. Furthermore, recurrence, morbidity, and mortality were evaluated. Results: Of the 187 consecutive patients undergoing meningioma resection over a period of 8 years, 131 (70.1%) were women ( p < 0.001). Meningiomas were classified as World Health Organization (WHO) grade I, grade II, and grade III in 66.8%, 31.0%, and 2.1%, of the cases, respectively ( p < 0.001). MIB-1 proliferation index was <1 in 7.5%, 1–5 in 52.9%, 6–10 in 22.4%, >10 in 11.8% of the lesions ( p < 0.001). In 82.4% of the cases, gross total resection was achieved. Recurrence occurred in 23 patients (12.3%), while overall morbidity and mortality rate was 41.2% and 7.7%, respectively. Conclusion: Based on our results, women are more than twice as likely to be affected, and the peak age is between 60 years and 70 years. Recurrence rate in our cohort was relatively low when compared to the data in the literature. The diagnosis of WHO grade II meningiomas, 31% in our cohort, is increasing since the 2007 WHO criteria have been published.

Pathology of Spinal Ependymomas

Neurosurgery ◽  
2013 ◽  
Vol 73 (2) ◽  
pp. 247-255 ◽  
Author(s):  
Phiroz E. Tarapore ◽  
Peter Modera ◽  
Agne Naujokas ◽  
Michael C. Oh ◽  
Beejal Amin ◽  
...  
Keyword(s):  
Adjuvant Radiotherapy ◽  
Histological Grade ◽  
Progression Free Survival ◽  
Extent Of Resection ◽  
World Health ◽  
Subtotal Resection ◽  
Who Grade ◽  
Grade Ii ◽  
Health Organization ◽  
Grade Iii

AbstractBACKGROUND:Ependymomas constitute approximately 40% of primary intraspinal tumors. Current World Health Organization (WHO) grading may not correlate with observed progression-free survival (PFS).OBJECTIVE:This retrospective study of prospectively collected data examines whether PFS is influenced by the histological grade or by the extent of resection. It also analyzes the usage and effectiveness of postoperative adjuvant radiotherapy.METHODS:We reviewed 134 consecutive patients with ependymomas of all grades. Pathology slides were re-reviewed and the histological grades were confirmed by a single neuropathologist. Postoperative residual or recurrence was evaluated with follow-up magnetic resonance imaging.RESULTS:There were 85 male and 49 female patients, ranging from 10 to 79 (median 41) years of age. Thirty patients had WHO grade I tumors, 101 had grade II tumors, and 3 had grade III tumors. Kaplan-Meier analysis of PFS demonstrated a mean duration of 6 years for grade I, 14.9 years for grade II, and 3.7 years for grade III (P &lt; .001). In grade II ependymomas, mean PFS was 11.2 years with subtotal resection and 17.8 years with gross total resection (P &lt; .01). PFS of patients who underwent subtotal resection was not significantly changed by adjuvant radiotherapy (P &lt; .36).CONCLUSION:Patients with grade II ependymoma have significantly longer PFS than patients with grade I ependymoma. The extent of resection did not affect PFS in grade I ependymoma but it did in grade II. Contrary to its higher grade, WHO grade II ependymoma carries a better prognosis than WHO grade I ependymoma.

Intraorbital Meningiomas: A Pathologic Review Using Current World Health Organization Criteria

2010 ◽  
Vol 134 (5) ◽  
pp. 766-770 ◽  
Author(s):  
Deepali Jain ◽  
Katayoon B. Ebrahimi ◽  
Neil R. Miller ◽  
Charles G. Eberhart
Keyword(s):  
Optic Nerve ◽  
World Health Organization ◽  
Neurofibromatosis Type ◽  
Clinical Findings ◽  
World Health ◽  
Who Grade ◽  
Brain Invasion ◽  
Adjacent Structures ◽  
Grade Ii ◽  
Health Organization

Abstract Context.—Meningiomas represent approximately 4% of all intraorbital tumors and can arise from the optic nerve or extend into the orbit from adjacent structures. Objective.—To examine a cohort of intraorbital meningiomas and use the current World Health Organization (WHO) scheme to assess the effect of changes to the classification of tumors at this site. Design.—The histopathology and clinical findings of intraorbital meningiomas resected between 1968 and 2008 at our institution were reviewed according to the WHO 2007 classification scheme. Results.—A total of 51 intraorbital meningiomas were reviewed. The mean age at presentation was 45 years, but 5 tumors arose in children. Two patients were known to have neurofibromatosis type 2, and 1 had inherited retinoblastoma. Orbital meningiomas were more frequently encountered in women (30 cases) than in men (21 cases). In 21 patients, the tumor was associated with the optic nerve. The most common (25 of 51 tumors; 49%) histopathologic subtype was meningothelial. Most (47 of 51; 92%) of the tumors were WHO grade I. Four tumors (8%) were WHO grade II, with 4 or more mitotic figures per 10 high-power fields, brain invasion, chordoid histology, or a combination of these features. Conclusions.—Intraorbital meningiomas were most frequently of the meningothelial or transitional subtypes and were WHO grade I. One relatively common intracranial subtype, fibrous meningioma, was not encountered. The percentage of WHO grade II tumors in the orbit (8%) is similar to that reported for intracranial tumors using the current grading scheme.

Association between fluorine-18–labeled fluorodeoxyglucose uptake and 1p and 19q loss of heterozygosity in World Health Organization Grade II gliomas

2007 ◽  
Vol 106 (4) ◽  
pp. 633-637 ◽  
Author(s):  
Florian Stockhammer ◽  
Ulrich-Wilhelm Thomale ◽  
Michail Plotkin ◽  
Christian Hartmann ◽  
Andreas von Deimling
Keyword(s):  
World Health Organization ◽  
Fdg Pet ◽  
Magnetic Resonance Images ◽  
World Health ◽  
Low Grade ◽  
Who Grade ◽  
Fdg Uptake ◽  
Grade Ii ◽  
Health Organization ◽  
Who Grade Ii Gliomas

Object Oligodendroglial tumors harboring combined 1p and 19q loss (1p/19q LOH) are characterized by a favorable prognosis and response to chemotherapy and radiotherapy, but detection of 1p/19q LOH relies on postoperative procedures. The authors investigated the potential of fluorine-18–labeled fluorodeoxyglucose (FDG) uptake in positron emission tomography (PET) to predict 1p/19q LOH preoperatively in tumors whose appearance on initial magnetic resonance images was consistent with that of low-grade glioma. Methods The study population comprised 25 patients who had undergone preoperative FDG-PET followed by tumor resection. Neuronavigation ensured a precise match of FDG uptake wi th the site of biopsy. All tumor specimens were graded according to the World Health Organization (WHO) classification system. Microsatellite analysis was used to identify 1p/19q LOH. In this series, 16 of 25 gliomas corresponded to WHO Grade II. In eight of these 16, 1p/19q LOH was detected. Raised glucose utilization within the tumor was seen in the six of eight WHO Grade II gliomas with 1p/19q LOH and in none of the WHO Grade II gliomas without this genetic alteration (p = 0.003). Conclusions These findings demonstrate the potential of FDG-PET to predict 1p/19q LOH in WHO Grade II gliomas.

scholarly journals Extracranial metastases in secondary glioblastoma multiforme: a case report

BMC Neurology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jessica Rossi ◽  
Lucia Giaccherini ◽  
Francesco Cavallieri ◽  
Manuela Napoli ◽  
Claudio Moratti ◽  
...  
Keyword(s):  
Brain Lesion ◽  
Rare Event ◽  
Subsequent Development ◽  
World Health ◽  
Who Grade ◽  
Systemic Involvement ◽  
Grade Ii ◽  
The Stability ◽  
Health Organization ◽  
Extracranial Metastases

Abstract Background Glioblastoma (GBM) is known for its devastating intracranial infiltration and its unfavorable prognosis, while extracranial involvement is a very rare event, more commonly attributed to IDH wild-type (primary) GBM evolution. Case presentation We present a case of a young woman with a World Health Organization (WHO) grade II Astrocytoma evolved to WHO grade IV IDH mutant glioblastoma, with subsequent development of lymphatic and bone metastases, despite the favorable biomolecular pattern and the stability of the primary brain lesion. Conclusions Our case highlights that grade II Astrocytoma may evolve to a GBM and rarely lead to a secondary metastatic diffusion, which can progress quite rapidly; any symptoms referable to a possible systemic involvement should be carefully investigated.

Prognostic value of initial magnetic resonance imaging growth rates for World Health Organization grade II gliomas

2006 ◽  
Vol 60 (3) ◽  
pp. 380-383 ◽  
Author(s):  
Johan Pallud ◽  
Emmanuel Mandonnet ◽  
Hugues Duffau ◽  
Michèle Kujas ◽  
Rémy Guillevin ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
World Health Organization ◽  
Growth Rates ◽  
Prognostic Value ◽  
World Health ◽  
Resonance Imaging ◽  
Grade Ii ◽  
Health Organization
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