Multimodal Management of Metastatic Malignant Meningiomas: The Role of Radiosurgery in Long-Term Local Control

Attuati, Luca; Zaed, Ismail; Morselli, Carlotta; Pecchioli, Guido; Fornari, Maurizio; Picozzi, Piero

doi:10.1016/j.wneu.2019.05.058

Cited by 8 publications

(7 citation statements)

References 65 publications

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“…The current results of Stereotactic radiosurgery (SRS) modified the clinical and surgical strategy. Partial debulking followed by adjuvant SRS achieves high tumor control rates with a lower level of complication ( 14 , 15 ). A careful preoperative planning allows to plan the tumor residual to be subjected to gamma knife.…”

Section: Discussionmentioning

confidence: 99%

Tentorial Notch Meningiomas: Innovative Preoperative Management and Literature Review

et al. 2022

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BackgroundTentorial meningiomas account for only 3–6% of all intracranial meningiomas. Among them, tentorial incisura (notch) location must be considered as a subgroup with specific surgical anatomy and indications, morbidity, and mortality. In this study, we propose an update on preoperative management in order to reduce postoperative deficits.MethodsWe retrospectively collected adult patients treated for incisural meningioma between January 1992 and December 2016 in two different neurosurgical departments. Demographic, clinical, and neuroradiological preoperative and postoperative data were analyzed. In the most recent subgroup of tumors, a preoperative digital simulation was performed to define a volumetric digital quantification of the tumor resection. A review of the pertinent literature has been also done.ResultsWe included 26 patients. The median age was 58.4 years. Onset neurological signs were cranial nerve deficit in 9 patients, hemiparesis in 7, gait disturbance in 3, and intracranial hypertension in 3 patients. Simpson grade I removal was achieved in 12 patients, II in 10, III in 3, and IV in 1 patient. An overall rate of 23% postoperative complications was observed. The average follow-up duration was 68.5 months. Residual tumor was reported in 8 patients. Five patients underwent gamma knife radiosurgery. In 34.6% of patients, the surgical approach was chosen with preoperative digital planning estimating the potential volume of postoperative residual tumor, the target for radiosurgical treatment.ConclusionsA multidisciplinary approach to plan incisural meningiomas management is important. To lower postoperative morbidity and mortality, a careful preoperative case analysis is useful. A planned residual tumor, supported by preoperative simulation imaging, could be safely treated with radiosurgery.

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Section: Discussionmentioning

confidence: 99%

Tentorial Notch Meningiomas: Innovative Preoperative Management and Literature Review

et al. 2022

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“…The underlying cellular mechanisms for this phenomenon have been subject of extensive research and hold promise to yield future therapeutic options [1]. While metastasis of meningiomas is extremely rare [2,3], tissue invasion is common and has wide implications for the treatment and clinical course of these tumors. More aggressive growth patterns, the predisposition for recurrence, and worse prognosis led to the acceptance of brain invasion as a stand-alone grading criterion for atypical grade 2 meningioma in 2016 [4].…”

Section: Introductionmentioning

confidence: 99%

Molecular neuropathology of brain‐invasive meningiomas

et al. 2022

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Invasion of brain tissue by meningiomas has been identified as one key factor for meningioma recurrence. The identification of meningioma tumor tissue surrounded by brain tissue in neurosurgical samples has been touted as a criterion for atypical meningioma (CNS WHO grade 2), but is only rarely seen in the absence of other high‐grade features, with brain‐invasive otherwise benign (BIOB) meningiomas remaining controversial. While post‐surgery irradiation therapy might be initiated in brain‐invasive meningiomas to prevent recurrences, specific treatment approaches targeting key molecules involved in the invasive process are not established. Here we have compiled the current knowledge about mechanisms supporting brain tissue invasion by meningiomas and summarize preclinical models studying targeted therapies with potential inhibitory effects.

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“…Several reviews have reported that metastatic lesions located in the liver account for 9.5% of the cases [ 1 , 9 , 16 , 17 , 18 ], and Attuati et al (2019) reported a frequency of hepatic metastases due to meningiomas (single organ metastases) of 3.2% (seven cases) [ 2 ]. Liver metastases from intracranial meningioma are usually asymptomatic [ 19 , 20 ], and this makes their incidence to be underestimated.…”

Section: ⧉ Introductionmentioning

confidence: 99%

The Myth of Prometheus in metastatic meningioma to the liver: from craniotomy to hepatectomy

Costea

Cucu²,

Bogdănici³

et al. 2022

Rom J Morphol Embryol

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Metastases from intracranial meningiomas are rare, and among them, meningiomas with hepatic dissemination are extremely rare. Therefore, there are currently no guidelines for staging and treatment of metastatic disease in meningioma, a disease that is a challenge for both the clinician and the pathologist. Our literature review revealed 24 cases of liver metastases originating from intracranial meningiomas. We used them to analyze the pathological patterns of dissemination and to assess the different management strategies available, the most efficient and beneficial being surgery and chemotherapy, especially in the case of meningiomas with hepatic and/or systemic dissemination.

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Multimodal Management of Metastatic Malignant Meningiomas: The Role of Radiosurgery in Long-Term Local Control

Cited by 8 publications

References 65 publications

Tentorial Notch Meningiomas: Innovative Preoperative Management and Literature Review

Tentorial Notch Meningiomas: Innovative Preoperative Management and Literature Review

Molecular neuropathology of brain‐invasive meningiomas

The Myth of Prometheus in metastatic meningioma to the liver: from craniotomy to hepatectomy

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