Journal articles on the topic 'Meningioma tumors'
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1
Yamazaki, Shintaro, Fumiharu Ohka, Masaki Hirano, Yukihiro Shiraki, Kazuya Motomura, Kuniaki Tanahashi, Takashi Tsujiuchi, et al. "TB-2 Patient-derived meningioma organoid model demonstrates FOXM1 dependent tumor proliferation." Neuro-Oncology Advances 3, Supplement_6 (December 1, 2021): vi5—vi6. http://dx.doi.org/10.1093/noajnl/vdab159.020.
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Abstract Recent comprehensive studies have revealed several molecular alterations that are frequently found in meningiomas. However, effective treatment reagents targeting specific molecular alterations have not yet been identified because of the limited number of representative research models of meningiomas. We established 18 organoid models comprising of two malignant meningioma cells (HKBMM and IOMM-Lee), 10 benign meningiomas, four malignant meningiomas, and two solitary fibrous tumors (SFTs). Using immunohistochemistry and molecular analyses consisting of whole exome sequencing, RNA-seq, and DNA methylation analyses, we compared the histological findings and molecular profiling of organoid models with those of parental tumors. The organoids exhibited consistent histological features and molecular profiles with those of the parental tumors. Using a public database of meningioma, we identified that upregulated forkhead box M1 (FOXM1) was correlated with increased tumor proliferation. Overexpression of FOXM1 in benign meningioma organoids increased organoid proliferation; depletion of FOXM1 in malignant organoids decreased proliferation. Additionally, thiostrepton, a FOXM1 inhibitor combined with radiation therapy, significantly inhibited proliferation of malignant meningioma organoid models (P<0.01). An organoid model for meningioma enabled us to elucidate the tumor biology of meningioma along with potent treatment targets for meningioma.
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McCutcheon, Ian E., Keith E. Friend, Tammy M. Gerdes, Bing-Mei Zhang, David M. Wildrick, and Gregory N. Fuller. "Intracranial injection of human meningioma cells in athymic mice: an orthotopic model for meningioma growth." Journal of Neurosurgery 92, no. 2 (February 2000): 306–14. http://dx.doi.org/10.3171/jns.2000.92.2.0306.
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Object. Although human meningioma cells have been heterotopically implanted in nude mice, introducing these cells into intracranial locations seems more likely to reproduce normal patterns of tumor growth. To provide an orthotopic xenograft model of meningioma, the authors implanted a controlled quantity of meningioma cells at subdural and intracerebral sites in athymic mice.Methods. Malignant (one tumor), atypical (two tumors), or benign (three tumors) meningiomas were placed into primary cell cultures. Cells (106/10 µl) from these cultures and from an immortalized malignant meningioma cell line, IOMM-Lee, were injected with stereotactic guidance into the frontal white matter or subdural space of athymic mice. Survival curves were plotted for mice receiving tumor cells of each histological type and according to injection site. Other mice were killed at intervals and their heads were sectioned whole. Hematoxylin and eosin staining of these sections revealed the extent of tumor growth.Conclusions. The median length of survival for mice with malignant, atypical, or benign tumors was 19, 42, or longer than 84 days, respectively. Atypical and malignant tumors were invasive, but did not metastasize extracranially. Malignant tumors uniformly showed leptomeningeal dissemination and those implanted intracerebrally grew locally and spread noncontiguously to the ventricles, choroid plexus, convexities, and skull base. Tumors formed in only 50% of mice injected with benign meningioma cells, whereas injection of more aggressive cells was uniformly successful at tumor production. The three types of human meningiomas grown intracranially in athymic mice maintained their relative positions in the spectrum of malignancy. However, atypical meningiomas became more aggressive after xenografting and acquired malignant features, implying that there had been immune constraint in the original host. Tumor cells injected into brain parenchyma migrated to more optimal environments and grew best there. This model provides insights into the biology of meningiomas and may be useful for testing new therapies.
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Maxwell, Marius, Sarah D. Shih, Theofanis Galanopoulos, E. Tessa Hedley-Whyte, and G. Rees Cosgrove. "Familial meningioma: analysis of expression of neurofibromatosis 2 protein Merlin." Journal of Neurosurgery 88, no. 3 (March 1998): 562–69. http://dx.doi.org/10.3171/jns.1998.88.3.0562.
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✓ Meningiomas are primarily benign brain tumors thought to arise through multistep tumorigenesis, involving both the activation of oncogenes and the loss of tumor suppressor genes. The recently isolated neurofibromatosis 2 (NF2) tumor suppressor gene has been found to be mutated in a large proportion of meningiomas. Almost all cases of familial meningioma occur in association with NF2. Familial meningioma in isolation from NF2 (sporadic) is exceedingly rare, with only 14 reports since 1959. The authors report the existence of a family lacking any stigmata of NF2, in which two members had spinal meningiomas. Tumor specimens were subjected to immunocytochemical analysis for the NF2 protein product Merlin, which has been implicated in the tumorigenesis of meningioma. Merlin immunoreactivity was present in both tumor specimens, implying that the NF2 tumor suppressor gene was not deleted in these tumors. This supports the hypothesis that a second tumor suppressor gene locus, other than NF2, acts in the formation of familial sporadic meningioma. The results are discussed in the context of putative oncogenic mechanisms of familial meningiomas.
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Iacob, G., and M. Craciun. "Atypical meningioma." Romanian Neurosurgery 19, no. 3 (November 9, 2012): 203–9. http://dx.doi.org/10.2478/v10282-012-0010-5.
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Abstract Objective: Atypical meningioma are an intermediate group of meningiomas, exhibiting less favourable biological behavior than classic benign tumours, but a relatively more favourable biological behavior than definitive malignant meningiomas. Subject of controversy, atypia in meningioma still generate discordance between accurate criteria defining malignancy and biological behavior, prediction of recurrence. Methods: This retrospective study intend to evaluate diagnosis on clinical and pathological data, treatment trends and early outcomes for 6 cases with atypical meningiomas occuring in 63 patients operated for benign meningioma in the last 5 years in our clinic between 2006-2011. All patients were explored CT, MRI, preoperative selective angiography and in all cases the WHO 2000 classification criteria were used to define atypical meningioma Results: Between 2006-2011 we operated 6 atypical meningioma of 63 benign meningiomas (9,52%). Tumor sites in the patients were: parasagittal (3 cases), convexity (2 cases), spheno-cavernous (1 case). All patients were operated and dural graft was done to all cases. The extent of surgical resection was Simpson’s grade 1 in 2 cases and Simpson’s grade 2 in four cases, to which radiation was administered after the first surgery with a dose ranging from 52-62 Gy. Regrowth (enlargement of tumour after subtotal resection) was noticed in 2 irradiated cases: one case after 2 years after the first operation, the patient was again operated - pathological diagnosis was malignant meningioma; in another case after 3 years, at operation it was the atypical meningioma. No chemotherapy was used in our cases. Conclusions: Atypical meningiomas are rare tumors, grow more rapidely, the diagnosis age ≥ 60 years, several histological criteria can define accurate identification to understand the biology of this group of tumors. Heterogenous contrast enhancement with marked peritumoral edema in neuroimaging are important; cerebral edema has prognostic value and should encourage fundamental and farmacologic research using anti VEGF and somatostatine analogs treatments. Surgery (Simpson grade 1) referring both tumor and dural implant area should be done de novo but also for recurrencies. Radiotherapy still are controversial without proven benefit and chemotherapy without statistic argues to improve quality of life.
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Sharifi, Guive, Mahmoud Lotfinia, Mahmoud Omidbeigi, Sina Asaadi, and Farahnaz Bidari Zerehpoosh. "Meningothelial meningioma of the oculomotor nerve: A case report and review of the literature." Surgical Neurology International 11 (October 2, 2020): 314. http://dx.doi.org/10.25259/sni_312_2020.
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Background: The origin of meningioma tumors is known as the meningothelial or arachnoid cap cells. The arachnoid granulations or villi are concentrated along with the dural venous sinuses in the cerebral convexity, parasagittally, and sphenoid wing regions. The majority of meningiomas are found in these locations with dural attachment. Infrequently, meningiomas develop without dural attachment but in dural adjacent. There are numerous reports of patients with cranial nerve involvement as a result of the compressive effect of the sinus cavernous or adjacent structures meningioma tumor on the cranial nerve. Case Description: In this study, we reviewed all reports of patients with third nerve involvement as a result of meningioma tumors in addition to the introduction of a new case. We present a 47-year-old woman presented with headache, diplopia, and ptosis. A gadolinium-enhanced mass on anterolateral of the left cerebral peduncle with no dural attachment was suggesting for Schwannoma at preoperative imaging. An adhesive 10 × 5 × 4 mm meningothelial meningioma arising from the oculomotor nerve was resected. Conclusion: The findings of this review suggest that there may be other mechanisms as the origin of meningiomas tumors. It is crucial to take into account origination mechanisms of meningioma using ectopic meningiomas due to the increasing prevalence of meningioma.
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Yamaguchi, Satoshi, Masaaki Takeda, Toshiyuki Takahashi, Hitoshi Yamahata, Takafumi Mitsuhara, Tadaaki Niiro, Junya Hanakita, Kazutoshi Hida, Kazunori Arita, and Kaoru Kurisu. "Ginkgo leaf sign: a highly predictive imaging feature of spinal meningioma." Journal of Neurosurgery: Spine 23, no. 5 (November 2015): 642–46. http://dx.doi.org/10.3171/2015.3.spine1598.
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OBJECT Spinal meningioma and schwannoma are the most common spinal intradural extramedullary tumors, and the differentiation of these 2 tumors by CT and MRI has been a matter of debate. The purpose of this article is to present a case series of spinal meningiomas showing unique imaging features: a combination of a fan-shaped spinal cord and a streak in the tumor. The authors termed the former imaging feature “ginkgo leaf sign” and evaluated its diagnostic value. METHODS The authors present 7 cases of spinal meningioma having the ginkgo leaf sign. Thirty spinal extramedullary tumors arising lateral or ventrolateral to the spinal cord were studied to evaluate the diagnostic value of the ginkgo leaf sign for spinal meningiomas. Among 30 cases, 12 tumors were spinal meningiomas and 18 tumors from the control group were all schwannomas. RESULTS Seven of the 12 spinal meningiomas were positive for the ginkgo leaf sign. The sign was not present in the control group tumors. The overall ability to use the ginkgo leaf sign to detect meningioma indicated a sensitivity of 58%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 78%. CONCLUSIONS The ginkgo leaf sign is highly specific to spinal meningiomas arising lateral or ventrolateral to the spinal cord. In the present series, the ginkgo leaf sign was perfectly predictive for spinal meningioma.
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Miyatake, Shin-Ichi, Yoji Tamura, Shinji Kawabata, Kyoko Iida, Toshihiko Kuroiwa, and Koji Ono. "Boron Neutron Capture Therapy for Malignant Tumors Related To Meningiomas." Neurosurgery 61, no. 1 (July 1, 2007): 82–91. http://dx.doi.org/10.1227/01.neu.0000279727.90650.24.
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Abstract OBJECTIVE Malignant meningiomas, similar to glioblastomas, are difficult tumors to control. We tried to control malignant tumors related to meningiomas by boron neutron capture therapy (BNCT). METHODS Since June 2005, we applied BNCT with 13 rounds of neutron irradiation to seven cases of malignant tumors related to meningiomas. Three were anaplastic meningiomas, two were papillary meningiomas, one was an atypical meningioma, and one was a sarcoma transformed from a meningioma with cervical lymph node metastasis. All patients had previously undergone repetitive surgeries and radiotherapy. Follow-up images were available for six patients with an observation period between 7 and 13 months. We applied 18F-boronophenylalanine (BPA)-positron emission tomography (PET) before BNCT in six of the seven patients. One patient underwent methionine-PET instead of 18F-BPA-PET. RESULTS Five of the six patients who underwent BPA-PET analysis showed good BPA uptake, with a greater than 2.7 tumor-to-healthy brain ratio. The atypical meningioma case showed a tumor-to-healthy brain ratio of 2.0. The original tumor sizes were between 13.6 and 109 ml. Two of the three anaplastic meningiomas showed a complete response, and all six patients available for follow-up imaging showed radiographic improvements. Clinical symptoms before BNCT, such as hemiparesis and facial pain, were improved after BNCT in all but one patient. In this patient, a huge atypical meningioma arose from the falcotentorial junction and extended to the bilateral occipital lobes and brainstem; visual problems worsened after repetitive BNCT, with an increase in peritumoral edema. CONCLUSION Malignant meningiomas seem to be good candidates for BNCT.
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Ragel, Brian T., Isaac L. Elam, David L. Gillespie, Jeannette R. Flynn, David A. Kelly, David Mabey, Harvey Feng, William T. Couldwell, and Randy L. Jensen. "A novel model of intracranial meningioma in mice using luciferase-expressing meningioma cells." Journal of Neurosurgery 108, no. 2 (February 2008): 304–10. http://dx.doi.org/10.3171/jns/2008/108/2/0304.
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Object Meningioma research has been hindered by the inability to sequentially measure intracranial tumor growth in a cost-effective, efficient manner. Recently, the luciferase gene has been transfected into cancer lines to obtain cells that express the luciferase enzyme, which oxidizes luciferin in a reaction that releases photon energy that can be measured noninvasively by bioluminescence imaging (BLI) systems. The authors describe a mouse model of intracranial meningioma that uses this novel BLI system. Methods The immortal meningioma cell lines CH-157-MN and IOMM-Lee were transfected with luciferase and neomycin phosphotransferase (LucNeo) and selected with G418. These cells were stereotactically implanted at skull base and cerebral convexity locations in nude mice. Animals were imaged for bioluminescence biweekly, and 5 mice underwent magnetic resonance (MR) imaging. Tumors were harvested for immunohistochemical and ultrastructural analysis. Results The CH-157-MN-LucNeo and IOMM-Lee-LucNeo cell lines were successfully implanted intracranially in mice. The tumor induction rate for CH-157-MN-LucNeo skull base tumors was 90% (36 of 40 procedures). Statistical analysis of CH-157-MN-LucNeo skull base tumor volume measured on MR imaging correlated with the results of BLI showed an R value of 0.900. The tumors exhibited characteristics of aggressive meningiomas by insinuating along arachnoid planes and invading brain. Conclusions Noninvasive BLI was successfully used to image intracranial meningiomas in mice. The tumors grew in a fashion similar to that of aggressive meningiomas in humans, and exhibited the microscopic, immunohistochemical, and ultrastructural features characteristic of meningiomas. This animal model overcomes the main obstacle in studying intracranial meningiomas by enabling sequential noninvasive tumor measurement in a cost-effective manner.
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Yamazaki, Shintaro, Fumiharu Ohka, Masaki Hirano, Kazuya Motomura, Kuniaki Tanahashi, Kazuhito Takeuchi, Yukihiro Shiraki, et al. "TB-03 Newly Established Meningioma Organoid Model Elucidated an Important Role of FOXM1 in Meningioma Progression." Neuro-Oncology Advances 2, Supplement_3 (November 1, 2020): ii7. http://dx.doi.org/10.1093/noajnl/vdaa143.029.
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Abstract Meningioma is the most frequently occurring intracranial neoplasms in adults. Tumor removal surgery and radiotherapy were the widely accepted standard treatment for meningioma. Most meningioma cases were cured by extended total removal. However, some tumors develop in locations less amenable to resection, resulting in tumor recurrence after incomplete tumor removal followed by radiotherapy. Although several comprehensive studies have revealed frequently found molecular alterations of meningiomas, effective treatment reagents targeting specific molecular alterations have not been identified yet because of limited number of representative research models such as tumor cell lines or animal models of meningiomas. Recently developed 3D culture technologies have led to the development of novel cancer models, termed organoid models, due to their quite high efficiency of establishment. In this study, we established primary organoid culture methods using malignant meningioma cell lines (e.g. HKBMM and IOMM-Lee) and patient-derived meningioma tissues. Using this novel method, we have been able to establish six organoid models (four WHO grade I meningiomas, one WHO grade III one and one solitary fibrous tumor (SFT)) using tumor tissues derived from six consecutive patients with 100% success rate. Histological analyses, whole exome sequencing and copy number analyses revealed that these organoids exhibited consistent histological features and molecular profiling with those of parental tumors. Using public database, we identified upregulated FOXM1 was correlated with increased tumor proliferation. Over-expression of FOXM1 in benign meningioma organoids increased organoid proliferation, while depletion of FOXM1 in malignant ones decreased their proliferation. We revealed that novel organoid model for meningioma enable to shed light on the tumor biology of meningioma.
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Rohringer, Martin, Garnette R. Sutherland, Deon F. Louw, and Anders A. F. Sima. "Incidence and clinicopathological features of meningioma." Journal of Neurosurgery 71, no. 5 (November 1989): 665–72. http://dx.doi.org/10.3171/jns.1989.71.5.0665.
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✓ The incidence of intracranial meningioma in Manitoba, Canada, was reviewed from 1980 through 1987. During that time, 193 tumors were diagnosed, with a male:female ratio of 1:2. This occurrence corresponded to crude incidence rates of 2.3/100,000 for all meningiomas and 0.17/100,000 for malignant meningiomas. Among malignant meningiomas, the male:female ratio was 1:1. The age-specific annual incidence rate increased with age up to the eighth decade where it peaked at 8.4/100,000. The distribution of histopathological subtypes was: 74 meningotheliomatous (38%), 64 transitional (33%), 14 malignant (7%), 14 fibroblastic (7%), seven psammomatous (4%), four angioblastic (2%), and 16 unknown (8%). The diagnosis of malignant meningioma was based on the World Health Organization criteria, with only Grade III and IV tumors included in this subtype. Clinical features did not allow for differentiation of benign from malignant neoplasms. Individuals with malignant tumors were, however, more likely to suffer paresis (50%) and less likely to be without deficit (14%) than their benign counterparts. The radiographic appearance of “mushrooming” was observed only in patients with malignant meningioma. All malignant tumors showed evidence of peritumoral edema; however, none exhibited calcification. During the 8-year study interval, the tumor recurred in 10 (71%) of the 14 patients with malignant meningioma. Tumor recurrence was accompanied by dedifferentiation from a more benign histology in four patients (2% of the total material).
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Kashimura, Hiroshi, Takashi Inoue, Kuniaki Ogasawara, Hiroshi Arai, Yasunari Otawara, Yoshiyuki Kanbara, and Akira Ogawa. "Prediction of meningioma consistency using fractional anisotropy value measured by magnetic resonance imaging." Journal of Neurosurgery 107, no. 4 (October 2007): 784–87. http://dx.doi.org/10.3171/jns-07/10/0784.
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Object Preoperative planning for meningiomas requires information about tumor consistency as well as location and size. In the present study the authors aimed to determine whether the fractional anisotropy (FA) value calculated on the basis of preoperative magnetic resonance (MR) diffusion tensor (DT) imaging could predict meningioma consistency. Methods In 29 patients with intracranial meningiomas, MR DT imaging was performed preoperatively, and the FA values of the tumors were calculated. Tumor consistency was intraoperatively determined as hard or soft, and the histological diagnosis of the tumor was established. Results Of the 29 tumors, 11 were classified as hard and 18 as soft. The FA values of fibroblastic meningiomas were significantly higher than those of meningothelial meningiomas (p = 0.002). The FA values of hard tumors were significantly higher than those of soft tumors (p = 0.0003). Logistic regression analysis demonstrated that the FA value was a significant independent predictor of tumor consistency (p = 0.007). Conclusions The FA value calculated from preoperative MR DT imaging predicts meningioma consistency.
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Plotkin, Scott, Jeffrey Allen, Dusica Babovic-Vuksanovic, Christine Dinh, Leia Nghiemphu, Lorenzo Trippa, Kaleb Yohay, and Jaishri Blakeley. "CTNI-65. INTUITT-NF2, AN ADAPTIVE PLATFORM-BASKET TRIAL FOR NEUROFIBROMATOSIS 2 PATIENTS WITH PROGRESSIVE TUMORS: INTERIM RESULTS OF THE BRIGATINIB TREATMENT ARM." Neuro-Oncology 24, Supplement_7 (November 1, 2022): vii88. http://dx.doi.org/10.1093/neuonc/noac209.330.
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Abstract Neurofibromatosis type 2 (NF2) predisposes affected individuals to vestibular schwannomas (VS), non-vestibular schwannomas (NVS), meningiomas, and ependymomas. We developed an adaptive platform-basket trial to screen multiple drugs against any type of progressive NF2-related tumor. We report the interim analysis of the first treatment arm with brigatinib, an ALK inhibitor that inhibits multiple tyrosine kinases. We conducted a multicenter, phase II, open-label study for subjects ≥12 years old with NF2 and progressive target tumors (baskets: VS, NVS, meningioma, or ependymoma). Up to 5 non-target tumors were followed in each participant. In stage 1, 20 participants (minimum of 2 participants per basket) were treated with brigatinib 180 mg daily. Tumor response was evaluated by MRI every 3 months in year 1 and every 6 months thereafter. Radiographic response (RR) was defined as ≥20% decrease in target tumor volume from baseline. The primary outcome was RR rate. Per protocol, the brigatinib arm would be discontinued if no target tumor achieved a RR at interim analysis. Twenty subjects (median age=25 years, 7 pediatric, 12 females) were treated. Target tumors included 10 VS, 3 NVS, 5 meningiomas, and 2 ependymomas; non-target tumors included 18 VS, 36 NVS, and 14 meningiomas. RR rate for target and non-target tumors was 5% and 22%, respectively. By tumor basket, RR was 28% for meningioma, 26% for non-VS, 4% for VS, and 0% for ependymomas. Annualized tumor growth rates decreased for VS, NVS, and meningioma during treatment. Brigatinib was well tolerated with one dose reduction and one discontinuation due to grade 2 diarrhea. Brigatinib treatment was associated with RR in meningiomas, VS, and NVS. In stage 2, the study will enroll 20 participants in the two most promising baskets (meningioma and NVS). This novel design provides unique ability to assess treatments for hereditary syndromes with multiple primary tumors.
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Pawloski, Jacob A., Hassan A. Fadel, Yi-Wen Huang, and Ian Y. Lee. "Genomic Biomarkers of Meningioma: A Focused Review." International Journal of Molecular Sciences 22, no. 19 (September 23, 2021): 10222. http://dx.doi.org/10.3390/ijms221910222.
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Meningiomas represent a phenotypically and genetically diverse group of tumors which often behave in ways that are not simply explained by their pathologic grade. The genetic landscape of meningiomas has become a target of investigation as tumor genomics have been found to impact tumor location, recurrence risk, and malignant potential. Additionally, targeted therapies are being developed that in the future may provide patients with personalized chemotherapy based on the genetic aberrations within their tumor. This review focuses on the most common genetic mutations found in meningiomas of all grades, with an emphasis on the impact on tumor location and clinically relevant tumor characteristics. NF-2 and the non-NF-2 family of genetic mutations are summarized in the context of low-grade and high-grade tumors, followed by a comprehensive discussion regarding the genetic and embryologic basis for meningioma location and phenotypic heterogeneity. Finally, targeted therapies based on tumor genomics currently in use and under investigation are reviewed and future avenues for research are suggested. The field of meningioma genomics has broad implications on the way meningiomas will be treated in the future, and is gradually shifting the way clinicians approach this diverse group of tumors.
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Salviero, Felipe, Cláuder Ramalho, João Noberto Stavale, Sérgio Cavalheiro, and Manoel Antônio De Paiva Neto. "Pineal region chordoid meningioma." JBNC - JORNAL BRASILEIRO DE NEUROCIRURGIA 24, no. 2 (April 3, 2018): 148–52. http://dx.doi.org/10.22290/jbnc.v24i2.1403.
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Background: Meningiomas correspond to only 8% of pineal region tumors. Chordoid meningioma (CM) comprises only 0.5 to 1.0% of all intracranial meningiomas and is even rarer in the pineal region. In the literature, we found only six cases of pineal region CMs reported. Clinical presentation: We describe a case of one patient with headache, confusion, slurred speech and gait disturbance. The ophthalmologic examination revealed vertical gaze paresis and near-light dissociation of papillary reflex. MRI disclosed a large pineal region tumor with heterogeneous contrast enhancement. The tumor was totally removed by an occipital transtentorial approach (OTA) in a “three-quarter prone” position. Histological analysis disclosed a CM. Conclusion: Chordoid meningioma is a very rare variant of meningioma and the pineal region is a poorly described site. This study contributes to the understanding of this heterogeneous entity, to consider the CM as a differential diagnosis of pineal region tumors and to provide proper management of affected patients.
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Mezue, Wilfred C., Samuel C. Ohaegbulam, Chika C. Ndubuisi, Mark C. Chikani, and David S. Achebe. "Intracranial meningiomas managed at Memfys hospital for neurosurgery in Enugu, Nigeria." Journal of Neurosciences in Rural Practice 03, no. 03 (September 2012): 320–23. http://dx.doi.org/10.4103/0976-3147.102613.
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ABSTRACT Introduction: The epidemiology and pathology of meningioma in Nigeria are still evolving and little has been published about this tumor in Nigeria, especially in the southeast region. The aim of this paper is to compare the characteristics of intracranial meningioma managed in our center with the pattern reported in the literature worldwide. Materials and Methods: Retrospective analysis of prospectively recorded data of patients managed for intracranial meningioma between January 2002 and December 2010 at a Private neurosurgery Hospital in Enugu, Nigeria. We excluded patients whose histology results were inconclusive. Results: Meningiomas constituted 23.8% of all intracranial tumors seen in the period. The male to female ratio was 1:1.1. The peak age range for males and females were in the fifth and sixth decades, respectively. The most common location is the Olfactory groove in 26.5% of patients followed by convexity in 23.5%. Presentation varied with anatomical location of tumor. Patients with olfactory groove meningioma (OGM) mostly presented late with personality changes and evidence of raised ICP. Tuberculum sellar and sphenoid region tumors presented earlier with visual impairment with or without hormonal abnormalities. Seizures occurred in 30.9% of all patients and in 45% of those with convexity meningiomas. Only 57.4% of the patients were managed surgically and there was no gender difference in this group. WHO grade1 tumors were the most common histological types occurring in 84.6%. One patient had atypical meningioma and two had anaplastic tumors. Conclusion: The pattern of meningioma in our area may have geographical differences in location and histology. Childhood meningioma was rare.
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Siregar, Rais, and Sabri Ibrahim. "Intradural Extramedullary Spinal En-Plaque Meningioma With Calcification: A Case Report And Literature Review." Asian Australasian Neuro and Health Science Journal (AANHS-J) 3, no. 3 (December 27, 2021): 28–35. http://dx.doi.org/10.32734/aanhsj.v3i3.7607.
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Abstract
Introduction: Intradural extramedullary (IDEM) tumors are benign neoplasms arising in the spinal canal about two-thirds of primary spinal tumors and 15% of tumors affecting the Central Nervous System. Spinal en-plaque meningioma is a type that grows in a sheet-like or collar-like, and incidence in the literature only ranging from 0.1% to 3.1%. Pain is the most clinical symptom, weakness and sensory changes also occur frequently. Magnetic resonance imaging (MRI) is the standard modality for the radiologic diagnosis of meningioma.
Case Report: A patient, 35 years old man with a diagnosis of intradural extramedullary spinal meningioma (IDEM) en-plaque with calcification, confirmed by the symptoms, workups such as spinal MRI, and intra-operative findings. The patient was successfully treated surgically with laminectomy and total tumor resection with a posterior approach.
Discussion: Spinal en-plaque meningioma is a type that grows in a sheet-like or collar-like manner around the spinal cord can involve dura extensively with significant neurological deficits. Patient was with lower limb weakness, and had a history of back pain radiating to the right limb for the last 1 year. Spinal meningiomas are primarily found in the Intradural Extramedullary, and the tumor diagnosis is typically fairly straight forward based on radiologic findings. Meningiomas are most commonly found in the thoracic region of the spine. In this case from MRI Imaging was revealed a mass in thoracic region of the spine pressing the spinal cord anteriorly. The management of spinal en-plaque meningioma is tumor resection surgery. A retrospective study suggested a significant improvement in neurological deficit post-tumor resection on patients with spinal IDEM tumor.
Conclusion: Spinal meningioma is a reasonably frequently found case of a spinal tumor but spinal en-plaque meningiomas are rarely found. MRI scan is the radiological gold standar diagnose spinal en-plaque meningiomas. Patient was successfully treated by total tumor resection using the laminectomy method and tumor resection with a posterior approach without any postoperative complications observed.
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Alexiou, George A., Georgios S. Markopoulos, Evrysthenis Vartholomatos, Anna C. Goussia, Lefkothea Dova, Savvas Dimitriadis, Stefania Mantziou, et al. "Intraoperative Flow Cytometry for the Evaluation of Meningioma Grade." Current Oncology 30, no. 1 (January 7, 2023): 832–38. http://dx.doi.org/10.3390/curroncol30010063.
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Meningiomas are the most frequent central nervous system tumors in adults. The majority of these tumors are benign. Nevertheless, the intraoperative identification of meningioma grade is important for modifying surgical strategy in order to reduce postoperative complications. Here, we set out to investigate the role of intraoperative flow cytometry for the differentiation of low-grade (grade 1) from high-grade (grade 2–3) meningiomas. The study included 59 patients. Intraoperative flow cytometry analysis was performed using the ‘Ioannina Protocol’ which evaluates the G0/G1 phase, S-phase, mitosis and tumor index (S + mitosis phase fraction) of a tumor sample. The results are available within 5 min of sample receipt. There were 41 grade 1, 15 grade 2 and 3 grade 3 meningiomas. High-grade meningiomas had significantly higher S-phase fraction, mitosis fraction and tumor index compared to low-grade meningiomas. High-grade meningiomas had significantly lower G0/G1 phase fraction compared to low-grade meningiomas. Thirty-eight tumors were diploids and twenty-one were aneuploids. No significant difference was found between ploidy status and meningioma grade. ROC analysis indicated 11.4% of tumor index as the optimal cutoff value thresholding the discrimination between low- and high-grade meningiomas with 90.2% sensitivity and 72.2% specificity. In conclusion, intraoperative flow cytometry permits the detection of high-grade meningiomas within 5 min. Thus, surgeons may modify tumor removal strategy.
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Massella Junior, Carlos Roberto, Marcus Vinicius de Morais, Rafael Pontes Figueiredo, Andrezza Garcia Morales, and Paulo Mácio Porto de Melo. "Chordoid Meningioma: Literature Review." Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 39, no. 01 (March 2020): 012–15. http://dx.doi.org/10.1055/s-0039-3402490.
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AbstractChordoid meningiomas (CMs) are a rare subgroup of tumors, accounting for ∼ 0.5% of all meningiomas. Chordoid meningioma tumors correspond to World Health Organization (WHO) Grade II lesions and behave aggressively, with an increased likelihood of recurrence. There are few genetic studies about CMs, but we understand that there is deletion at many chromosomal loci. Histologically, CMs are characterized by strands and cords of meningothelial cells arranged in a mucinous stroma. Morphologically, it can mimic other chondroid and myxoid tumors within the brain and its vicinity, thus posing a diagnostic challenge. Chordoid meningiomas have an aggressive clinical course and a propensity to recur compared with classical meningiomas. The goal of the treatment is surgery, with total resection of the tumor; however, due to its high degree of recurrence, radiotherapy is often necessary as an adjuvant treatment.
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Mansour, Kareman, Dalal Anwar Elwi, Sara Elsayed Khalifa, and Heba Abdelmonem Ibrahim. "Immunohistochemical Expression of MUC4 in Different Meningioma Subtypes in Comparison to Some Mesenchymal Non-Meningothelial Tumors." Open Access Macedonian Journal of Medical Sciences 9, A (August 14, 2021): 626–31. http://dx.doi.org/10.3889/oamjms.2021.6783.
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BACKGROUND: Meningiomas are the most common primary tumors of the central nervous system worldwide. Routinely used immunohistochemical markers for diagnosis of confusing meningioma cases as epithelial membrane antigen lack specificity and sensitivity. MUC4 is glycosylated membrane-associated mucin expressed by normal epithelia and many cancers. However, it is recently noticed to be expressed in meningiomas. AIM: Intensity of MUC4 expression is needed to be verified whether it is the same among different subtypes or not. MATERIALS AND METHODS: Fifty cases of different intracranial meningioma subtypes and thirty cases of mesenchymal nonmeningothelial tumors were immunohistochemically stained with MUC4 antibody. The results of MUC4 expression intensity were associated with some clinical and pathological parameters. RESULTS: Most studied meningioma cases (84%) showed positive MUC4 expression. Meningothelial meningioma subtype showed characteristic pattern of diffuse and moderate to strong MUC4 staining. While fibroblastic meningioma showed mostly negative staining pattern and focal weak staining pattern if positive. A statistically significant relationship was detected between tumor subtype and intensity of MUC4 expression. On contrary, most included mesenchymal cases were MUC4 negative with statistical significance. Hence, the sensitivity of MUC4 as diagnostic marker for meningioma was 84%, while the specificity was 93.3%. Furthermore, meningioma histologic subtype showed significant relationship with age. CONCLUSION: The current study results suggest that MUC4 could be used as meningioma diagnostic marker with some limitations. Moreover, meningioma should be included in the differential diagnosis of MUC4 positive tumors.
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David, D. Stalin. "Parasagittal Meningioma Brain Tumor Classification System Based on Mri Images and Multi Phase Level Set Formulation." Biomedical and Pharmacology Journal 12, no. 2 (April 9, 2019): 939–46. http://dx.doi.org/10.13005/bpj/1720.
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The most common type of brain tumor known as Meningioma arises from the meninges and encloses the spine and the brain inside the skull. It accounts for 30% of all types of brain tumor. Meningioma’s can occur in many parts of the brain and accordingly it is named. In this paper, we propose Meningioma brain tumor classification system using MRI image is developed . Firstly, based on the characteristics of MRI image and Chan-Vese model, we use multiphase level set method to get the interesting region. Therefore, we obtain two matrixes, in which one contains the whole cell's boundary, and the other contains the boundary of some cells. Secondly, with respect to the cells' boundary, it is necessary to further processing, which ensures the boundary of some cells is a discrete region. Mathematical Morphology brings a fancy result during the discrete processing. At last, we consider every discrete region according to the tumor's features to judge whether a tumor appears in the image or not. Our method has a desirable performance in the presence of common tumors. For some non-convex tumors, we utilized a traditional way (SVM and LBP) as a second processing, which increased the coverage and accuracy. Experiments show that our method has a high coverage without any learning-based classifiers for most common tumors, which saves a lot time and reduces a lot workload. Therefore, the proposed method has a good practical application for assisting physicians in detecting Meningiom tumors using MRI images.
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Zhang, Huiyuan, Lin Qi, Yuchen Du, Frank Braun, Mari Kogiso, Lei Huang, Tiemo Klisch, et al. "TMOD-21. TARGETING ANAPLASTIC MENINGIOMA WITH PANOBINOSTAT IN PATIENT-DERIVED ORTHOTOPIC XENOGRAFT (PDOX) MODELS DERIVED FROM A MATCHING PAIR OF PRIMARY AND RECURRENT TUMORS." Neuro-Oncology 21, Supplement_6 (November 2019): vi267. http://dx.doi.org/10.1093/neuonc/noz175.1120.
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Abstract BACKGROUND Meningioma is the most common brain tumor in adults. Despite the overall benign nature of meningioma, skull base tumors can be difficult to completely resect while others exhibit progression and aggressive profiles. The lack of clinically relevant animal models is blocking the development of novel therapies. MATERIAL AND METHODS Twelve surgical specimens (1 × 105) from 11 adult meningioma patients were implanted into the frontal cranial-base of the brain of SCID mice. Mice were then followed and assessed for tumor formation. Tumor growth was confirmed by small animal MRI. Pathologic features of the PDOX models and the matched patient tumors were compared with standard H&E and immunohistochemical staining. RNAseq was performed to examine the molecular fidelity of PDOX tumors and to identify new therapeutic targets. A panel of 60 clinically-relevant drugs was developed for screening drug sensitivity. In vivo examination of therapeutic efficacy of Panobinostat was performed in two models by treating preformed PDOX tumors with i.p. injection (10 mg/kg), 5 days on, 5 days off for 2 cycles. RESULTS Intracranial xenograft formation was confirmed in two samples derived from the same patient, the first an atypical meningioma (K029MEN-P) and the second, which progressed to anaplastic meningioma at recurrence (K029MEN-R). MRI scanning revealed that the PDOX tumors grew from the skull base. These patient tumor cells can be cryopreserved for long-term maintenance of tumorigenicity. The xenograft tumors replicated histopathological features of parental tumors. Overall gene expression profiles of PDOX were similar to the original patient tumors. Using MEN primary culture cells, we screened 60 drugs and identified 12 (20%) active compounds. Panobinostat also significantly prolonged survival of mice bearing orthotopic meningiomas. CONCLUSION A set of meningioma PDOX models derived from primary and recurrent tumor was established. Our data further demonstrate that panobinostat exerts potent antitumor activity against high-grade meningioma.
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Hoon Kim, Jeong, and Hee Jun Yoo. "CTNI-55. PREDICTIVE FACTORS FOR HIGH GRADE TRANSFORMATION IN BENIGN MENINGIOMAS." Neuro-Oncology 22, Supplement_2 (November 2020): ii55. http://dx.doi.org/10.1093/neuonc/noaa215.221.
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Abstract OBJECT Meningiomas are generally slow-growing, benign tumors, most of which are classified as WHO Grade I. Rarely, benign meningiomas may recur after surgery with transformation into WHO Grade II atypical meningiomas. As atypical meningiomas are different from benign meningiomas in terms of clinical course, and prognosis, predicting the transformation is important for patient management. The purpose of the study was to investigate the radiological and pathological factors that predict the risk of tumor progression from benign to atypical meningioma. METHOD All patients treated with recurrent meningiomas in whom the tumor showed histopathologically confirmed high grade transformation between 2001 and 2017 were included. To evaluate the predictors for transformation, patients’ medical records for previous benign meningioma before transformation were collected. Each patient was matched with 4 age and sex-matched controls treated with benign meningioma, and were analyzed. RESULTS Fourteen patients with high grade transformation were included. The median time interval of transformation was 63 months (range of 19 – 132). Multivariate analysis indicated that increased mitotic index (OR, 10.409, 95% CI, 1.297–83.549, p=0.027) was significant predictive factor of transformation. And prominent peritumoral edema (OR, 33.822, 95% CI, 0.935–223.688, p=0.054) showed relative risk for transformation. CONCLUSION Increased mitotic index and prominent peritumoral edema may be predictors for high grade transformation of benign meningiomas. Although these tumors do not meet the criteria for atypical meningioma, they may be required more attentive observation and management than other benign meningiomas.
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Wagle, V. G., D. Melanson, R. Ethier, G. Bertrand, and W. Feindel. "Diagnostic Potential of Magnetic Resonance in Cases of Foramen Magnum Meningiomas." Neurosurgery 21, no. 5 (November 1, 1987): 622–26. http://dx.doi.org/10.1227/00006123-198711000-00003.
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Abstract Meningioma is a histologically benign tumor that is second in frequency only to gliomas among primary intracranial tumors. Its extracerebral development and generally clear demarcation from the brain does not make it easier to detect on magnetic resonance (MR) scanning. Only 2 to 3% of meningiomas occur in the foramen magnum, and these tumors are often clinically misdiagnosed. We discuss four cases of foramen magnum meningioma, with emphasis on MR scanning.
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Nakano, Masataka, Toshihide Tanaka, Aya Nakamura, Mitsuyoshi Watanabe, Naoki Kato, Takao Arai, Yuzuru Hasegawa, et al. "Multiple Pulmonary Metastases following Total Removal of a Bilateral Parasagittal Meningioma with Complete Occlusion of the Superior Sagittal Sinus: Report of a Case." Case Reports in Neurological Medicine 2012 (2012): 1–7. http://dx.doi.org/10.1155/2012/121470.
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Pulmonary metastases of benign meningiomas are extremely rare. The case of a 34-year-old man with bilateral parasagittal meningioma who developed pulmonary metastases is described. The meningioma was an enormous hypervascular tumor with invasion of the superior sagittal sinus. The tumor was resected completely and histologically diagnosed as transitional meningioma. The Ki-67 labeling index was 5%. Four months after operation, the patient subsequently developed bilateral multiple lung lesions later identified as metastases. The lung lesions were partially removed surgically and histologically diagnosed as meningothelial meningioma WHO grade I. The Ki-67 labeling index was 2%. The histological findings demonstrated that the tumor occupied the arterial lumen and the perivascular space, suggesting that pulmonary tumors might metastasize via the vascular route. The histopathological features and mechanisms of metastasizing meningiomas are reviewed and discussed.
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Koike, Hirofumi, Minoru Morikawa, Hideki Ishimaru, Reiko Ideguchi, Masataka Uetani, Takeshi Hiu, Takayuki Matsuo, and Mitsuharu Miyoshi. "Quantitative Chemical Exchange Saturation Transfer Imaging of Amide Proton Transfer Differentiates between Cerebellopontine Angle Schwannoma and Meningioma: Preliminary Results." International Journal of Molecular Sciences 23, no. 17 (September 5, 2022): 10187. http://dx.doi.org/10.3390/ijms231710187.
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Vestibular schwannomas are the most common tumor at the common cerebellopontine angle, followed by meningiomas. Differentiation of these tumors is critical because of the different surgical approaches required for treatment. Recent studies have demonstrated the utility of amide proton transfer (APT)-chemical exchange saturation transfer (CEST) imaging in evaluating malignant brain tumors. However, APT imaging has not been applied in benign tumors. Here, we explored the potential of APT in differentiating between schwannomas and meningiomas at the cerebellopontine angle. We retrospectively evaluated nine patients with schwannoma and nine patients with meningioma who underwent APT-CEST MRI from November 2020 to April 2022 pre-operation. All 18 tumors were histologically diagnosed. There was a significant difference in magnetization transfer ratio asymmetry (MTRasym) values (0.033 ± 0.012 vs. 0.021 ± 0.004; p = 0.007) between the schwannoma and meningioma groups. Receiver operative curve analysis showed that MTRasym values clearly differentiated between the schwannoma and meningioma groups. At an MTRasym value threshold of 0.024, the diagnostic sensitivity, specificity, positive predictive value, and negative predictive values for MTRasym were 88.9%, 77.8%, 80.0%, and 87.5%, respectively. Our results demonstrated the ability of MTRasym values on APT-CEST imaging to discriminate patients with schwannomas from patients with meningiomas.
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Harada, Takehiko, Richard M. Irving, John H. Xuereb, David E. Barton, David G. Hardy, David A. Moffat, and Eamonn R. Maher. "Molecular genetic investigation of the neurofibromatosis type 2 tumor suppressor gene in sporadic meningioma." Journal of Neurosurgery 84, no. 5 (May 1996): 847–51. http://dx.doi.org/10.3171/jns.1996.84.5.0847.
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✓ The authors investigated the role of somatic mutations of the neurofibromatosis type 2 (NF2) gene in sporadic meningioma. Neurofibromatosis 2 is a dominantly inherited familial tumor syndrome predisposing affected patients to a variety of central nervous system tumors including vestibular schwannoma and meningioma. Neurofibromatosis type 2 is caused by germline mutations in the NF2 tumor suppressor gene. In addition, the authors and others have reported that somatic NF2 gene mutations occur frequently in nonfamilial vestibular schwannoma. In this study, molecular genetic analysis was performed on 23 nonfamilial meningiomas. Paired DNA samples extracted from the blood and tumors of the patients were analyzed for loss of heterozygosity (LOH) in the region of the NF2 gene on chromosome 22 using closely linked DNA markers. The NF2 gene mutations were sought by single-stranded conformation polymorphism analysis and DNA sequencing. Fourteen (61%) of 23 meningiomas showed LOH in the region of the NF2 gene on chromosome 22. Somatic NF2 gene mutations were detected in eight meningiomas (35%) after screening all 17 exons. All tumors with NF2 gene mutations showed simultaneous chromosome 22 LOH. Review of the histopathological findings of the cases studied did not demonstrate any predominance of genetic abnormalities in a particular histological type of meningioma. These results are compatible with the hypothesis that the NF2 gene acts as a tumor suppressor and that its inactivation is important in the pathogenesis of sporadic meningioma.
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Rana, Rashmi, Vaishnavi Rathi, Kirti Chauhan, Kriti Jain, Satnam Singh Chhabra, Rajesh Acharya, Samir Kumar Kalra, et al. "Exploring the role of epidermal growth factor receptor variant III in meningeal tumors." PLOS ONE 16, no. 9 (September 28, 2021): e0255133. http://dx.doi.org/10.1371/journal.pone.0255133.
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Meningioma is the second most common type of intracranial brain tumor. Immunohistochemical techniques have shown prodigious results in the role of epidermal growth factor receptor variant III (EGFR vIII) in glioma and other cancers. However, the role of EGFR vIII in meningioma is still in question. This study attempt the confer searches for the position attained by EGFR vIII in progression and expression of meningioma. Immunohistochemistry technique showed that EGFR vIII is highly expressed in benign tumors as compared to the atypical meningioma with a highly significant p-value (p<0.05). Further analysis by flow cytometry results supported these findings thus presented high intensity of EGFR vIII in low grades of meningioma. The study revealed that the significant Ki 67 values, to predictor marker for survival and prognosis of the patients. Higher expression of EGFR vIII in low grades meningiomas as compared to high-grade tumors indicate towards its oncogenic properties. To our knowledge, limited studies reported in literature expressing the EGFR vIII in meningioma tumors. Hence, Opinions regarding the role that EGFR vIII in tumorigenesis and tumor progression are clearly conflicting and, therefore, it is crucial not only to find out its mechanism of action, but also to definitely identify its role in meningioma.
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Sahu, Samaresh, Saurabh Maheshwari, Saikat Bhattacharjee, Vibhuti Maria, Pushkar Mendiratta, and Rakesh Kumar. "Meningioma: Is apparent diffusion coefficient value of any importance? A study from the tertiary care center." Medicine India 1 (December 22, 2022): 15. http://dx.doi.org/10.25259/medindia_13_2022.
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Objectives: Meningiomas are one of the most common intracranial tumors accounting for 14–20% of all intracranial tumors. Diffusion-weighted imaging (DWI) along with the calculation of apparent diffusion coefficient (ADC) is a novel, non-invasive, and reliable technique of choice for the pre-operative assessment and the treatment planning of different types of meningiomas. Our study aimed to correlate the ADC values of meningiomas with their histopathological grade. Materials and Methods: We studied 21 patients with meningioma. These were initially diagnosed on imaging and confirmed on histopathology. We calculated the normalized ADC (NADC) values from the DWI of their lesion. NADC values and atypical morphological features were utilized to type the meningiomas as typical or atypical. These findings were correlated with histopathological reports of grading of meningioma. Results: There was no significant correlation between the grades of meningioma and the ADC values. The normalized ADC values varied from 0.14 to 1.37 × 10−3 mm2/s for Gr I meningioma in our series and most of our cases fell in this category of meningioma. We had a solitary case of Gr-II meningioma and the ADC value for this lesion was 1.26 × 10−3 mm2/s. Conclusion: Meningiomas are a common group of tumors in the brain with a quest to characterize the grades preoperatively on imaging. The NADC is a better method as compared to plain ADC values for this purpose. In our series, we did not find any correlation of NADC on pre-operative imaging to the grades of tumors.
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Yamamoto, Masahiro, Tomomi Sanomachi, Shuhei Suzuki, Hiroyuki Uchida, Hajime Yonezawa, Nayuta Higa, Tomoko Takajo, et al. "Roles for hENT1 and dCK in gemcitabine sensitivity and malignancy of meningioma." Neuro-Oncology 23, no. 6 (February 8, 2021): 945–54. http://dx.doi.org/10.1093/neuonc/noab015.
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Abstract Background High-grade meningiomas are aggressive tumors with high morbidity and mortality rates that frequently recur even after surgery and adjuvant radiotherapy. However, limited information is currently available on the biology of these tumors, and no alternative adjuvant treatment options exist. Although we previously demonstrated that high-grade meningioma cells were highly sensitive to gemcitabine in vitro and in vivo, the underlying molecular mechanisms remain unknown. Methods We examined the roles of hENT1 (human equilibrative nucleoside transporter 1) and dCK (deoxycytidine kinase) in the gemcitabine sensitivity and growth of meningioma cells in vitro. Tissue samples from meningiomas (26 WHO grade I and 21 WHO grade II/III meningiomas) were immunohistochemically analyzed for hENT1 and dCK as well as for Ki-67 as a marker of proliferative activity. Results hENT1 and dCK, which play critical roles in the intracellular transport and activation of gemcitabine, respectively, were responsible for the high gemcitabine sensitivity of high-grade meningioma cells and were strongly expressed in high-grade meningiomas. hENT1 expression was required for the proliferation and survival of high-grade meningioma cells and dCK expression. Furthermore, high hENT1 and dCK expression levels correlated with stronger tumor cell proliferative activity and shorter survival in meningioma patients. Conclusions The present results suggest that hENT1 is a key molecular factor influencing the growth capacity and gemcitabine sensitivity of meningioma cells and also that hENT1, together with dCK, may be a viable prognostic marker for meningioma patients as well as a predictive marker of their responses to gemcitabine.
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Yamamoto, Masahiro, Hiroyuki Uchida, Hajime Yonezawa, Nayuta Higa, Yuki Yamada, Yukihiko Sonoda, Hirofumi Hirano, Koji Yoshimoto, and Chifumi Kitanaka. "ET-7 Roles for hENT1 and dCK in gemcitabine sensitivity and malignancy of meningioma." Neuro-Oncology Advances 3, Supplement_6 (December 1, 2021): vi5. http://dx.doi.org/10.1093/noajnl/vdab159.017.
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Abstract Background: High-grade meningiomas are aggressive tumors with high morbidity and mortality rates that frequently recur even after surgery and adjuvant radiotherapy. However, limited information is currently available on the biology of these tumors, and no alternative adjuvant treatment options exist. Although we previously demonstrated that high-grade meningioma cells were highly sensitive to gemcitabine in vitro and in vivo, the underlying molecular mechanisms remain unknown. Methods: We examined the roles of hENT1 (human equilibrative nucleoside transporter 1) and dCK (deoxycytidine kinase) in the gemcitabine sensitivity and growth of meningioma cells in vitro. Tissue samples from meningiomas (26 WHO grade I and 21 WHO grade II/III meningiomas) were immunohistochemically analyzed for hENT1 and dCK as well as for Ki-67 as a marker of proliferative activity. Results: hENT1 and dCK, which play critical roles in the intracellular transport and activation of gemcitabine, respectively, were responsible for the high gemcitabine sensitivity of high-grade meningioma cells and were strongly expressed in high-grade meningiomas. hENT1 expression was required for the proliferation and survival of high-grade meningioma cells and dCK expression. Furthermore, high hENT1 and dCK expression levels correlated with stronger tumor cell proliferative activity and shorter survival in meningioma patients. Conclusions: The present results suggest that hENT1 is a key molecular factor influencing the growth capacity and gemcitabine sensitivity of meningioma cells and also that hENT1, together with dCK, may be a viable prognostic marker for meningioma patients as well as a predictive marker of their responses to gemcitabine.
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Choudhury, Abrar, Martha Cady, Calixto Lucas, Brisa Palikuqi, Ophir Klein, Shawn Hervey-Jumper, Joanna Phillips, et al. "STEM-27. A PERIVASCULAR STEM CELL UNDERLIES VERTEBRATE MENINGEAL TUMORIGENESIS." Neuro-Oncology 23, Supplement_6 (November 2, 2021): vi26—vi27. http://dx.doi.org/10.1093/neuonc/noab196.101.
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Abstract BACKGROUND Meningiomas are the most common primary intracranial tumors in humans and dogs, but biologic drivers and cell types underlying meningeal tumorigenesis are incompletely understood. Here we integrate meningioma single-cell RNA sequencing with stem cell approaches to define a perivascular stem cell underlying vertebrate meningeal tumorigenesis. METHODS Single-cell RNA sequencing was performed on 57,114 cells from 8 human meningiomas, 54,607 cells from 3 dog meningiomas, and human meningioma xenografts in mice. Results were validated using immunofluorescence (IF), immunohistochemistry (IHC), and deconvolution of bulk RNA sequencing of 200 human meningiomas. Mechanistic and functional studies were performed using clonogenic and limiting dilution assays, xenografts, and genetically engineered mouse models. RESULTS Copy number variant identification from human meningioma single cells distinguished tumor cells with loss of chr22q from non-tumor cells with intact chr22q. A single cluster distinguished by expression of Notch3 and other cancer stem cell genes had an intermediate level of loss of chr22q, suggesting this cluster may represent meningioma stem cells. In support of this hypothesis, pseudotime trajectory analysis demonstrated transcriptomic progression starting from Notch3+ cells and encompassing all other meningioma cell types. Notch3+ meningioma cells had transcriptomic concordance to mural pericytes, and IF/IHC of prenatal and adult human meninges, as well as lineage tracing using a Notch3-CreERT2 allele in mice, confirmed Notch3+ cells were restricted to the perivascular stem cell niche in mammalian meningeal development and homeostasis. Integrating human and dog meningioma single cells revealed Notch3+ cells in tumor and non-tumor clusters in dog meningiomas. Notch3 IF/IHC and cell-type deconvolution of bulk RNA sequencing showed Notch3+ cells were enriched in high-grade human meningiomas. Notch3 overexpression in human meningioma cells increased clonogenic growth in vitro, and increased tumorigenesis and tumor growth in vivo, decreasing overall survival. CONCLUSIONS Notch3+ stem cells in the perivascular niche underlie vertebrate meningeal tumorigenesis.
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Moliterno, Jennifer, William P. Cope, Emma D. Vartanian, Anne S. Reiner, Roselyn Kellen, Shahiba Q. Ogilvie, Jason T. Huse, and Philip H. Gutin. "Survival in patients treated for anaplastic meningioma." Journal of Neurosurgery 123, no. 1 (July 2015): 23–30. http://dx.doi.org/10.3171/2014.10.jns14502.
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OBJECT While most meningiomas are benign, 1%–3% display anaplastic features, with little current understanding regarding the molecular mechanisms underlying their formation. In a large single-center cohort, the authors tested the hypothesis that two distinct subtypes of anaplastic meningiomas, those that arise de novo and those that progress from lower grade tumors, exist and exhibit different clinical behavior. METHODS Pathology reports and clinical data of 37 patients treated between 1999 and 2012 for anaplastic meningioma at Memorial Sloan–Kettering Cancer Center (MSKCC) were retrospectively reviewed. Patients were divided into those whose tumors arose de novo and those whose tumors progressed from previously documented benign or atypical meningiomas. RESULTS Overall, the median age at diagnosis was 59 years and 57% of patients were female. Most patients (38%) underwent 2 craniotomies (range 1–5 surgeries) aimed at gross-total resection (GTR; 59%), which afforded better survival when compared with subtotal resection according to Kaplan-Meier estimates (median overall survival [OS] 3.2 vs 1.3 years, respectively; p = 0.04, log-rank test). Twenty-three patients (62%) presented with apparently de novo anaplastic meningiomas. Compared with patients whose tumors had progressed from a lower grade, those patients with de novo tumors were significantly more likely to be female (70% vs 36%, respectively; p = 0.04), experience better survival (median OS 3.0 vs 2.4 years, respectively; p = 0.03, log-rank test), and harbor cerebral hemispheric as opposed to skull base tumors (91% vs 43%, respectively; p = 0.002). CONCLUSIONS Based on this single-center experience at MSKCC, anaplastic meningiomas, similar to glial tumors, can arise de novo or progress from lower grade tumors. These tumor groups appear to have distinct clinical behavior. De novo tumors may well be molecularly distinct, which is under further investigation. Aggressive GTR appears to confer an OS advantage in patients with anaplastic meningioma, and this is likely independent of tumor progression status. Similarly, those patients with de novo tumors experience a survival advantage likely independent of extent of resection.
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Zhang, Huiyuan, Lin Qi, Yuchen Du, L. Frank Huang, Frank K. Braun, Mari Kogiso, Yanling Zhao, et al. "Patient-Derived Orthotopic Xenograft (PDOX) Mouse Models of Primary and Recurrent Meningioma." Cancers 12, no. 6 (June 5, 2020): 1478. http://dx.doi.org/10.3390/cancers12061478.
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Background. Meningiomas constitute one-third of all primary brain tumors. Although typically benign, about 20% of these tumors recur despite surgery and radiation, and may ultimately prove fatal. There are currently no effective chemotherapies for meningioma. We, therefore, set out to develop patient-derived orthotopic xenograft (PDOX) mouse models of human meningioma using tumor. Method. Of nine patients, four had World Health Organization (WHO) grade I tumors, five had WHO grade II tumors, and in this second group two patients also had recurrent (WHO grade III) meningioma. We also classified the tumors according to our recently developed molecular classification system (Types A, B, and C, with C being the most aggressive). We transplanted all 11 surgical samples into the skull base of immunodeficient (SCID) mice. Only the primary and recurrent tumor cells from one patient—both molecular Type C, despite being WHO grades II and III, respectively—led to the formation of meningioma in the resulting mouse models. We characterized the xenografts by histopathology and RNA-seq and compared them with the original tumors. We performed an in vitro drug screen using 60 anti-cancer drugs followed by in vivo validation. Results. The PDOX models established from the primary and recurrent tumors from patient K29 (K29P-PDOX and K29R-PDOX, respectively) replicated the histopathology and key gene expression profiles of the original samples. Although these xenografts could not be subtransplanted, the cryopreserved primary tumor cells were able to reliably generate PDOX tumors. Drug screening in K29P and K29R tumor cell lines revealed eight compounds that were active on both tumors, including three histone deacetylase (HDAC) inhibitors. We tested the HDAC inhibitor Panobinostat in K29R-PDOX mice, and it significantly prolonged mouse survival (p < 0.05) by inducing histone H3 acetylation and apoptosis. Conclusion. Meningiomas are not very amenable to PDOX modeling, for reasons that remain unclear. Yet at least some of the most malignant tumors can be modeled, and cryopreserved primary tumor cells can create large panels of tumors that can be used for preclinical drug testing.
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Wallace, Dhiren, Gerald Wallace, Nichols Fenwick, John Vender, Ambika Sood, Samantha Mattox, and Suash Sharma. "PATH-38. METASTATIC MENINGIOMA CAUSING CHRONIC RESPIRATORY FAILURE." Neuro-Oncology 22, Supplement_2 (November 2020): ii172. http://dx.doi.org/10.1093/neuonc/noaa215.719.
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Abstract Meningiomas are the most common primary intracranial tumor accounting for almost 37% of all CNS tumors. Malignant meningiomas are uncommon, accounting for 0.5% of all meningiomas. Malignant meningioma that is metastatic outside the cranium/skull is even rarer, with only a few case reports. Metastases to the lung and abdomen have been reported and thought to travel via venous drainage. WHO Grading suggest that Grade III meningiomas have the greatest potential to metastasize extra-cranially. We present the case for the 47-year-old Senegalese American man with biopsy proven Grade II meningioma metastatic to his lungs with resultant hypercapnic respiratory failure.
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Pierce, John T., Steve S. Cho, Shayoni Nag, Ryan Zeh, Jun Jeon, David Holt, Amy Durham, MacLean P. Nasrallah, Sunil Singhal, and John Y. K. Lee. "Folate Receptor Overexpression in Human and Canine Meningiomas—Immunohistochemistry and Case Report of Intraoperative Molecular Imaging." Neurosurgery 85, no. 3 (August 3, 2018): 359–68. http://dx.doi.org/10.1093/neuros/nyy356.
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Abstract BACKGROUND Meningiomas are well-encapsulated benign brain tumors and surgical resection is often curative. Nevertheless, this is not always possible due to the difficulty of identifying residual disease intraoperatively. We hypothesized that meningiomas overexpress folate receptor alpha (FRα), allowing intraoperative molecular imaging by targeting FRα with a near-infrared (NIR) dye. OBJECTIVE To determine FRα expression in both human and canine meningioma cohorts to prepare for future clinical studies. Present a case study of a meningioma resection with intraoperative NIR fluorescence imaging. METHODS Tissue samples of 27 human meningioma specimens and 7 canine meningioma specimens were immunohistochemically stained for FRα along with normal dura, skeletal muscle, and kidney tissue. We then enrolled a patient with a pituitary adenoma and tuberculum sella meningioma in a clinical trial in which the patient received an infusion of folate-linked, NIR fluorescent dye prior to surgery. RESULTS In the cohort of human meningiomas, 9 WHO grade I, 12 grade II, and 6 grade III tumors were identified. Eighty-nine percent of WHO grade I, 67% of grade II, and 50% of grade III tumors overexpressed FRα. In the 7 canine meningioma samples, 100% stained positively for FRα. Both human and canine normal dura from autopsy samples demonstrated no evidence of FRα overexpression. In the case study, the meningioma demonstrated a high NIR signal-to-background-ratio of 4.0 and demonstrated strong FRα immunohistochemistry staining. CONCLUSION This study directly demonstrates FRα overexpression in both human and canine meningiomas. We also demonstrate superb intraoperative imaging of a meningioma using a FRα-targeting dye.
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Darshan, H. R., Biren Khimji Patel, Ajit Singh, Prakash Nair, Rajalakshmi Poyuran, and H. V. Easwer. "Simultaneous trigonal and spinal meningioma with varied histology: A rare case report." Surgical Neurology International 12 (December 14, 2021): 611. http://dx.doi.org/10.25259/sni_1051_2021.
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Background: Meningioma is one of the most common neoplasms of the central nervous system. Multiple meningiomas without neurofibromatosis are not a usual occurrence. Intraventricular meningioma with spinal meningioma is rare and not been reported in the literature. Case Description: We report a case of a 63-year-old male with the left trigonal and spinal meningioma. Both the meningiomas were resected in different settings. The histological examination of tumors revealed to be of varied histology, that is, meningothelial and atypical meningioma, respectively. Conclusion: Although various cases with multiple cranial and spinal meningiomas are described, this is the first case of an intraventricular and spinal meningioma. With varied histology, the case also reaffirms the theory of polyclonal origin of multiple meningiomas.
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Magill, Stephen T., Jacob S. Young, Ricky Chae, Manish K. Aghi, Philip V. Theodosopoulos, and Michael W. McDermott. "Relationship between tumor location, size, and WHO grade in meningioma." Neurosurgical Focus 44, no. 4 (April 2018): E4. http://dx.doi.org/10.3171/2018.1.focus17752.
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OBJECTIVEPrior studies have investigated preoperative risk factors for meningioma; however, no association has been shown between meningioma tumor size and tumor grade. The objective of this study was to investigate the relationship between tumor size and grade in a large single-center study of patients undergoing meningioma resection.METHODSA retrospective chart review of patients undergoing meningioma resection at the University of California, San Francisco, between 1985 and 2015 was performed. Patients with incomplete information, spinal meningiomas, multiple meningiomas, or WHO grade III meningiomas were excluded. The largest tumor dimension was used as a surrogate for tumor size. Univariate and multivariate logistic regression models were used to investigate the relationship between tumor grade and tumor size. A recursive partitioning analysis was performed to identify groups at higher risk for atypical (WHO grade II) meningioma.RESULTSOf the 1113 patients identified, 905 (81%) had a WHO grade I tumor and in 208 (19%) the tumors were WHO grade II. The median largest tumor dimension was 3.6 cm (range 0.2–13 cm). Tumors were distributed as follows: skull base (n = 573, 51%), convexity/falx/parasagittal (n = 431, 39%), and other (n = 109, 10%). On univariate regression, larger tumor size (p < 0.001), convexity/falx/parasagittal location (p < 0.001), and male sex (p < 0.001) were significant predictors of WHO grade II pathology. After controlling for interactions, multivariate regression found male sex (OR 1.74, 95% CI 1.25–2.43), size 3–6 cm (OR 1.69, 95% CI 1.08–2.66), size > 6 cm (OR 3.01, 95% CI 1.53–5.94), and convexity/falx/parasagittal location (OR 1.83, 95% CI 1.19–2.82) to be significantly associated with WHO grade II. Recursive partitioning analysis identified male patients with tumors > 3 cm as a high-risk group (32%) for WHO grade II meningioma.CONCLUSIONSLarger tumor size is associated with a greater likelihood of a meningioma being WHO grade II, independent of tumor location and male sex, which are known risk factors.
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Carrasquilla, Michael, Jonathan Cantalino, Kathryn Hay, Kelsi Chesney, Anousheh Sayah, Emily Sloan, Joseph Watson, et al. "RADT-28. MULTI-SESSION RADIOSURGERY FOLLOWING SURGERY FOR INTRACRANIAL MENINGIOMAS: 10-YEAR OUTCOMES FROM A SINGLE INSTITUTION PROTOCOL." Neuro-Oncology 24, Supplement_7 (November 1, 2022): vii55. http://dx.doi.org/10.1093/neuonc/noac209.218.
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Abstract INTRODUCTION Meningioma is the most common adult primary intracranial tumor. Surgical resection is the favored treatment with radiotherapy often utilized for residual or recurrent disease. Long-term outcomes are well-established for single-session radiosurgery but mature outcomes for multisession radiosurgery do not yet exist. We report our institution’s 10-year efficacy and toxicity outcomes for 5-fraction radiosurgery following surgical resection of intracranial meningiomas. METHODS All intracranial meningioma patients treated at our institution between 2002-2018 with 5-fraction radiosurgery following surgery were eligible for inclusion. Standard variables were analyzed to predict local failure and overall survival. RESULTS Forty-one consecutive patients with a female predominance (76%) and median age of 58 years (range: 27–84) were included. Thirty benign (73%) and 11 atypical meningiomas (27%) with a median gross tumor volume of 7.79cc (range: 0.38-52.63) were treated. All patients completed radiosurgery for residual tumor (41%) or recurrent disease (59%). A median dose of 3000cGy (range: 2500-3500cGy), was delivered to a median isodose line of 82% (range: 71%-90%). The median follow-up from the date of surgery was 10 years. Nine tumors (22.0%) progressed following radiosurgery. The local control rate at 10-years was significantly better for benign tumors than atypical tumors (93% vs 27%, p = 0.001). Factors found to be predictive of local failure on multivariate analysis were tumor grade (HR: 13.8, p = 0.002) and tumor volume (HR: 1.08, p = 0.031). For benign tumors all failures occurred at the margin of the unirradiated tumor bed, while atypical tumors failed predominately in-field (71%). Three patients with atypical meningioma developed radiation necrosis following aggressive treatment (3500cGy). Overall survival at 10-years was 93% for benign tumors and 60% for atypical tumors (p = 0.026). CONCLUSION Multisession radiosurgery following surgery for benign intracranial meningiomas provides excellent long-term tumor control with minimal toxicity. However, for atypical meningiomas this approach results in poor local control.
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Weil, Stuart M., Robert J. Gewirtz, and John M. Tew. "Concurrent Intradural and Extradural Meningiomas of the Cervical Spine." Neurosurgery 27, no. 4 (October 1, 1990): 629–31. http://dx.doi.org/10.1227/00006123-199010000-00021.
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Abstract A case of an extradural spinal meningioma presenting with a separate intradural meningioma at the same cord level is reported. Review of the English literature on spinal epidural meningiomas reveals a high incidence of concurrent intradural tumors in patients with epidural meningiomas. This leads to the conclusion that the intradural space should be evaluated carefully when an epidural meningioma is encountered.
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Larson, Jeffrey J., Harry R. van Loveren, M. Gregory Balko, and John M. Tew. "Evidence of meningioma infiltration into cranial nerves: clinical implications for cavernous sinus meningiomas." Journal of Neurosurgery 83, no. 4 (October 1995): 596–99. http://dx.doi.org/10.3171/jns.1995.83.4.0596.
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✓ Anatomical and biological studies of cavernous sinus meningiomas help us understand the biological heterogeneity of these tumors. The question of whether cavernous sinus meningiomas infiltrate cranial nerves is clinically important because of the effect on treatment planning. In the authors' experience of treating 36 patients with cavernous sinus meningiomas, tumor invasion into a cranial nerve was documented in two patients in whom a cranial nerve was resected during the cavernous sinus dissection. In both patients, histological examination using hematoxylin and eosin and bodian stains showed infiltration of the cranial nerves by a benign meningioma which, to the best of the authors' knowledge, is a condition previously unreported. This histological finding of meningioma invasion into a cranial nerve demonstrates the biological heterogeneity of cavernous sinus meningiomas and raises concern about the invasive character of meningioma. Because not all tumor cells can be identified radiologically or by direct visualization at surgery, occult tumor infiltration predisposes a patient to recurrence despite the best neurosurgical efforts. Evidence of cranial nerve infiltration by meningioma suggests that, in some circumstances, cavernous sinus dissection in the hope of total removal of a meningioma may be futile and, in the long term, may provide no advantage over treatment options with lower morbidity.
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Piątek, Paula, Stanisław Kwiatkowski, and Olga Milczarek. "Spinal meningiomas in pediatric patients – A case series and literature review." Surgical Neurology International 13 (September 30, 2022): 445. http://dx.doi.org/10.25259/sni_365_2022.
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Background: Meningiomas are the most frequent intracranial tumors in the adult population; however, they are rare in pediatric patients. In children, meningiomas often require further diagnosis of genetic comorbidities. As many as, 50% of young patients with meningiomas suffer from neurofibromatosis type 2 (NF2). Spinal meningiomas include only 10% of pediatric meningiomas. Case Description: Between 2000 and 2017, three children were hospitalized in the Neurosurgery Department. The patients reported prolonged periods of increasing neurological symptoms. In each case, a total gross tumor resection was performed. Histopathology result in each patient was meningioma psammomatosum. Only one girl required adjuvant radiotherapy (RTH) due to recurrent tumors. Magnetic resonance imaging (MRI) showed spinal nerves schwannomas and bilateral vestibular schwannomas in two patients with NF2. Conclusion: A slow tumor growth is characteristic of spinal meningiomas. Back pain is a frequent initial symptom of a slowly growing tumor mass. Subsequently, neurological deficits gradually increase. Patients require a long follow-up period and control MRI-scan. Children with diagnosed spinal meningioma should be strictly controlled because of the high risk of their developing other tumors associated with NF2. Surgical resection is the primary treatment modality of meningiomas. Adjuvant RTH should be recommended only for selected patients.
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Hao, Suyang, Thomas W. Smith, Peigou G. Chu, Qin Liu, Chi Young Ok, Bruce A. Woda, Di Lu, et al. "The Oncofetal Protein IMP3: A Novel Molecular Marker to Predict Aggressive Meningioma." Archives of Pathology & Laboratory Medicine 135, no. 8 (August 1, 2011): 1032–36. http://dx.doi.org/10.5858/2009-0652-oar2.
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Context.—One of the major clinical challenges is to predict recurrence of meningioma. Recently, we have found that IMP3, an oncofetal RNA-binding protein, is a biomarker to predict aggressive tumors. Objective.—To investigate whether IMP3 can be used as a new biomarker to predict the recurrence and overall survival of patients with meningiomas. Design.—One hundred seven patients with primary meningiomas were investigated for expression of IMP3 by immunohistochemistry and whether expression of this molecule correlated with tumor recurrence and overall survival. Results.—Tumor recurrence was found in 13 of 107 patients with primary meningioma. Seven of 107 patients (6.5%) with primary meningiomas expressed IMP3. Kaplan-Meier plots and log-rank tests showed that patients with IMP3-positive tumors had a much higher recurrence rate (P = .004) and a poorer overall survival (P < .001) than did patients with IMP3-negative tumors. The 5-year recurrence-free and overall survival rates were 0% and 36% in IMP3-positive patients versus 89% and 94% in IMP3-negative patients, respectively. Multivariable analysis of IMP3 status (positive versus negative) in primary tumors showed a hazard ratio of 17.89 for recurrence (P = .01), which was much higher than hazard ratios associated with all other known risk factors including higher tumor grades and Ki-67 labeling index. Conclusions.—IMP3 is a potential independent prognostic biomarker that can be used at the time of initial diagnosis of meningioma to identify patients who have a high risk of developing a recurrence.
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Hosainey, Sayied Abdol Mohieb, David Bouget, Ingerid Reinertsen, Lisa Millgård Sagberg, Sverre Helge Torp, Asgeir Store Jakola, and Ole Solheim. "Are there predilection sites for intracranial meningioma? A population-based atlas." Neurosurgical Review 45, no. 2 (October 21, 2021): 1543–52. http://dx.doi.org/10.1007/s10143-021-01652-9.
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Abstract Meningioma is the most common benign intracranial tumor and is believed to arise from arachnoid cap cells of arachnoid granulations. We sought to develop a population-based atlas from pre-treatment MRIs to explore the distribution of intracranial meningiomas and to explore risk factors for development of intracranial meningiomas in different locations. All adults (≥ 18 years old) diagnosed with intracranial meningiomas and referred to the department of neurosurgery from a defined catchment region between 2006 and 2015 were eligible for inclusion. Pre-treatment T1 contrast-enhanced MRI-weighted brain scans were used for semi-automated tumor segmentation to develop the meningioma atlas. Patient variables used in the statistical analyses included age, gender, tumor locations, WHO grade and tumor volume. A total of 602 patients with intracranial meningiomas were identified for the development of the brain tumor atlas from a wide and defined catchment region. The spatial distribution of meningioma within the brain is not uniform, and there were more tumors in the frontal region, especially parasagittally, along the anterior part of the falx, and on the skull base of the frontal and middle cranial fossa. More than 2/3 meningioma patients were females (p < 0.001) who also were more likely to have multiple meningiomas (p < 0.01), while men more often have supratentorial meningiomas (p < 0.01). Tumor location was not associated with age or WHO grade. The distribution of meningioma exhibits an anterior to posterior gradient in the brain. Distribution of meningiomas in the general population is not dependent on histopathological WHO grade, but may be gender-related.
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Taleb, Khalid, and Anna Laucis. "DDEL-14. SYSTEMIC THERAPY USE FOR THE TREATMENT OF MENINGIOMA: A SYSTEMATIC REVIEW." Neuro-Oncology 24, Supplement_7 (November 1, 2022): vii97. http://dx.doi.org/10.1093/neuonc/noac209.360.
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Abstract INTRODUCTION Meningiomas are the most common primary central nervous system tumor. Many studies have investigated systemic therapy agents for treating meningiomas, but no study has systematically evaluated the various agents used while comparing outcomes. The goal of this study was to investigate the recent systemic therapy agents used to treat meningioma tumors and to compare relevant clinical outcomes such as progression-free survival and overall survival in patients with meningioma tumors receiving systemic therapy agents as part of their care.Materials and METHODS A systematic literature review was performed to investigate systemic therapy agents used to treat meningioma tumors. The PubMed database was used for this review and articles published from 7/4/2011 to 7/4/2021 were evaluated. The exclusion criteria included the following: animal and cell line studies, case reports, review articles, articles in a foreign language (other than English), as well as articles not related to meningioma or to systemic therapy agents. RESULTS 163 articles were initially evaluated. After excluding 152 articles using the exclusion criteria for our study, a total of 11 articles exploring 14 different systemic therapy agents were ultimately included and compared, mainly focusing on the two clinical outcomes of progression-free survival and overall survival. The study findings suggest that Bevacizumab may have the most promising results for reducing peri-tumoral edema and extending progression-free survival, with the highest observed progression-free survival at six months of 86% compared to lower progression-free survival for other systemic therapy agents. CONCLUSION This systematic review study evaluated systemic therapy agents used to treat meningioma tumors. Bevacizumab was found to have the most promising results overall. However, further studies are now needed to evaluate the efficacy and possible side effects of Bevacizumab amongst a larger population of patients with different meningioma tumor grades, locations, and treatment responses.
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Garcia-Segura, Monica Emili, Anders Wilder Erickson, Rishi Jairath, David G. Munoz, and Sunit Das. "Necrosis and Brain Invasion Predict Radio-Resistance and Tumor Recurrence in Atypical Meningioma: A Retrospective Cohort Study." Neurosurgery 88, no. 1 (August 20, 2020): E42—E48. http://dx.doi.org/10.1093/neuros/nyaa348.
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Abstract BACKGROUND Meningiomas are the most common tumors occurring in the central nervous system, with variable recurrence rates depending on World Health Organization grading. Atypical (Grade II) meningioma has a higher rate of recurrence than benign (Grade I) meningioma. The efficacy of adjuvant radiotherapy (RT) to improve tumor control has been questioned. OBJECTIVE To investigate clinical and histopathological predictors of tumor recurrence and radio-resistance in atypical meningiomas. METHODS This cohort study retrospectively reviewed all patients in St. Michael's Hospital CNS tumor patient database who underwent surgical resection of a Grade II meningioma from 1995 to 2015. Cases with neurofibromatosis type II, multiple satellite tumors, spinal cord meningioma, radiation-induced meningioma, and perioperative death were excluded. Patient demographics, neuropathological diagnosis, tumor location, extent of resection, radiation therapy, and time to recurrence or progression were recorded. Cox univariate regression and Kaplan-Meier survival analysis were employed to identify risk factors for recurrence and radio-resistance. RESULTS Among 181 patients, the combination of necrosis and brain invasion was associated with an increased recurrence risk (hazard ratio [HR] = 4.560, P = .001) and the lowest progression-free survival (PFS) relative to other pathological predictors. This trend was maintained after gross total resection (GTR, P = .001). RT was associated with decreased PFS (P = .001), even in patients who received GTR (P = .001). CONCLUSION The combination of necrosis and brain invasion is a strong predictor of tumor recurrence and radio-resistance in meningioma, regardless of EOR or adjuvant RT. Our findings question the sensibility of brain invasion as an absolute criterion for Grade II status.
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Rajnish Kumar Jaiswal and Sibaji Dasgupta. "Atypical presentation of the World Health Organization Grade 1 meningioma: A case report." Asian Journal of Medical Sciences 13, no. 4 (April 1, 2022): 196–99. http://dx.doi.org/10.3126/ajms.v13i4.41708.
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Meningiomas are the most common benign neoplasm of the brain whereas ectopic presentation, although reported, is rare. Among these ectopic tumors, there are a group of purely intraosseous meningiomas, which usually are diagnosed differentially from common primary osseous tumor such as fibrous dysplasia and osteoid osteoma. The World Health Organization (WHO) Grade 1 meningioma with an involvement of scalp, calvarial bone, dura, and brain seen rarely. This type of atypical presentation of the WHO Grade 1 meningioma rarely documented. The main theories to justify the unusual topography appear to be embryological remains of neuroectodermal tissue or cellular dedifferentiation. Surgical treatment seems the best curative option. Meningioma with bony involvement could be very aggressive tumor, need to prepare accordingly for surgery.
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Dirven, Clemens M. F., Jacques Grill, Martine L. M. Lamfers, Paul van der Valk, Angelique M. Leonhart, Victor W. van Beusechem, Hidde J. Haisma, et al. "Gene therapy for meningioma: improved gene delivery with targeted adenoviruses." Journal of Neurosurgery 97, no. 2 (August 2002): 441–49. http://dx.doi.org/10.3171/jns.2002.97.2.0441.
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Object. Due to their surgical inaccessibility or aggressive behavior, some meningiomas cannot be cured with current treatment strategies. Gene therapy is an emerging strategy for the treatment of brain tumors, which the authors investigated to determine whether adenoviruses could be used for gene transfer in meningioma cells. Methods. The presence of the high-affinity Coxsackievirus and adenovirus receptor (CAR) for adenovirus type 5, as well as endothelial growth factor receptor (EGFR) and alphav integrins (ITGAVs), were analyzed in primary tumors by using immunohistochemical studies and in primary meningioma cell cultures by using fluorescence-activated cell sorting. Targeting of adenoviruses to EGFR was achieved using bispecific antibodies, whereas targeting of adenoviruses to the ITGAVs was accomplished by insertion of an RGD (arginine-glycine-aspartic acid) motif in the adenovirus fiber HI loop. Gene transfer efficiency of untargeted and targeted vectors was compared in primary cell cultures and in spheroids derived from patients' resected tumor material. The presence of CARs was observed in all tumors and in all but one of the derived primary meningioma cells. The higher expression of EGFRs and ITGAVs indicated that these receptors could be used as alternative targets to redirect the adenoviruses. Redirection of adenoviruses to the EGFRs or integrins enhanced gene transfer threefold (range two—sevenfold) for EGFRs in primary meningioma cells and ninefold (range three—23-fold) for integrins (p = 0.002, analysis of variance). The effect of adenovirus targeting was confirmed in spheroids composed of primary meningioma cells. Conclusions. Gene transfer with adenoviruses targeted to tumor-specific receptors is very effective in primary meningioma cells and spheroids. These vectors are promising agents for gene therapy of meningiomas.
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Борисов, Eduard Borisov, Сороковиков, Vladimir Sorokovikov, Бывальцев, Vadim Byvaltsev, Степанов, and Ivan Stepanov. "PERITUMORAL EDEMA AT BRAIN MENINGIOMAS." Бюллетень Восточно-Сибирского научного центра Сибирского отделения Российской академии медицинских наук 1, no. 1 (April 22, 2016): 7–11. http://dx.doi.org/10.12737/21472.
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Among edema-producing neoplasms of central neural system, the meningiomas are unique. Meningiomas are histologically
benign, slow growing and originate extracerebrally. The development of accompanying peritumoral brain edema
(PВE) occurs in 40–60 % of meningiomas and often with a high degree of PВE with no obvious relation to the size and
histologic features of the meningioma. The aim of our study was to determine the correlation between such parameters
as gender, age of the patient, localization of the tumor tissue and the presence/severity of PBE. At meningiomas PBE
was present in 70,1 % of patients. Meningioma with the presence of PBE occur more often than tumors without PBE.
Olfactory groove tumors have more pronounced degree of PBE, unlike meningiomas of parasagittal localization and
the region of the wings of the sphenoid bone. Mixed meningiomas had a greater degree of PBE unlike meningotheliomatozic
and fibroblastic variants.
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Di Nunno, Vincenzo, Caterina Giannini, Sofia Asioli, Alfredo Conti, Julia Furtner, Damiano Balestrini, and Alicia Tosoni. "Diagnostic and Therapeutic Strategy in Anaplastic (Malignant) Meningioma, CNS WHO Grade 3." Cancers 14, no. 19 (September 26, 2022): 4689. http://dx.doi.org/10.3390/cancers14194689.
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Background: Meningiomas are the most common primary central nervous system malignancies accounting for 36% of all intracranial tumors. However, only 1% of meningioma is classified as malignant (anaplastic) meningioma. Due to their rarity, clinical management of these tumors presents several gaps. Methods: We carried out a narrative review aimed to investigate current knowledge of anaplastic meningioma focusing on their pathological and radiological diagnosis, molecular assessment, and loco-regional and systemic management. Results: The most frequent genetic alteration occurring in meningioma is the inactivation in the neurofibromatosis 2 genes (merlin). The accumulation of copy number losses, including 1p, 6p/q, 10q, 14q, and 18p/q, and less frequently 2p/q, 3p, 4p/q, 7p, 8p/q, and 9p, compatible with instability, is restricted to NF2 mutated meningioma. Surgery and different RT approaches represent the milestone of grade 3 meningioma management, while there is a marginal role of systemic therapy. Conclusions: Anaplastic meningiomas are rare tumors, and diagnosis should be suspected and confirmed by trained radiologists and pathologists. Despite the current marginal role of systemic therapy, it is possible that the increasing knowledge of molecular altered pathways of the disease will lead to the development of novel effective systemic treatments.
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Herrgott, Grayson, Thais Sabedot, Ruicong She, Michael Wells, Karam Asmaro, Tathiane Malta, Maritza Mosella, et al. "EPCO-30. MACHINE-LEARNING PREDICTIVE MODELS BASED ON DNA METHYLATION SIGNATURES DETECTED IN LIQUID BIOPSY SPECIMENS ACCURATELY PREDICT THE DIAGNOSIS AND PROGNOSIS OF MENINGIOMAS." Neuro-Oncology 23, Supplement_6 (November 2, 2021): vi8. http://dx.doi.org/10.1093/neuonc/noab196.029.
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Abstract BACKGROUND Detection of distinct epigenetic features in circulating cell-free DNA (cfDNA) of liquid biopsy specimens (e.g. blood) provides an opportunity to diagnose and prognosticate central nervous system (CNS) tumors. Utilization of distinctive cell-type genome-wide DNA methylation patterns allows for development of machine-learning (ML) models with the ability to predict tumor diagnosis and prognosis, and remains widely unexplored in meningiomas using LB. METHODS We profiled the cfDNA methylome (EPIC array) in serum specimens from patients with meningiomas, other CNS tumors and nontumor conditions (n= 63, 190 and 18, respectively) and harnessed internal and external meningioma tissue methylome data. For diagnostic model development, we identified “meningioma specific” signatures through comparison of meningioma and non-meningioma serum specimens (Wilcoxon rank-sum test) which exhibited tissue methylation similarities named Meningioma- epigenetic Liquid Biopsy (MeLB), and were then employed to develop and cross-validate a Random-Forest derived “MeLB” score to discriminate meningiomas from the other conditions. To predict recurrence risk (RR), we classified a meningioma tissue cohort as ‘favorable’ or ‘unfavorable’ (low and high RR, respectively), using a validated ML outcome model and identified outcome-specific methylation markers with serum subgroup specificities used as input to train a Random-Forest to predict RR in serum-based specimens. RESULTS Prediction models based on meningioma-specific methylation markers detected in the serum presented a high accuracy in classification of samples as meningioma or not (Accuracy: 89.6%, Sensitivity: 80%, Specificity: 93.8%). The prognostic model using tissue-serum matching methylation markers was validated across an independent tissue-based cohort (Accuracy: 88%, Sensitivity: 86%, Specificity: 88%) and allowed for classification of serum samples according to RR. CONCLUSIONS Machine-learning models using DNA methylation markers identified in the serum can accurately diagnose and predict prognosis in patients with meningioma. After validation in an external cohort, these approaches may improve presurgical diagnosis and therapeutic management of patients with this type of tumor.