Spinal meningiomas in patients younger than 50 years of age: a 21-year experience

Abstract

<jats:p content-type="fine-print"><jats:italic>Object.</jats:italic> Spinal meningiomas occur most frequently in older patients. They are well-circumscribed and slow-growing tumors that are associated with good patient outcomes following surgery. Spinal meningiomas occurring in younger patients may be more aggressive, with a worse prognosis. The authors present their 21-year experience with spinal meningiomas in patients younger than 50 years of age.</jats:p> <jats:p content-type="fine-print"><jats:italic>Methods.</jats:italic> The authors reviewed data obtained in 40 patients (age &lt; 50 years) treated at the Mayo Clinic, Rochester, during the past 21 years; in all cases the lesions were histologically confirmed spinal meningiomas. Five men (12.5%) and 35 women (87.5%) (mean age 34.5 ± 10.9 years) underwent 52 operations for 41 tumors. The mean follow-up duration was 82 ± 93 months (range 0–445 months). The data obtained in these patients were compared with those derived from a random control cohort of 40 patients older than age 50 years in whom spinal meningiomas were resected at the Mayo Clinic during a similar period. In this cohort, there were 33 women and seven men whose mean age was 67.1 ± 9.5 years. The mean follow-up duration for the older group was 88 ± 72.3 months (range 18–309 months).</jats:p> <jats:p content-type="fine-print">Compared with the random cohort of older patients, younger patients there tended to have more tumors located in the cervical spine (39%) as well as a greater number of predisposing factors such as neurofibromatosis Type 2, radiation exposure, or trauma. Nine (22%) of the patients younger than 50 years of age required reoperation for residual or recurrent tumor compared with two (5%) in the older patient control group. The overall mortality rate at the completion of the study for the younger patients was 10%.</jats:p> <jats:p content-type="fine-print"><jats:italic>Conclusions.</jats:italic> Spinal meningiomas in younger patients have a worse prognosis than similar tumors in older patients.</jats:p>

Multiple meningiomas within the spinal canal: case report with 23 tumors

“…Usually they are circumscribed and shows a slow growth and have a good post-surgical prognosis. On the other hand, the meningiomas that occur in younger patients might have an aggressive behavior and an unfavorable prognosis 21 .…”

Quality of life in adult intradural primary spinal tumors: 36-Item Short Form Health Survey correlation with McCormick and Aminoff-Logue scales

“…9 Patients older than 50 years benefited moderately from surgery; 5% required reoperation for residual or recurrent tumor compared with 22% of those younger than 50 years. 17 Resection of a single eloquent nerve root involved in a nerve sheath tumor is the main risk factor related to recurrence. Other risk factors include tumor pathological pattern of schwannoma, preoperative functional status with deficit of the involved nerve root, extradural nerve sheath tumors, cervical location of the tumor, and extraradicular tumor growth.…”

Spinal meningiomas: surgical management and outcome

“…Cohen-Gadol, et al, 3 found that rates of recurrence and reoperation in patients younger than 50 years of age were higher than those in older patients because of a higher frequency of spinal meningiomas with cervical spine locations, extradural tumor extension, and en plaque growth, all of which made total resection more difficult. Deen, et al, 4 also reported a higher rate of recurrence (20%) in patients younger than 21 years of age.…”

“…They occurred far less frequently in the cervical spine (14-27%) and only rarely in the lumbar spine (2-14%). Cohen-Gadol, et al, 3 found that in patients younger than 50 years of age there tended to be a higher frequency (39%) of spinal meningiomas located in the cervical spine, and the majority were located in the high cervical region. Levy, et al, 16 reported that tumor location varied according to sex, with significantly more thoracic spine meningiomas appearing in female patients.…”