Multiple extraneural metastases from a benign intracranial meningioma

Abstract Background The surgery of giant intracranial meningiomas (GIM) is difficult due to its large size, prominent vascularity, including and limiting visualization of various neurovascular structures, and severe cerebral edema. In this study, we will evaluate the surgical outcome of giant meningiomas according to our experience at our hospital in management of giant intracranial meningioma. Main body A retrospective analysis of 48 patients with histologically proven meningioma (≥ 6-cm diameter) who underwent surgical treatment at Benha University hospitals over a period of 5 years (June 2014/June 2019) is presented. Details regarding clinical presentation, imaging findings, surgical results and complications, and follow-up status were collected. The study group was composed of 41 females and 7 males. The age of the study group ranged from 38 to 69 years with an average of 49 years. The mean follow-up period was 36 months. Different approaches were used according to tumor location with the aim of gross total removal. Gross total removal was achieved in 90% of cases (43 cases). There were 2 cases with intraoperative complications not related to surgery. Recurrence was present in 4 cases. Mortality in this series was 4% (2 cases) with no reported intraoperative mortality. Conclusion Management of giant intracranial meningioma is a relatively common practice in neurosurgical centers in developing countries with the aim of radical total surgical removal being the first and most optimum option. Large size makes surgery difficult, but young age, meticulous surgical techniques, proper localization, trying to minimize operative time, and Simpson grade are of special value. Interdisciplinary cooperation is essential to avoid the common complications like pulmonary embolism (PE), postoperative hematoma in tumor bed that leads to bad surgical outcome.

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Image-Guided Multisession Radiosurgery of Skull Base Meningiomas

Cancers ◽

10.3390/cancers12123569 ◽

2020 ◽

Vol 12 (12) ◽

pp. 3569

Author(s):

Alfredo Conti ◽

Antonio Pontoriero ◽

Giuseppe Iatì ◽

Salvatore M. Cardali ◽

Anna Brogna ◽

...

Keyword(s):

Skull Base ◽

Stereotactic Radiosurgery ◽

Cranial Nerves ◽

Progression Free Survival ◽

Motor Deficits ◽

Intracranial Meningioma ◽

Treatment Schedule ◽

Fractionated Radiotherapy ◽

Patient Reported ◽

Skull Base Meningiomas

Background: The efficacy of single-session stereotactic radiosurgery (sSRS) for the treatment of intracranial meningioma is widely recognized. However, sSRS is not always feasible in cases of large tumors and those lying close to critically radiation-sensitive structures. When surgery is not recommended, multi-session stereotactic radiosurgery (mSRS) can be applied. Even so, the efficacy and best treatment schedule of mSRS are not yet established. The aim of this study is to validate the role of mSRS in the treatment of skull base meningiomas. Methods: A retrospective analysis of patients with skull base meningiomas treated with mSRS (two to five fractions) at the University of Messina, Italy, from 2008 to 2018, was conducted. Results: 156 patients met the inclusion criteria. The median follow-up period was 36.2 ± 29.3 months. Progression-free survival at 2-, 5-, and 10- years was 95%, 90%, and 80.8%, respectively. There were no new visual or motor deficits, nor cranial nerves impairments, excluding trigeminal neuralgia, which was reported by 5.7% of patients. One patient reported carotid occlusion and one developed brain edema. Conclusion: Multisession radiosurgery is an effective approach for skull base meningiomas. The long-term control is comparable to that obtained with conventionally-fractionated radiotherapy, while the toxicity rate is very limited.

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In Reply to the Letter to the Editor Regarding “Effect of Surgeon Experience on Surgical Outcome of 80-Year-Old or Older Intracranial Meningioma Patients”

World Neurosurgery ◽

10.1016/j.wneu.2021.04.108 ◽

2021 ◽

Vol 151 ◽

pp. 319

Author(s):

Ilari Rautalin ◽

Christoph Schwartz ◽

Mika Niemelä ◽

Miikka Korja

Keyword(s):

Surgical Outcome ◽

Intracranial Meningioma ◽

Letter To The Editor ◽

Surgeon Experience

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Risk of Developing Postoperative Deficits Based on Tumor Location after Surgical Resection of an Intracranial Meningioma

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0038-1667066 ◽

2018 ◽

Vol 80 (01) ◽

pp. 059-066 ◽

Cited By ~ 4

Author(s):

Jeff Ehresman ◽

Tomas Garzon-Muvdi ◽

Davis Rogers ◽

Michael Lim ◽

Gary Gallia ◽

...

Keyword(s):

Cognitive Deficits ◽

Tertiary Care ◽

Treatment Strategies ◽

Tumor Location ◽

Radiation Hazard ◽

Motor Deficits ◽

Intracranial Meningioma ◽

Preoperative Radiation ◽

Simpson Grade ◽

Vision Deficits

Object Meningiomas occur in various intracranial locations. Each location is associated with a unique set of surgical nuances and risk profiles. The incidence and risk factors that predispose patients to certain deficits based on tumor locations are unclear. This study aimed to determine which preoperative factors increase the risk of patients having new deficits after surgery based on tumor location for patients undergoing intracranial meningioma surgery. Methods Adult patients who underwent primary, nonbiopsy resection of a meningioma at a tertiary care institution between 2007 and 2015 were retrospectively reviewed. Stepwise multivariate logistic regression analyses were used to identify associations with postoperative deficits based on tumor location. Results Postoperatively, from the 761 included patients, there were 39 motor deficits (5.1%), 23 vision deficits (3.0%), 19 language deficits (2.5%), 27 seizures (3.5%), and 26 cognitive deficits (3.4%). The factors independently associated with any postoperative deficits were preoperative radiation (hazard ratio [HR] [95% confidence interval, CI] 3.000 [1.346–6.338], p = 0.008), cerebellopontine angle tumors (HR [95% CI] 2.126 [1.094–3.947], p = 0.03), Simpson grade 4 resections (HR [95% CI] 2.000 [1.271–3.127], p = 0.003), preoperative motor deficits (HR [95% CI] 1.738 [1.005–2.923], p = 0.048), preoperative cognitive deficits (HR [95% CI] 2.033 [1.144–3.504], p = 0.02), and perioperative pulmonary embolisms (HR [95% CI] 11.741 [2.803–59.314], p = 0.0009). Conclusion Consideration of the factors associated with postoperative deficits in this study may help guide treatment strategies for patients with meningiomas.

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Extensive Extraneural Metastases of Cerebral Glioblastoma in a Pediatric Patient: An Extreme Case Report and Comprehensive Review of the Literature

Pediatric Neurosurgery ◽

10.1159/000515348 ◽

2021 ◽

pp. 1-6

Author(s):

Kadir Oktay ◽

Dogu Cihan Yildirim ◽

Arbil Acikalin ◽

Kerem Mazhar Ozsoy ◽

Nuri Eralp Cetinalp ◽

...

Keyword(s):

Case Report ◽

Pediatric Patients ◽

Extreme Case ◽

Rare Condition ◽

Review Of The Literature ◽

Pertinent Literature ◽

Cervical Lymph Nodes ◽

Case Presentation ◽

Comprehensive Review ◽

Extraneural Metastases

Introduction: Extraneural metastases of glioblastoma are very rare clinical entities, especially in pediatric patients. Because of their rarity, they can be confused with other pathological processes. Case Presentation: We report a case of 16-year-old boy with extensive extraneural metastases of glioblastoma. Lung, liver, cervical lymph nodes, skin, and bone metastases were detected in the patient. Conclusion: We describe the presentation, evaluation, and diagnosis of this rare condition with regard to pertinent literature.

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Intracranial meningioma in a patient with osteogenesis imperfecta

Open Medicine ◽

10.2478/s11536-008-0053-7 ◽

2008 ◽

Vol 3 (4) ◽

pp. 517-520

Author(s):

Parmenion Tsitsopoulos ◽

Ioannis Anagnostopoulos ◽

Vasileios Tsitouras ◽

Ioannis Venizelos ◽

Philippos Tsitsopoulos

Keyword(s):

Osteogenesis Imperfecta ◽

Muscle Power ◽

Brain Mri ◽

Intracranial Meningioma ◽

Type I ◽

Mri Scans ◽

Heritable Disorder ◽

History Of ◽

One Year ◽

Gait Disturbances

AbstractOsteogenesis imperfecta (OI) is a heritable disorder characterized mainly by connective tissue manifestations. In dinstinct cases, several neurological features have also been described. A 46-year-old male with a known family history of OI type I presented with progressive gait disturbances and diminished muscle strength. Brain MRI scans revealed an infiltrative intracranial mass occupying both frontoparietal lobes. The patient underwent surgical intervention. The histological diagnosis was an atypical (Grade II) meningioma. The bony parts demonstrated a mixture of osseous defects due to OI and infiltration by the tumor. At one-year follow up the patient′s muscle power partially returned while repeat MRI scans were negative for tumor recurrence.

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