Giant posterior fossa meningioma: the importance of early diagnosis and challenges concerning treatment

Antunes, Cristiano; Ramos, Rui; Machado, Maria João; Filipe, Miguel Afonso

doi:10.1136/bcr-2018-228454

Cited by 6 publications

(3 citation statements)

References 7 publications

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“…The study by Narayan et al [ 28 ], which was until now the largest series with 80 cases of GIMs, demonstrated that regression analysis showed age, sex, location of the tumor [ 44 , 45 ], Simpson grade of excision, and histology of tumor were the factors that significantly affected the KPS, complications, and recurrence [ 39 , 46 ]. Our series confirms just some of these findings whereas the mortality rate, recurrence rate, Simpson grade, and KPS are comparable between the two groups, but there is a higher rate of complications in the first 30 days after the surgical procedure for GIMs compared with smaller meningiomas [ 47 , 48 , 49 , 50 ]. We identified a higher incidence of postoperative ischemia, infections, and seizure in the GIM group.…”

Section: Discussionsupporting

confidence: 85%

The Surgical Risk Factors of Giant Intracranial Meningiomas: A Multi-Centric Retrospective Analysis of Large Case Serie

et al. 2022

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Giant intracranial meningiomas (GIMs) are a subgroup of meningiomas with huge dimensions with a maximum diameter of more than 5 cm. The mechanisms by which a meningioma can grow to be defined as a “giant” are unknown, and the biological, radiological profile and the different outcomes are poorly investigated. We performed a multi-centric retrospective study of a series of surgically treated patients suffering from intracranial meningioma. All the patients were assigned on the grounds of the preoperative imaging to giant and medium/large meningioma groups with a cut-off of 5 cm. We investigated whether the presence of large diameter and peritumoral brain edema (PBE) on radiological diagnosis indicates different mortality rates, grading, characteristics, and outcomes in a multi-variate analysis. We found a higher risk of developing complications for GIMs (29.9% versus 14.8%; p < 0.01). The direct proportional relationship between PBE volume and tumor volume was present only in the medium/large group (Pearson correlation with p < 0.01) and not in the GIM group (p = 0.47). In conclusion, GIMs have a higher risk of developing complications in the postoperative phase than medium/large meningioma without higher risk of mortality and recurrence.

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Section: Discussionsupporting

confidence: 85%

The Surgical Risk Factors of Giant Intracranial Meningiomas: A Multi-Centric Retrospective Analysis of Large Case Serie

et al. 2022

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“…Furthermore, various cases reported a higher prevalence among female patients in acquiring this ailment; some of these studies thus emphasized the most common risk factors mentioned earlier (Table 1). As for the treatment of giant intracranial meningiomas, the gold standard is total resection of the tumor, which depends on the tumor's size and location [14,15]. Table 1 highlights that the predominance of male patients diagnosed with giant malignant meningioma is extremely rare, but it predominantly affects women.…”

Section: Discussionmentioning

confidence: 99%

Giant Extracranial Meningioma Associated With Hormonal Imbalances Due to Thyroidectomy: Case Report and Literature Review

Toader,

Bratu,

Covache-Busuioc

et al. 2023

Cureus

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Meningiomas represent a prevalent class of primary brain tumors, with malignancies such as World Health Organization grade III meningiomas posing significant clinical challenges due to their aggressive nature and potential for recurrence. This case report showcases the clinical journey of a 67-year-old female patient presenting with a giant malignant meningioma post-thyroidectomy, who unfortunately succumbed to postoperative complications. The report offers a comprehensive analysis of the tumor's clinical presentation, including its substantial size, which qualifies it as a 'giant' meningioma, and explores the patient's endocrine dysfunction as a possible contributing factor to her neurological pathology. In the broader context of meningioma management, the report synthesizes data from multiple studies, underscoring the higher incidence of such malignancies in post-pubertal women and the complexity of treatment modalities. Surgical resection remains the cornerstone of treatment, especially when combined with adjuvant therapies. The report concludes with a discussion on the persistent gaps in knowledge regarding the pathogenesis of giant malignant meningiomas and the need for further research, particularly concerning the role of endocrine dysregulation in their development. This case underscores the imperative for multidisciplinary approaches and individualized treatment strategies in the management of malignant meningiomas, with an emphasis on the intricate interplay between endocrine factors and tumor progression.

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“…The rarity of clinical observations, complex anatomical localization and high surgical risks suggest individual treatment planning. Anatomically, the region of Foramen Magnum is considered in the following borders: anterior -from the lower third of the clivus to the upper edge of C2 vertebra body; lateral -from the jugular tubercle of the occipital bone to the upper edge of C2 vertebra arc; posterior -from the anterior margin of the occipital bone scales to C2 vertebra spinous process [8][9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Contemporary Approaches to Diagnostics and Treatment of Foramen Magnum Meningiomas

Yuri

Arnold

Andrei

et al. 2019

BJSTR

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34 cases of cranio cervical junction area meningiomas were analyzed. These can be found among 1.6% of the total number of patients with primary symptomatic intracranial meningiomas. Lateral or anterolateral tumor localization was observed in 31 (91.2%) cases, posterior -in 2 (5.9%), anterior without lateralization -in 1 (2.9%). 27 (79.4%) patients underwent surgical intervention within suboccipital approach, 7 (20.6%) -posterolateral suboccipital (transcondylar) approach. Total tumor resection was performed in 24 (70.6%) cases, subtotal -in 6 (17.6%) cases, partial -in 4 (11.8%). Postoperative mortality and tumor recurrence were not observed during the whole observation period. Suboccipital lateral approach with laminectomy to the level of lower tumor pole was enough to provide adequate microsurgical craniovertebral meningioma resection without resection of atlanto-occipital articulation. The approach to neoplasm matrix was performed after tumor partial resection without brain stem traction. The use of intraoperative neuromonitoring provided control of brain stem functions at all stages of tumor resection and vertebral artery isolation.

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Giant posterior fossa meningioma: the importance of early diagnosis and challenges concerning treatment

Cited by 6 publications

References 7 publications

The Surgical Risk Factors of Giant Intracranial Meningiomas: A Multi-Centric Retrospective Analysis of Large Case Serie

The Surgical Risk Factors of Giant Intracranial Meningiomas: A Multi-Centric Retrospective Analysis of Large Case Serie

Giant Extracranial Meningioma Associated With Hormonal Imbalances Due to Thyroidectomy: Case Report and Literature Review

Contemporary Approaches to Diagnostics and Treatment of Foramen Magnum Meningiomas

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