ENINGIOMAS are usually benign tumors that arise from the leptomeningeal cells of the arachnoid membrane surrounding the brain and spinal cord. However, recurrence after seemingly complete surgical removal occurs in eight to 15% of cases, and tumor control rates achieved with radiotherapy are only 80%. 20,35,36,53 Moreover, a surgical cure is not always achievable in meningiomas involving the skull base or vital neurovascular structures. Results achieved with chemotherapeutic treatments in the past were not convincing, and even drugs such as temozolomide-which have shown high efficacy against malignant brain tumors-have failed to inhibit the growth of refractory meningiomas in Phase II studies. 7,26,39,45 The development of novel treatment strategies based on molecular information has not yet been successfully translated into common clinical practice.Arachidonic acid is a v6 polyunsaturated fatty acid that is converted into biologically active lipid compounds called eicosanoids. Eicosanoids constitute a large family of biologically active lipid mediators produced by two enzyme classes: the cyclooxygenases (COX-1 and COX-2) and the lipoxygenases (5-LO, 12-LO, and 15-LO). Both classes catalyze the same enzymatic reaction that occurs in the synthesis of PG 2 and PGH 2 , which are successively metabolized to PGE 2 , PGD 2 , PGF 2 , thromboxane A 2 , and prostacyclin PGI 2 (Fig. 1 Object. The current treatment for recurrent or malignant meningiomas with adjuvant therapies has not been satisfactory, and there is an intense interest in evaluating new molecular markers to act as therapeutic targets. Enzymes of the arachidonic acid (AA) cascade such as cyclooxygenase (COX)-2 or 5-lipoxygenase (5-LO) are upregulated in a number of epithelial tumors, but to date there are hardly any data about the expression of these markers in meningiomas. To find possible targets for chemotherapeutic intervention, the authors evaluated the expression of AA derivatives at different molecular levels in meningiomas.Methods. One hundred and twenty-four meningioma surgical specimens and normal human cortical tissue samples were immunohistochemically and cytochemically stained for COX-2, COX-1, 5-LO, and prostaglandin E receptor 4 (PTGER4). In addition, Western blot and polymerase chain reaction (PCR) analyses were performed to detect the presence of eicosanoids in vivo and in vitro.Results. Sixty (63%) of 95 benign meningiomas, 21 (88%) of 24 atypical meningiomas, all five malignant meningiomas, and all normal human cortex samples displayed high COX-2 immunoreactivity. All cultured specimens and IOMM-Lee cells stained positive for COX-2, COX-1, 5-LO, and PTGER4. The PCR analysis demonstrated no changes in eicosanoid expression among meningiomas of different World Health Organization grades and in normal human cortical and dura mater tissue.Conclusions. Eicosanoid derivatives COX-1, COX-2, 5-LO, and PTGER4 enzymes show a high universal expression in meningiomas but are not upregulated in normal human cortex and dura tissue. This finding of the ...