Location and Diameter of Intracranial Meningioma as Predictors of Peritumoral Brain Oedema and Mass Effect

Liyanage, U. A.; Mathangasinghe, Y.; Wijerathne, Pradeep; Sahathevan, Vithoosan; Pallewatte, Aruna

doi:10.1016/j.jmir.2020.04.004

Cited by 4 publications

(2 citation statements)

References 19 publications

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“…19 Furthermore, Liyanage et al demonstrated that infratentorial meningiomas were less likely to be associated with edema and mass effect. 18 Our analysis of a cohort of NF2 mutant meningiomas provides a more comprehensive understanding of these correlations. We found that infratentorial NF2 mutant meningiomas were typically smaller and less likely to be associated with edema compared to their supratentorial counterparts.…”

Section: Discussionmentioning

confidence: 99%

“…16,17 Infratentorial meningiomas in general have been reported to behave differently from their supratentorial counterparts, with less mass effect and edema, and with less recurrence despite less extensive resection. 18,19 However, there remains a surprising paucity of literature evaluating how and why meningiomas may differ based on their location relative to the tentorium. We sought to investigate how the clinical behavior and genomic features of the most common genomic subgroup of meningiomas, namely NF2 mutant meningiomas, may differ according to supratentorial and infratentorial location.…”

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confidence: 99%

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Clinical and genomic differences in supratentorial versus infratentorial NF2 mutant meningiomas

Tabor

O’Brien

Vasandani

et al. 2023

Journal of Neurosurgery

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OBJECTIVE Mutations in NF2 are the most common somatic driver mutation in sporadic meningiomas. NF2 mutant meningiomas preferentially arise along the cerebral convexities—however, they can also be found in the posterior fossa. The authors investigated whether NF2 mutant meningiomas differ in clinical and genomic features based on their location relative to the tentorium. METHODS Clinical and whole exome sequencing (WES) data for patients who underwent resection of sporadic NF2 mutant meningiomas were reviewed and analyzed. RESULTS A total of 191 NF2 mutant meningiomas were included (165 supratentorial, 26 infratentorial). Supratentorial NF2 mutant meningiomas were significantly associated with edema (64.0% vs 28.0%, p < 0.001); higher grade—i.e., WHO grade II or III (41.8% vs 3.9%, p < 0.001); elevated Ki-67 (55.0% vs 13.6%, p < 0.001); and larger volume (mean 45.5 cm3 vs 14.9 cm3, p < 0.001). Furthermore, supratentorial tumors were more likely to harbor the higher-risk feature of chromosome 1p deletion (p = 0.038) and had a larger fraction of the genome altered with loss of heterozygosity (p < 0.001). Infratentorial meningiomas were more likely to undergo subtotal resection than supratentorial tumors (37.5% vs 15.8%, p = 0.021); however, there was no significant difference in overall (p = 0.2) or progression-free (p = 0.4) survival. CONCLUSIONS Supratentorial NF2 mutant meningiomas are associated with more aggressive clinical and genomic features as compared with their infratentorial counterparts. Although infratentorial tumors have higher rates of subtotal resection, there is no associated difference in survival or recurrence. These findings help to better inform surgical decision-making in the management of NF2 mutant meningiomas based on location, and may guide postoperative management of these tumors.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%