scholarly journals Use of Saito technique to resect an anterior lumbar spine meningioma: Technical note

2021 ◽  
Vol 12 ◽  
pp. 276
Author(s):  
Ignacio J. Barrenechea ◽  
Luis M. Marquez ◽  
Marcelo Pastor
Keyword(s):  
Insertion Site ◽  
Technical Note ◽  
World Health ◽  
Total Removal ◽  
Total Resection ◽  
Dural Repair ◽  
Simpson Grade ◽  
Grade Ii ◽  
Spinal Meningiomas ◽  
Health Organization

Background: Complete (Simpson Grade I: total removal) resections for anterior spinal meningiomas are especially challenging. This is largely attributed to difficulty obtaining a water-tight dural repair where the tumor has infiltrated the dura requiring duroplasty, thus often resulting in just a Simpson Grade II resection (i.e. coagulation of the dural implantation site). Here, we present a 56-year-old female who underwent resection of a ventral lumbar meningioma utilizing the Saito technique, that effectively separated the dura into two layers, removing just the inner layer but leaving the outer layer intact for direct dural repair. Methods: A 56-year-old female underwent a L1–L2 laminectomy. The anterior intradural resection of tumor was achieved with the Saito technique; this required cutting circumferentially around the tumor insertion site, and removing only the inner layer. Results: Postoperatively, the patient did well without tumor recurrence over 8 years. The postoperative biopsy confirmed a World Health Organization Grade I meningothelial meningioma. Conclusion: Saito’s technique proved to be a safe and effective method for achieving gross total resection of an anterior lumbar meningioma.

Revisiting Adjuvant Radiotherapy After Gross Total Resection of World Health Organization Grade II Meningioma

2017 ◽  
Vol 103 ◽  
pp. 655-663 ◽  
Author(s):  
Christopher S. Graffeo ◽  
Heather E. Leeper ◽  
Avital Perry ◽  
Joon H. Uhm ◽  
Daniel J. Lachance ◽  
...  
Keyword(s):  
World Health Organization ◽  
Adjuvant Radiotherapy ◽  
World Health ◽  
Gross Total Resection ◽  
Total Resection ◽  
Grade Ii ◽  
Health Organization

Effect of Gross Total Resection in World Health Organization Grade II Astrocytomas: SEER-Based Survival Analysis

2017 ◽  
Vol 103 ◽  
pp. 741-747 ◽  
Author(s):  
Alexander J. Schupper ◽  
Brian R. Hirshman ◽  
Kate T. Carroll ◽  
Mir Amaan Ali ◽  
Bob S. Carter ◽  
...  
Keyword(s):  
Survival Analysis ◽  
World Health Organization ◽  
World Health ◽  
Gross Total Resection ◽  
Total Resection ◽  
Grade Ii ◽  
Health Organization

scholarly journals Benign meningiomas (WHO Grade I) with atypical histological features: correlation of histopathological features with clinical outcomes

2016 ◽  
Vol 124 (1) ◽  
pp. 106-114 ◽  
Author(s):  
Ariel E. Marciscano ◽  
Anat O. Stemmer-Rachamimov ◽  
Andrzej Niemierko ◽  
Mykol Larvie ◽  
William T. Curry ◽  
...  
Keyword(s):  
Prognostic Significance ◽  
Risk Groups ◽  
World Health ◽  
Who Grade ◽  
Simpson Grade ◽  
Atypical Features ◽  
Additional Surgery ◽  
Increased Risk ◽  
Grade Ii ◽  
Health Organization

OBJECT World Health Organization (WHO) Grade I (benign) meningiomas with atypical features may behave more aggressively than similarly graded tumors without atypical features. Here, the prognostic significance of atypical features in benign meningiomas was determined. METHODS Data from patients diagnosed with WHO Grade I benign meningiomas per the 2007 WHO criteria and who underwent surgery between 2002 and 2012 were retrospectively reviewed. Patients were stratified by the absence or presence of 1 to 2 atypical features with review of the clinical and histological factors. RESULTS A total of 148 patients met the inclusion criteria (n = 77 with atypia; n = 71 without atypia). The median follow-up duration after pathological diagnosis was 37.5 months. Thirty patients had progression/recurrence (P/R) after initial treatment, and 22 (73%) of 30 patients with P/R had 1–2 atypical features. The presence of atypical features was significantly associated with P/R (p = 0.03) and independent of the MIB-1 labeling index. The 1-year and 5-year actuarial rates of P/R were 9.6% versus 1.4% and 30.8% versus 13.8% fortumors with and without atypical features, respectively. Higher Simpson grade resection (II–IV vs I) was associated with the increased risk of P/R (p < 0.001). Stratification of patients into low-risk (Simpson Grade I), intermediate-risk (Simpson Grade II–IV with no atypical features), and high-risk groups (Simpson Grade II–IV with atypical features) was significantly correlated with increased risk of P/R (p < 0.001). CONCLUSIONS Patients with benign meningiomas with atypical features and those undergoing Simpson Grade II–IV resection are at significantly increased risk of P/R. Patients with these features may benefit from the consideration of additional surgery and/or radiation therapy.

scholarly journals Poor Prognostic Factors for Surgical Treatment of Spinal Intramedullary Ependymoma (World Health Organization Grade II)

2020 ◽  
Vol 14 (6) ◽  
pp. 821-828
Author(s):  
Osahiko Tsuji ◽  
Narihito Nagoshi ◽  
Ryota Ishii ◽  
Satoshi Nori ◽  
Satoshi Suzuki ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Prognostic Factors ◽  
World Health Organization ◽  
Scale Score ◽  
Multiple Logistic Regression Analysis ◽  
World Health ◽  
Total Resection ◽  
Grade Ii ◽  
Health Organization

Study Design: Single-center retrospective study.Purpose: We aimed to explore the postoperative prognostic factors for spinal intramedullary ependymoma.Overview of Literature: Ependymoma (World Health Organization grade II) is the most frequent intramedullary spinal tumor and is treated by total resection. However, postoperative deterioration of motor function occasionally occurs.Methods: Eighty patients who underwent surgical resection at Keio University and Fujita Health University in Tokyo, Japan between 2003 and 2015 with more than 2 years of follow-up were enrolled. A good surgical result was defined as an improvement in the modified McCormick Scale score by one grade or more or having the same clinical grade as was observed preoperatively. Meanwhile, a poor result was defined as a reduction in the McCormick Scale score of one grade or more or remaining in grade IV or V at final follow-up. Univariate and multivariate logistic regression analyses of the following factors were performed in the two groups: sex, age, preoperative Visual Analog Scale (VAS), tumor location, the extent of tumor resection, hemosiderin caps, cavity length, and tumor length on magnetic resonance imaging.Results: At final follow-up, 15 patients were included in the poor results group and 65 in the good results group. In the univariate analysis, the factors related to poor results were as follows: higher age, preoperative McCormick Scale score severity, higher preoperative VAS, thoracic location, hemosiderin capped, and non-gross total resection (GTR). A multiple logistic regression analysis was conducted and showed that age, worse preoperative McCormick Scale score, and non-GTR were significant factors for poor prognosis.Conclusions: The independent risk factors for motor deterioration after ependymoma resection were age, worse preoperative McCormick Scale score, and non-GTR. Early surgery for patients with even mild neurological disorders could facilitate functional outcomes. These results may contribute to determining the optimal timing of surgery for spinal intramedullary ependymoma.

Simpson Grade I-III Resection of Spinal Atypical (World Health Organization Grade II) Meningiomas is Associated With Symptom Resolution and Low Recurrence

Neurosurgery ◽  
2015 ◽  
Vol 76 (6) ◽  
pp. 739-746 ◽  
Author(s):  
Sam Q. Sun ◽  
Chunyu Cai ◽  
Vijay M. Ravindra ◽  
Paul Gamble ◽  
Chester K. Yarbrough ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Confidence Interval ◽  
World Health ◽  
Gross Total Resection ◽  
Adjuvant Radiation ◽  
Total Resection ◽  
Adjuvant Radiation Therapy ◽  
Symptom Resolution ◽  
Simpson Grade ◽  
Health Organization

Abstract BACKGROUND: Because of their rarity, outcomes regarding spinal atypical meningiomas (AMs) remain unclear. OBJECTIVE: To describe the recurrence rate and postoperative outcomes after resection of spinal AMs, and to discuss an appropriate resection strategy and adjuvant therapy for spinal AMs. METHODS: Data from all patients who presented with spinal AMs to 2 tertiary referral centers between 1998 and 2013 were obtained by chart review. RESULTS: From 102 patients with spinal meningioma, 20 AM tumors (7 cervical, 11 thoracic, 2 thoracolumbar) were identified in 18 patients (median age, 50 years [range, 19-75] at time of resection; 11% male; median follow-up, 32 months [range, 1-179] after resection). Before resection, patients had sensory deficits (70%), pain (70%), weakness (60%), ataxia (50%), spasticity (65%), and incontinence (35%). One tumor presented asymptomatically. Simpson grade I, II, III, and IV resection were achieved in 3 (15%), 13 (65%), 2 (10%), and 2 (10%) tumors, respectively. One patient that underwent Simpson grade III resection received adjuvant radiation therapy. After Simpson grade I-III or gross total resection, no tumors recurred (0%; confidence interval, 0%-17.6%). After Simpson grade IV resection, 1 tumor recurred (50%; confidence interval, 1.3%-98.7%). With the exception of 1 patient who had bilateral paraplegia perioperatively, all other patients experienced improvement of preoperative symptoms after surgery (median time, 3.6 months [range, 1-13] after resection). CONCLUSION: Despite published cases suggesting an aggressive clinical course for spinal AMs, this series of spinal AMs reports that gross total resection without adjuvant radiation therapy resulted in symptom resolution and low recurrence.

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 &lt; 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.

scholarly journals Clinical Aspects of Spinal Meningiomas: a Review

Folia Medica ◽  
2021 ◽  
Vol 63 (1) ◽  
pp. 24-29
Author(s):  
Georgi Apostolov ◽  
Ivo Kehayov ◽  
Borislav Kitov
Keyword(s):  
Clinical Symptoms ◽  
Age Groups ◽  
World Health ◽  
Axial Position ◽  
Clinical Aspects ◽  
Degree Of Malignancy ◽  
Grade Ii ◽  
Histological Characteristics ◽  
Spinal Meningiomas ◽  
Health Organization

Spinal meningiomas are found in all age groups, predominantly in women aged over 50 years. The clinical symptoms of this condition may range from mild to significant neurological deficit, varying widely depending on the location, position in relation to the spinal cord, size and histological type of the tumor. Magnetic resonance imaging is the diagnostic tool of choice because it shows the location, size, the axial position of the tumor, and the presence of concomitant conditions such as spinal malformations, edema or syringomyelia. &nbsp;According to the degree of malignancy, the World Health Organization divides meningiomas into three grades: grade I - benign; grade II &ndash; atypical, and grade III - malignant. The goal of the surgery is total resection which is achievable in 82%&ndash;98% of cases. Advances in radiosurgery have led to its increased use as primary or adjunct therapy. The current paper aims to review the fundamental clinical as-pects of spinal meningiomas such as their epidemiology, clinical presentation, histological characteristics, diagnostics, and management.

scholarly journals Recurrent Sphenocavernous Meningioma

2021 ◽  
Author(s):  
Mizuho Inoue ◽  
Mohamed Labib ◽  
Alexander Yang ◽  
A. Samy Youssef
Keyword(s):  
Tumor Resection ◽  
Intensity Modulated Radiotherapy ◽  
Residual Tumor ◽  
World Health ◽  
Neurological Deficits ◽  
Falciform Ligament ◽  
Total Resection ◽  
Anterior Clinoid Process ◽  
Who Grade ◽  
Health Organization

AbstractA case of a recurrent sphenocavernous meningioma is presented. The patient is a 42-year-old male who presented with an episode of transient right-sided numbness. A magnetic resonance imaging (MRI) revealed a large left sphenocavernous meningioma. The patient underwent a frontotemporal craniotomy for tumor resection. Near total resection was achieved with minimal residual in the left cavernous sinus (CS) and orbital apex. The pathology was consistent with meningioma, World Health Organization (WHO) grade I. A follow-up MRI was done 9 months after surgery and showed a growth of the residual tumor, which was treated with intensity modulated radiotherapy. Tumor growth was detected on serial imaging over a 4-year period. Surgical resection was offered. A left frontotemporal craniotomy with pretemporal transcavernous approach was performed. The bone flap was reopened and the dura was opened in a Y-shaped fashion. The roof of the optic canal was drilled off, and the falciform ligament was opened to decompress the optic nerve. The tumor was disconnected from the anterior clinoid region (the anterior clinoid process was eroded by the tumor) and reflected off the wall of the lateral CS. Tumor was adherent to the V2 fascicles (the lateral CS wall was resected in the first surgery) and was sharply dissected off. Gross total resection was achieved. The pathology was consistent with meningioma, WHO grade I. The patient had an unremarkable postoperative course without any new neurological deficits.The link to the video can be found at: https://youtu.be/KVBVw_86JqM.

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.

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