Peritumoral edema in meningiomas: pathophysiology, predictors, and principles for treatment

Jarrah, Ryan; Bhandarkar, Archis R.; Stefano, Frank De; Amare, Abrham; Aljameey, Usama A; Reardon, Taylor

doi:10.1007/s12094-022-03009-0

Cited by 7 publications

(3 citation statements)

References 42 publications

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Section: Discussionmentioning

confidence: 99%

“…However, the results may have been influenced by the 29% of patients who had good prognosis grade 1 meningiomas. Bevacizumab also exerts an anti-edema effect that can lessen edema around the tumor by decreasing vascular permeability through inhibiting VEGF expression (30,32). Due to their dura-based anatomical position, absence of the blood-brain barrier, and suppressed immunological caused by high PD-L1 expression-linked to poor prognosismeningiomas are more likely to experience tumor recurrence or progression (33,34).…”

Section: Discussionmentioning

confidence: 99%

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Case Report: Recurrent meningioma with multiple metastases

Zhou

2023

Front. Oncol.

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Post-surgery recurrence of meningiomas with multiple extracranial metastases is rare. Currently, information on extracranial metastases is limited, and no clear predictors and standardized treatment protocols can be applied clinically. Herein, we report a case of meningioma that recurred after two surgeries and had multiple distant metastases. Computed tomography revealed multiple enlarged lymph nodes in the para-aortic arch, left lower lung region, retroperitoneum, and abdominopelvic region, as well as soft tissue mass-like lesions under the liver capsule in the right lobe of the liver. Magnetic resonance imaging showed space-occupying lesions under the cranial plate of the left parietal lobe. Tissue biopsy confirmed the diagnosis of recurrent meningioma with extracranial metastases. Immune checkpoint inhibitors and anti-angiogenic drugs were administered. After two treatment cycles, the patient’s clinical symptoms were significantly relieved, and the imaging assessment confirmed a stable disease. Although it did not meet our expectations, this combination therapy still demonstrated a possible benefit in improving meningioma patients’ survival and quality of life. In this report, along with the case, we also review the relevant literature on the subject and discuss the associated risk factors and treatment options.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Case Report: Recurrent meningioma with multiple metastases

Zhou

2023

Front. Oncol.

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“…PTE can raise the intracranial pressure (ICP) leading to serious symptoms, increase the di culty of resection and lead to more treatment complications [8][9]. Several factors such as tumor size, tumor location, histologic type and hormonal and biochemical behavior have been reported to contribute to PTE [10][11][12][13]. Previous studies suggested that the destruction of brain-totumor interface, the rich blood supply of tumor and compression of brain tissue by meningioma may promote the development of PTE.…”

Section: Imaging Analysismentioning

confidence: 99%

Postoperative peritumoral edema can predict the prognosis in intracranial meningioma with preoperative peritumoral edema

Ying

Dong

et al. 2023

Preprint

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Purpose Peritumoral edema (PTE) in intracranial meningiomas correlates to surgical outcomes. But only depending on preoperative PTE in meningioma does not accurately predict the prognosis after resection. We aimed to investigate whether postoperative PTE could improve the prognosis prediction of meningioma patients with preoperative PTE. Methods We retrospectively reviewed postoperative MRI scans in 3 months after operation of 371 patients with preoperative PTE of meningioma that underwent surgery between 2015 and 2017. All the patients were classified into two different groups according to whether had postoperative PTE fadeaway within 3 months after operation. Clinical manifestations, histopathology characteristics, radiology data and follow-up outcomes were noted. T-tests and chi-square tests were used to compare clinical characteristics. Univariate and multivariate Cox analysis and Kaplan‒Meier method were utilized to screen for clinical prognostic factors. Result Kaplan-Meier model showed that the progression-free survival of patients with postoperative PTE are shorter than who with postoperative PTE fadeaway in 3 months after operation (HR = 3.30 ,P = 0.006). Multivariate Cox analyses showed that the predictors for recurrence of meningioma with preoperative: high WHO grades (HR = 4.989, P＜0.001), superior sagittal sinus invasion (HR = 2.290, P = 0.047), postoperative PTE in 3 months after operation (HR = 1.804, P = 0.044) and subtotal resection (HR = 3.940, P = 0.003). Conclusion According to our research, we found that postoperative PTE in 3 months after operation can predict the outcomes of patients of meningioma with preoperative PTE. Besides, we demonstrated that there were also some predictors for recurrence: male, high WHO grades, superior sagittal sinus invasion and subtotal resection.

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