Interdisciplinary Therapeutic Approaches to Atypical and Malignant Meningiomas

Abstract

Meningiomas have the highest incidence among brain tumors. In contrast to benign tumors that constitute the majority of this tumor entity, the treatment of aggressive meningiomas (WHO Grade 2 and 3) is more challenging, requiring gross total removal of the tumor and the affected dura and adjuvant radiotherapy. Sometimes the location and/or the configuration of the tumor do not favor radical surgical resection without endangering the patient’s clinical condition after surgery and pharmacological therapy has, until now, not been proven to be a reliable alternative. Discussion: In this narrative review, we discuss the current literature with respect to the management of meningiomas, discussing the importance of the grade of resection in the overall prognosis of the patient and in the planning of adjuvant therapy. Conclusions: According to the location and size of the tumor, radical resection should be taken into consideration. In patients with aggressive meningiomas, adjuvant radiotherapy should be performed after surgery. In cases of skull base meningiomas, a maximal, though safe, resection should take place before adjuvant therapy. An interdisciplinary approach is beneficial for patients with primary or recurrent meningioma.

Analysis of risk factors affecting wound healing and wound infection after meningioma resection

“…This operation is not necessary for patients with ageing, poor function of heart, lungs and other important organs, complete paralysis of limbs for more than 3 months, and patients with no hope of recovery from surgery. Meningioma grows from the dura, 11 mostly in the dorsal or lateral side of the spinal cord, a few can be in the ventral side of the spinal cord, 12 the base is generally wide and some patients have a large surgical resection area. The surgical incision is in the head or near the spine, and the postoperative care of the incision is extremely important 13 .…”

177Lu-FAP-2286 Therapy in a Patient With Metastatic Rhabdoid Meningioma

“…During subsequent chemoradiotherapy, ultrasonic contrast and enhanced CT suggested the presence of liver and bone metastases. There is no definitive treatment for meningioma metastasis 1 . Because the patient’s disease progressed during chemotherapy, the adverse effects of temozolomide were not tolerated.…”