Natural history of intraventricular meningiomas: systematic review

Abstract

Review the data published on the subject to create a more comprehensive natural history of intraventricular meningiomas (IVMs). A Medline search up to March 2018 using "intraventricular meningioma" returned 98 papers. As a first selection step, we adopted the following inclusion criteria: series and case reports about IVMs, as well as papers written in other languages, but abstracts written in English were evaluated. Six hundred eighty-one tumors were evaluated from 98 papers. The majority of the tumors were located in the lateral ventricles (602-88.4%), fourth ventricle (59-8.7%), and third ventricle (20-2.9%). These tumors accounted for a mortality rate of 4.0% (25 deaths) and a recurrence rate of 5.3% (26 recurrences). The majority of the tumors were grade I (89.8%) and consisted of the following subtypes: fibrous, 39.7% (n = 171); transitional, 22.0% (n = 95); meningothelial, 18.6% (n = 80); angiomatosus, 3.2% (n = 14); psammomatous, 2.6% (n = 11); and others, 13.9% (n = 60). Forty-five patients (7.4%) presented with grade II (GII) tumors, and 17 patients (2.8%) presented with grade III (GIII) tumors. These tumors follow the histopathological distribution of meningiomas in general, with the exception of the higher prevalence of the fibrous subtype, possibly due to its embryonic origin. Recurrence and mortality were lower than in other localizations likely due to a complete surgical resection rate than in the convexity and skull base, which suggests that GTR is the gold standard for the management of IVMs.

Trigone ventricular meningiomas — clinical characteristics, histopathology and results of surgical treatment

“…Histopathologically, all subtypes of meningiomas are diagnosed, and fibromatous, fibroblastic, meningothelial and psammomatous are the most common. Pereira et al in a recent systematic review emphasised that the fibrous subtype constitutes as much as 40% of all IVMs [4]. In our series, 12 (80%) meningiomas were WHO grade I and three (20%) meningiomas were atypical, including one with malignant transformation to WHO grade III.…”

“…This could be an argument for the observation of asymptomatic tumours. Interestingly, this option for IVMs has been mentioned [4], although we were unable to identify any reports of IVM observation in the Pubmed database. In the series of Nakamura et al, only 15% of intraventricular tumours were meningiomas [15].…”

“…The most common location of IVMs is the lateral ventricle, followed by the third and fourth ventricle [4]. Nakamura et al analysed 532 cases of IVMs in publications up to 2003 and found that the frequencies were 77.8%, 15.6% and 6.6%, respectively [15].…”

“…Based on the literature, about 90% of IVMs are benign tumours, 7-8% are atypical, and 3% are anaplastic tumours [4,17]. Histopathologically, all subtypes of meningiomas are diagnosed, and fibromatous, fibroblastic, meningothelial and psammomatous are the most common.…”

“…In 1938, Cushing and Eisenhardt described three cases of intraventricular tumours in a group of 313 patients operated on for meningiomas, including the first case of a third ventricular meningioma [3]. Recently, Pereira et al systematically reviewed 682 IVMs from 98 papers [4].…”