BACKGROUND Meningiomas represent the most common primary intracranial tumor in adults.The majority of meningiomas are indolent,benign,and sporadic in nature.The incidence of meningiomas is directly proportional to the...BACKGROUND Meningiomas represent the most common primary intracranial tumor in adults.The majority of meningiomas are indolent,benign,and sporadic in nature.The incidence of meningiomas is directly proportional to the age,peaking around 65 years.The presenting symptomatology of intracranial meningiomas is mainly dependent on their anatomical location,as with the majority of brain tumors.Surgical resection and radiation therapy remain the treatment modality for meningiomas of all grades.CASE SUMMARY We present a case describing a 78-year-old female who came in following a ground level fall.The primary assessment was notable for a history of similar recurrent falls and subtle left-sided peripheral visual field loss.Further neurological examination was otherwise largely unremarkable.A computed tomography scan of the head revealed a large extra-axial mass located along the posterior aspect of the falx.Follow-up magnetic resonance imaging confirmed a lesion measuring around 6.6 cm×4.2 cm×5.5 cm.A partial surgical resection of the right-sided portion of the lesion was performed.Complete resection was limited by insufficient visualization and challenges with hemostatic control of the left parafalcine region.Further histopathological analysis confirmed a fibrous meningioma with focal necrosis,consistent with World Health Organization Grade 2 classification.She was subsequently scheduled for outpatient follow-up to assess the residual tumor management.CONCLUSION This case highlights the importance of maintaining a high index of suspicion for intracranial pathology in elderly patients with nonspecific presentation.展开更多
BACKGROUND Malignant meningioma metastasizes systemically,primarily due to its role in epithelial-mesenchymal transition.Although the prognosis is extremely poor,drug development efforts have been limited,because this...BACKGROUND Malignant meningioma metastasizes systemically,primarily due to its role in epithelial-mesenchymal transition.Although the prognosis is extremely poor,drug development efforts have been limited,because this tumor is categorized as a rare form.AIM To examine growth suppressive effect of GO-Y030,a diarylpentanoid curcumin analog,(1E,4E)-1,5-bis[3,5-bis(methoxymethoxy)phenyl]penta-1,4-dien-3-one against the malignant meningioma.METHODS The growth suppression of malignant meningioma cells by GO-Y022 and GOY030 were examined,using IOMM-Lee and HKBMM cell lines.Male nude mice aged eight weeks,specifically BALB/cSlc-nu/nu mice received a subcutaneous inoculation of IOMM-Lee(107 cells/site)on their back and 30μg/kg of recombinant hepatocellular growth factor(HGF)was injected into the tumor every three days.After confirmed the growth tumor mass,500μL of GO-Y030 diluted with PBS were administrated intraperitoneally daily at doses of 1 mg/kg and 2 mg/kg,respectively.RESULTS GO-Y030 exhibits a growth inhibitory effect on malignant meningioma cell lines,IOMM-Lee and HKBMM ranging from 0.8-2.0μM in vitro.Notably,GO-Y030’s inhibitory effect is about 10 to 16th times more potent than that of curcumin,which has previously demonstrated potential in combating malignant meningioma.In mouse models,the intraperitoneal administration of GO-Y030 effectively suppresses the growth of malignant meningioma tumors that have been inoculated in the back(P=0.002).High-performance liquid chromatography analysis has confirmed the distribution of GO-Y030 in the bloodstream and brain tissue.Moreover,GOY030 demonstrates the ability to significantly suppress HGF(P<0.01),nuclear factor kappa B(P<0.001),and Ncadherin(P<0.001),all of which contribute to the epithelial-mesenchymal transition.CONCLUSION GO-Y030 holds promise as a potent compound for the systemic inhibition of malignant meningioma.GO-Y030 has higher tumor growth inhibitory effect against meningiomas than curcumin,which is known to have antitumor activity through multi-molecular target control resulting in apoptosis induction.GO-Y030 controls at least three molecules of HGF,nuclear factor kappa B,and N-cadherin.展开更多
Objective:The World Health Organization(WHO)grading based on histopathology cannot always accurately predict tumor behavior of meningiomas.To overcome the limitations of the WHO grading,the study aims to propose a nov...Objective:The World Health Organization(WHO)grading based on histopathology cannot always accurately predict tumor behavior of meningiomas.To overcome the limitations of the WHO grading,the study aims to propose a novel oxidative stress-based molecular classification for WHO grade 2/3 meningiomas.Methods:Differentially expressed oxidative stress-related genes were analyzed between 86 WHO grade 1(low grade)meningiomas and 99 grade 2/3(high grade)meningiomas.An oxidative stress-based molecular classification was developed in high-grade meningiomas through consensus clustering analysis.Immune microenvironment features,responses to immunotherapy and chemotherapy,and targeted drugs were evaluated.Three machine learning models:logistic regression,support vector machine,and random forest,were built for differentiating the classification.Key oxidative stress-related geneswere verified in humanmeningeal cells(HMC)and two meningioma cells(CH-157MN and IOMMLee)via reverse transcription quantitative polymerase chain reaction(RT-qPCR)and western blot.After knockdown of Forkhead Box M1(FOXM1)or Prion Protein(PRNP),cell growth,migration,and reactive oxygen species(ROS)levels were measured through cell counting kit-8(CCK-8),transwell,and immunofluorescence,respectively.Results:We classified high-grade meningiomas into two oxidative stress-based clusters,termed cluster 1 and cluster 2.Cluster 1 exhibited higher infiltrations of immune and stromal cells and higher expression of classic immune checkpoints:Cluster of Differentiation 86(CD86),Programmed Cell Death 1(PDCD1),and Leukocyte-Associated Immunoglobulin-Like Receptor 1(LAIR1),indicating that cluster 1 meningiomas might respond to immunotherapy.Drug sensitivity was heterogeneous between the two clusters.Three classifiers were established,which could accurately differentiate this molecular classification.FOXM1 and PRNP were experimentally evidenced to be highly expressed inmeningioma cells,and their knockdown hindered cell growth and migration and triggered ROS accumulation.Conclusion:In summary,our findings established a novel oxidative stress-based molecular classification and identified potential treatment vulnerabilities in high-grade meningiomas,which might assist personalized clinical management.展开更多
<strong>Aims:</strong> The current study aimed to evaluate the efficacy, side effects of radiotherapy and factors influencing treatment outcome in patients received radiotherapy for cerebral meningiomas. &...<strong>Aims:</strong> The current study aimed to evaluate the efficacy, side effects of radiotherapy and factors influencing treatment outcome in patients received radiotherapy for cerebral meningiomas. <strong>Methods and Material:</strong> In the last two decades, a total of 35 patients with cerebral meningioma who received radiotherapy in our clinic were evaluated statistically in terms of survival, toxicity and prognostic factors. The records of patients diagnosed with cerebral meningioma who underwent postoperative radiotherapy were retrospectively analyzed. Statistical analysis used: Statistical comparisons were made using IBM SPSS v24.0. Kaplan-Meier method was used to compare survival times. <strong>Results:</strong> Five of the patients had grade I meningioma showing recurrence, 18 were grade II meningioma and 12 were grade III meningioma. Patients were treated with 54 or 60 Gy adjuvant radiotherapy with 2 Gy daily fractions according to histopathological grade and operation type. Three and five-year overall survival rates were 56% and 40%, respectively and median overall survival was 36 months. Progression was observed in 15 of the 35 patients included in the study. Three and five-year progression-free survival (PFS) rates of the patients were 56% and 50%, respectively. There was a statistically significant correlation between histopathological grade and overall survival among patients. However;no statistical difference found in overall survival of patients in terms of tumor location, operation type and age. <strong>Conclusions:</strong> In the treatment of cerebral meningiomas, changes in radiotherapy dose and field designs can be predicted according to the tumor grade and operation type. In addition, it is thought that large scale studies are needed to determine prognostic factors more meticulously.展开更多
Meningiomas, the most common intracranial primary tumors, are always benign. Extracranial and distant metastases can occur in malignant meningiomas. This case report describes a male in his 50 s with malignant meningi...Meningiomas, the most common intracranial primary tumors, are always benign. Extracranial and distant metastases can occur in malignant meningiomas. This case report describes a male in his 50 s with malignant meningioma and metastases to the subcutaneous soft tissue. Preoperative color Doppler ultrasound showed that the tumor had an abundant blood flow. Intraoperative pathological examination revealed a malignant tumor. Postoperative pathological examination revealed malignant tumors in the forehead;thus, malignant meningiomas were suspected. Immunohistochemistry revealed grade Ⅲ malignant meningioma. Malignant meningiomas have the ability to readily spread and metastasize;however, cases of malignant meningiomas disintegrating the bone and metastasizing to the subcutaneous part of the head have not been reported.展开更多
An 83-year-old woman had been diagnosed with a left frontal apex mass for more than 20 years without any symptoms. Recently, the rate of protrusion of the perceived mass increased rapidly. Malignant lesions were consi...An 83-year-old woman had been diagnosed with a left frontal apex mass for more than 20 years without any symptoms. Recently, the rate of protrusion of the perceived mass increased rapidly. Malignant lesions were considered by CT/MR, not excluding metastatic lesions;malignant lesions were also considered by PET-CT, and no other tumor lesions were found in the whole body. The histopathological diagnosis was WHO grade 3 anaplastic meningioma. The patient underwent gross total resection (GTR) with no postoperative abnormalities.展开更多
Objective: To evaluate the clinical and radiological factors that affect therecurrence of the meningioma patient so as to effectively prevent and cure recurrence of meningiomapatients more earlier. Methods: The clinic...Objective: To evaluate the clinical and radiological factors that affect therecurrence of the meningioma patient so as to effectively prevent and cure recurrence of meningiomapatients more earlier. Methods: The clinical features and radiological aspects in 145 cases ofmeningiomas undergoing operation during 1993-1997 were retrospectively studied. The data of only 83cases of all 145 cases were available. The factors were evaluated with univariate and multivariateanalysis. Results: With univariate analysis, 7 factors showed highly significance to recurrence ofmeningiomas: tumor size, tumor location, tumor shape, edema, extent of resection, pathologicalgrade, CT enhancement. With multivariate analysis, 4 factors showed significant danger to recurrenceof meningiomas: pathological grade, extent of resection, tumor shape and CT enhancement.Conclusion: The main factors that affect the recurrence of meningioma patients are pathologicalgrade, extent of resection, tumor shape and CT enhancement.展开更多
Introduction: Meningiomas are tumors formed by arachnoid cells, typically attached to the inner surface of the dura mater. Malignant forms are rare and no case has been reported in the Malagasy literature. The objecti...Introduction: Meningiomas are tumors formed by arachnoid cells, typically attached to the inner surface of the dura mater. Malignant forms are rare and no case has been reported in the Malagasy literature. The objective of our study is to report two Malagasy cases of malignant meningioma and to discuss the epidemiological and anatomical-clinical particularities of this tumor. Observation: The first patient, a 41-year-old woman, presented with a rapidly progressive intracranial hypertension syndrome. The patient had undergone surgery two years earlier for a grade II meningioma and had no family history of meningioma, neurofibromatosis, or personal history of brain irradiation or head trauma. Her brain scan showed a heterogeneous polylobed left parieto-occipital mass with a meningeal implantation base. The anatomopathological examination of the samples revealed a malignant meningioma. The second patient was a 33-year-old man, operated for grade I meningioma eleven months before admission, with no other personal or family history. The patient was hospitalized for tumor recurrence with signs of intracranial hypertension. The brain computed tomography (CT) scan showed a heterogeneous extra-axial tumor in right temporo-parietal lobe. Surgical excision was performed. On histological examination, a proliferation of tumor cells of meningothelial appearance with papillary architecture was observed, leading to the diagnosis of malignant meningioma. Conclusion: Malignant meningioma is a rare and serious entity. The clinical manifestations are nonspecific and imaging may mimic a low-grade meningioma. The diagnosis of certainty is histological and is based on essentially morphological criteria. The latter condition the overall survival of the patient and the therapeutic conduct.展开更多
This case is a 49-year-old female patient who presented with suspected eustachian tube dysfunction symptoms that were refractory to medical treatment. She presented with conductive hearing loss and aural fullness on t...This case is a 49-year-old female patient who presented with suspected eustachian tube dysfunction symptoms that were refractory to medical treatment. She presented with conductive hearing loss and aural fullness on the left. A physical exam revealed an epitympanic fleshy mass in the middle ear with effusion. Imaging with MRI and CT showed opacification of the epitympanum with surrounding bony demineralization bilaterally left greater than right and significant thinning versus dehiscence of the tegmen mastoideum and tympani on the left with only thinning of the tegmen on the right. An MR temporal bone with and without contrast, demonstrated enhancement of the left middle ear extending to the tegmen and corresponding enhancement of the dura along the floor of the left middle cranial fossa as well as extending along foramen ovale into the infratemporal fossa. There was to a lesser degree similar appearance on the right. A biopsy of the middle ear mass on the left revealed meningioma. This case highlights the need to widen your differential with common symptoms when they are refractory to treatment.展开更多
Meningiomas are the most common extra-axial central nervous system tumours and often discovered in the middle to late adult life and especially in women. About 85%-90% of meningiomas are benign, 5%-10% are intermediat...Meningiomas are the most common extra-axial central nervous system tumours and often discovered in the middle to late adult life and especially in women. About 85%-90% of meningiomas are benign, 5%-10% are intermediate-grade, and 3%-5% are malignant. Metaplastic meningioma is a rare subtype of WHO Grade I meningioma histologically characterized by the presence of mesenchymal components. The presence of pure and extensive cartilaginous differentiation in meningiomas is extremely rare and remains a diagnostic dilemma. We report, perhaps the first case of this entity in a 52-year-old woman and discuss the pathogenesis, the imaging features and the histopathologicals data.展开更多
Objective:To discuss the role of 3D-computed tomography angiography(3D-CTA) technology in reducing injuries of large meningioma surgery.Methods:3D-CTA preoperative examinations were done in 473 patients with large men...Objective:To discuss the role of 3D-computed tomography angiography(3D-CTA) technology in reducing injuries of large meningioma surgery.Methods:3D-CTA preoperative examinations were done in 473 patients with large meningioma(simulated group).The images were analyzed by 30 post-processing workstation.By observing the major intracranial blood vessels,venous sinus,and the compression and invasion pattern in the nerve region,assessing risk level of the surgery,simulating the surgical procedures,the surgical removal plan,surgical routes and tumor blood-supplying artery embolisation plan were performed.Two hundred and fifty seven large meningioma patients who didn’t underwent 3D-CTA preoperative examination served as control group.The incidence of postoperative complications,intraoperative blood transfusion and the operation time were compared between these two groups.Results:Compared with the control group,the Simpson’s grade 1 and 11 resection rate was 80.3%(380/473),similar with that of the control(81.3%,209/257).The incidence of postoperative complications in 3D-CTA simulated group was 37.0%which was significantly lower than that(48.2%) of the control(P【0.01). The intraoperative blood supply for simulated group and the control was(523.4±208.1) mL and (592.0±263.3) mL,respectively,with significant difference between two groups(P【0.01).And the operation time[(314.8±106.3)]min was significantly lower in simulated group than that in the control[(358.4±147.9) min](P【0.01).Conclusions:Application of 3D-CTA imaging technology in risk level assessment before large-scaled meningioma resection could assist in the rational planning of tumor resectin,surgical routes,and is helpful in reducing injuries and complications and enhancing the prognosis of the patients.展开更多
Objective： Metaplastic meningioma is a rare subtype of benign meningiomas, classified as WHO grade I with well prognosis. Here we presented our experiences on 15 cases of metaplastic meningioma, to investigate the cl...Objective： Metaplastic meningioma is a rare subtype of benign meningiomas, classified as WHO grade I with well prognosis. Here we presented our experiences on 15 cases of metaplastic meningioma, to investigate the clinicopathological features, therapies and prognosis of these cases. Methods： 15 patients underwent surgical treatment for intracranial metaplastic meningioma between 2001 and 2010 at Neurosurgery Department of Huashan Hospital, Shanghai, China. The clinical data, radiological manifestation, treatment strategy, pathological findings and prognosis of all patients were analyzed retrospectively. Results： Among the 15 cases （10 males and 5 females）, the age ranged from 22 to 74 years old （the mean age was 50.67-year old）. The clinical manifestations include headache, dizziness, seizure attack, vision decrease, and weakness of bilateral lower limbs. All the patients received surgical treatment, combined with radiotherapy in some cases. In the follow-up period, recurrence occurred in 2 cases, of which 1 patient died of other system complications. Conclusions： Metaplastic meningiomas are characterized by focal or widespread mesenchymal differentiation with formation of bone, cartilage, fat, and xanthomatous tissue elements. Surgical removal is the optimal therapy, and the overall prognosis is well. But recurrence may occur in some cases, thus radiotherapy is necessary for such kind of patients.展开更多
Objective:Meningiomas are neoplasms that arise from the meninges of the central nervous system(CNS).They constitute about25.6%of CNS tumors diagnosed in Egypt.Some morphological variants of meningiomas display aggress...Objective:Meningiomas are neoplasms that arise from the meninges of the central nervous system(CNS).They constitute about25.6%of CNS tumors diagnosed in Egypt.Some morphological variants of meningiomas display aggressive behavior,leading to brain-invasive growth pattern.Although meningiomas are usually treated by complete surgical excision,the risk of postoperative recurrence remains.Hence,additional biomarkers for predicting aggressive behavior must be discovered.This study aims to explore the clinical and biological relevance of the protein expression levels ofβ-catenin and galectine-3 in meningioma and to understand the pathobiology of this neoplasm.Methods:This retrospective study was carried out on 153 cases of meningioma by using tissue microarrays and immunohistochemistry forβ-catenin and galectine-3.Results:Highβ-catenin expression was significantly associated with transitional and meningiotheliomatous meningiomas,low tumor grade,low recurrence rate,and low incidence of brain invasion.Meanwhile,high galectin-3 expression was associated with brain invasion,recurrence,high tumor grade,and tumor type.Logistic regression analysis indicated that among all variables included in the model,β-catenin and galactin-3 expression levels were significant predictors of tumor recurrence(P<0.001).Conclusions:Galectin-3 andβ-catenin are involved in meningioma recurrence but not in brain invasion.These molecules could be important potential therapeutic targets and predictors for meningiomas.展开更多
AIM：To investigate clinical features of optic nerve sheath meningioma（ONSM） that was misdiagnosed,and to find methods to reduce the misdiagnoses.METHODS：Retrospective series study.Twenty-five misdisgnosed patients...AIM：To investigate clinical features of optic nerve sheath meningioma（ONSM） that was misdiagnosed,and to find methods to reduce the misdiagnoses.METHODS：Retrospective series study.Twenty-five misdisgnosed patients with unilateral ONSM were collected from Jan.2008 to Jan.2015 and the clinical records reviewed.RESULTS：Patients were misdiagnosed with acute papillitis most frequently（P=17）,immediately followed by optic atrophy（P=8）,ischemic optic neuropathy（P=5）,acute retrobulbar optic neuritis（P=5）,optic disc vasculitis（P =3）.For each patient,the minimum frequency of misdiagnoses was once and the maximum was 4 times.As for the lasting time of being misdiagnosed,the shortest was 1.5mo and the longest was 45 mo.Twentyone cases（84%） were once treated with glucocorticoids,and its side effects was found in seventeen patients.Twenty patients（80%） complained with varying degree of vision loss.When a definite diagnosis was made,sixteen cases（64%） showed slight exophthalmos and eighteen cases（72%） had the tubular ONSM.CONCLUSION：ONSM without loss obvious exophthalmos is easily misdiagnosed in clinic,and for most of these ONSMs are tubular.展开更多
Angioarchitecture plays an important role in the malignant development of intracranial hemangiopericytoma. It remains poorly understood whether high frequency of hemorrhage during clinical surgery for intracranial hem...Angioarchitecture plays an important role in the malignant development of intracranial hemangiopericytoma. It remains poorly understood whether high frequency of hemorrhage during clinical surgery for intracranial hemangiopericytoma is associated with angioarchitecture. The present study utilized hematoxylin-eosin staining, and immunohistochemical staining with epithelial membrane antigen, vimentin, CD34, von Willebrand factor （vWF） and CD133 to observe characteristics of angioarchitecture. In addition, silver stains were used to demonstrate changes in reticular fibers in the wall of vessel channels in intracranial hemangiopericytoma and meningioma. Five patterns of angioarchitecture were identified in intracranial hemangiopericytoma, namely tumor cell islands, vasculogenic mimicry, mosaic blood vessels, sprouting angiogenesis, and intussusceptive angiogenesis. Several CD133＋ tumor cells were found to form tumor cell islands. A connection between vWF ^＋ and vWF channels was detected in the pattern of intussusceptive angiogenesis, and some vimentin^＋ tumor cells were embedded in the periodic acid-Schiff positive channel wall. Incomplete threads of reticular fibers formed the walls of larger pseudo-vascular channels and some tumor clumps or scattered tumor cells were detected ＂floating＂ in them. The angioarchitecture, specific markers and reticular fibers of intracranial hemangiopericytoma were significantly different from meningioma. Angioarchitecture provides a functional vascular network for vascular evolution in intracranial hemangiopericytoma and contributes to significant intra-operative bleeding.展开更多
Objective： Intracranial meningiomas, especially those located at anterior and middle skull base, are difficult to be completely resected due to their complicated anatomy structures and adjacent vessels. It＇s essenti...Objective： Intracranial meningiomas, especially those located at anterior and middle skull base, are difficult to be completely resected due to their complicated anatomy structures and adjacent vessels. It＇s essential to locate the tumor and its vessels precisely during operation to reduce the risk of neurological deficits. The purpose of this study was to evaluate intraoperative ultrasonography in displaying intracranial meningioma and its surrounding arteries, and evaluate its potential to improve surgical precision and minimize surgical trauma. Methods： Between December 2011 and January 2013, 20 patients with anterior and middle skull base meningioma underwent surgery with the assistance of intraoperative ultrasonography in the Neurosurgery Department of Shanghai Huashan Hospital. There were 7 male and 13 female patients, aged from 31 to 66 years old. Their sonographic features were analyzed and the advantages of intraoperative ultrasonography were discussed. Results： The border of the rneningioma and its adjacent vessels could be exhibited on intraoperative ultrasonography. The sonographic visualization allowed the neurosurgeon to choose an appropriate approach before the operation. In addition, intraoperative ultrasonography could inform neurosurgeons about the location of the tumor, its relation to the surrounding arteries during the operation, thus these essential arteries could be protected carefully. Conclusions： Intraoperative ultrasonography is a useful intraoperative technique. When appropriately applied to assist surgical procedures for intracranial meningioma, it could offer very important intraoperative information （such as the tumor supplying vessels） that helps to improve surgical resection and therefore might reduce the postoperative morbidity.展开更多
The expression of basic fibroblast growth factor (bFGF) and fibroblast growth factor receptor-1 (FGFR-1) in human meningiomas and the relationships between their expression and the tumors' histological features an...The expression of basic fibroblast growth factor (bFGF) and fibroblast growth factor receptor-1 (FGFR-1) in human meningiomas and the relationships between their expression and the tumors' histological features and angiogenesis were investigated by means of immunohistochemical technique. The expression of bFGF and FGFR-1 was detected by antibody of bFGF or FGFR-1. The tumors' angiogenesis was evaluated by microvascular density (MVD) and, which was observed by use of CD34-antibody immunohistochemically. The results showed that there were varied degrees of the expression of bFGF and FGFR-1 proteins in meningiomas. The expression was correlated with the tumors' histological characters and angiogenesis. It was concluded that bFGF and FGFR-1 might play important roles in meningiomas' angiogenesis and proliferation. The expression positive rate of bFGF and FGFR-1 may provide an indication of evaluating the histological and malignant degree of the tumor.展开更多
BACKGROUND Primary pulmonary meningioma(PPM)is a rare disease that is usually benign.The most common presentation of PPM is isolated pulmonary nodules or masses,so the disease can mimic any other lung tumor on imaging...BACKGROUND Primary pulmonary meningioma(PPM)is a rare disease that is usually benign.The most common presentation of PPM is isolated pulmonary nodules or masses,so the disease can mimic any other lung tumor on imaging,especially lung cancer or metastasis.CASE SUMMARY A 47-year-old asymptomatic woman presented with a well-defined,lobulated pulmonary mass with calcification in the left lower lobe.The mass measured 69 mm×57 mm×61 mm and was found during a chest computed tomography(CT)performed for physical examination.Contrast-enhanced CT and positron emission tomography(PET)/CT revealed mild enhancement of the mass,with accumulation of 18-fluoro-2-deoxy-D-glucose(18F-FDG).Transbronchial biopsy suggested a provisional diagnosis of low-grade neuroendocrine tumor.Subsequent enhanced head magnetic resonance imaging revealed no positive lesions.An open cuff resection of the left lower lobe and wedge resection of the lingual segment were performed.Histopathological and immunohistochemical examination revealed that the mass was a PPM.CONCLUSION PPM should be considered in the differential diagnosis of isolated pulmonary masses found incidentally on CT and should be diagnosed based on a combination of radiological and histological features.Surgical resection is currently the main treatment strategy.No recurrence of benign PPMs has been reported after complete resection.展开更多
BACKGROUND Entrapment of the temporal horn (ETH) is a rare pathologic condition. It is a kind of focal hydrocephalus caused by obstruction of flow pathway of cerebrospinal fluid. It is caused by various conditions, bu...BACKGROUND Entrapment of the temporal horn (ETH) is a rare pathologic condition. It is a kind of focal hydrocephalus caused by obstruction of flow pathway of cerebrospinal fluid. It is caused by various conditions, but ETH secondary to postoperative gamma-knife radiosurgery (GKS) is extremely rare. CASE SUMMARY A 52-year old previously healthy woman underwent resection of a large intraventricular meningioma. A small fragment of residual tumor with no obvious enlargement of the temporal horn was observed 3 mo after surgery, and she was referred for GKS. Two months after GKS, she complained of headache and progressive paralysis of the left limb. Magnetic resonance imaging revealed enlargement of the temporal horn. There was a second procedure to resect the residual tumor 8 mo after GKS. After the second procedure, she recovered smoothly. As of the date of this writing, she has remained in good condition. CONCLUSION This case reminds us that ETH should be considered in the treatment of intraventricular meningiomas, especially before GKS.展开更多
BACKGROUND The coexistence of meningioma and other intracranial primary benign tumors is rare,especially in non-neurofibromatosis type 2,and there is limited guidance for the management of such patients.Here,we report...BACKGROUND The coexistence of meningioma and other intracranial primary benign tumors is rare,especially in non-neurofibromatosis type 2,and there is limited guidance for the management of such patients.Here,we report a series of 5 patients with concomitant meningioma and other intracranial benign tumors,including subependymoma and pituitary adenoma.CASE SUMMARY Five non-neurofibromatosis type 2 patients with simultaneous occurrence of meningioma and other intracranial benign tumors were retrospectively reviewed.The patients had no history of previous irradiation.The clinical features,pre-and postoperative imaging,surgical procedure and pathological findings were extracted from electronic medical records.There were 4 female patients(80%)and 1 male patient(20%).The mean age was 42.8 years(range:29-52 years).The coexisting tumors included subependymoma in 1 case(20%)and pituitary adenoma in 4 cases(80%).The most common clinical symptom was headache(3/5,60%).Four patients(80%)underwent craniotomy.One patient(20%)underwent transsphenoidal surgery followed by transcranial operation.All tumor diagnoses were confirmed by histopathological examination.The mean follow-up was 38.8 mo(range:23-96 mo),and all 5 patients were in a stable condition at the last follow-up.CONCLUSION The simultaneous occurrence of meningioma and other intracranial benign tumors is a rare clinical event.Histological examination is necessary for the accurate diagnosis.Neurosurgeons should select the appropriate surgical strategy according to the clinical features of each patient,which may provide a more favorable prognosis for individual patients.展开更多
文摘BACKGROUND Meningiomas represent the most common primary intracranial tumor in adults.The majority of meningiomas are indolent,benign,and sporadic in nature.The incidence of meningiomas is directly proportional to the age,peaking around 65 years.The presenting symptomatology of intracranial meningiomas is mainly dependent on their anatomical location,as with the majority of brain tumors.Surgical resection and radiation therapy remain the treatment modality for meningiomas of all grades.CASE SUMMARY We present a case describing a 78-year-old female who came in following a ground level fall.The primary assessment was notable for a history of similar recurrent falls and subtle left-sided peripheral visual field loss.Further neurological examination was otherwise largely unremarkable.A computed tomography scan of the head revealed a large extra-axial mass located along the posterior aspect of the falx.Follow-up magnetic resonance imaging confirmed a lesion measuring around 6.6 cm×4.2 cm×5.5 cm.A partial surgical resection of the right-sided portion of the lesion was performed.Complete resection was limited by insufficient visualization and challenges with hemostatic control of the left parafalcine region.Further histopathological analysis confirmed a fibrous meningioma with focal necrosis,consistent with World Health Organization Grade 2 classification.She was subsequently scheduled for outpatient follow-up to assess the residual tumor management.CONCLUSION This case highlights the importance of maintaining a high index of suspicion for intracranial pathology in elderly patients with nonspecific presentation.
基金Supported by TAIHO Pharmaceutical,No.AS2023A000122715Nippon Kayaku,No.NKCS20230416001.
文摘BACKGROUND Malignant meningioma metastasizes systemically,primarily due to its role in epithelial-mesenchymal transition.Although the prognosis is extremely poor,drug development efforts have been limited,because this tumor is categorized as a rare form.AIM To examine growth suppressive effect of GO-Y030,a diarylpentanoid curcumin analog,(1E,4E)-1,5-bis[3,5-bis(methoxymethoxy)phenyl]penta-1,4-dien-3-one against the malignant meningioma.METHODS The growth suppression of malignant meningioma cells by GO-Y022 and GOY030 were examined,using IOMM-Lee and HKBMM cell lines.Male nude mice aged eight weeks,specifically BALB/cSlc-nu/nu mice received a subcutaneous inoculation of IOMM-Lee(107 cells/site)on their back and 30μg/kg of recombinant hepatocellular growth factor(HGF)was injected into the tumor every three days.After confirmed the growth tumor mass,500μL of GO-Y030 diluted with PBS were administrated intraperitoneally daily at doses of 1 mg/kg and 2 mg/kg,respectively.RESULTS GO-Y030 exhibits a growth inhibitory effect on malignant meningioma cell lines,IOMM-Lee and HKBMM ranging from 0.8-2.0μM in vitro.Notably,GO-Y030’s inhibitory effect is about 10 to 16th times more potent than that of curcumin,which has previously demonstrated potential in combating malignant meningioma.In mouse models,the intraperitoneal administration of GO-Y030 effectively suppresses the growth of malignant meningioma tumors that have been inoculated in the back(P=0.002).High-performance liquid chromatography analysis has confirmed the distribution of GO-Y030 in the bloodstream and brain tissue.Moreover,GOY030 demonstrates the ability to significantly suppress HGF(P<0.01),nuclear factor kappa B(P<0.001),and Ncadherin(P<0.001),all of which contribute to the epithelial-mesenchymal transition.CONCLUSION GO-Y030 holds promise as a potent compound for the systemic inhibition of malignant meningioma.GO-Y030 has higher tumor growth inhibitory effect against meningiomas than curcumin,which is known to have antitumor activity through multi-molecular target control resulting in apoptosis induction.GO-Y030 controls at least three molecules of HGF,nuclear factor kappa B,and N-cadherin.
基金supported by Hubei Provincial Natural Science Foundation of China(grants 2023AFB208)the Chinese Primary Health Care Foundation(Grant No.cphcf-2022-222)+2 种基金2025 Hubei Provincial Natural Science Foundation Innovation and Development Joint Fund Project:(JCZRLH202500457)Shanghai Foundation for Anti-Cancer&Cancer Prevention Development Phase II Exploration Oncology Research Fund Project:“Study on the Mechanism of ANO9-Mediated Cetuximab Resistance in Head and Neck Squamous Cell Carcinoma”(No Grant Number)Qingdao Sheci Public Welfare Relief Center Pan-Cancer Treatment Research Fund Project:(QD-HN30008).
文摘Objective:The World Health Organization(WHO)grading based on histopathology cannot always accurately predict tumor behavior of meningiomas.To overcome the limitations of the WHO grading,the study aims to propose a novel oxidative stress-based molecular classification for WHO grade 2/3 meningiomas.Methods:Differentially expressed oxidative stress-related genes were analyzed between 86 WHO grade 1(low grade)meningiomas and 99 grade 2/3(high grade)meningiomas.An oxidative stress-based molecular classification was developed in high-grade meningiomas through consensus clustering analysis.Immune microenvironment features,responses to immunotherapy and chemotherapy,and targeted drugs were evaluated.Three machine learning models:logistic regression,support vector machine,and random forest,were built for differentiating the classification.Key oxidative stress-related geneswere verified in humanmeningeal cells(HMC)and two meningioma cells(CH-157MN and IOMMLee)via reverse transcription quantitative polymerase chain reaction(RT-qPCR)and western blot.After knockdown of Forkhead Box M1(FOXM1)or Prion Protein(PRNP),cell growth,migration,and reactive oxygen species(ROS)levels were measured through cell counting kit-8(CCK-8),transwell,and immunofluorescence,respectively.Results:We classified high-grade meningiomas into two oxidative stress-based clusters,termed cluster 1 and cluster 2.Cluster 1 exhibited higher infiltrations of immune and stromal cells and higher expression of classic immune checkpoints:Cluster of Differentiation 86(CD86),Programmed Cell Death 1(PDCD1),and Leukocyte-Associated Immunoglobulin-Like Receptor 1(LAIR1),indicating that cluster 1 meningiomas might respond to immunotherapy.Drug sensitivity was heterogeneous between the two clusters.Three classifiers were established,which could accurately differentiate this molecular classification.FOXM1 and PRNP were experimentally evidenced to be highly expressed inmeningioma cells,and their knockdown hindered cell growth and migration and triggered ROS accumulation.Conclusion:In summary,our findings established a novel oxidative stress-based molecular classification and identified potential treatment vulnerabilities in high-grade meningiomas,which might assist personalized clinical management.
文摘<strong>Aims:</strong> The current study aimed to evaluate the efficacy, side effects of radiotherapy and factors influencing treatment outcome in patients received radiotherapy for cerebral meningiomas. <strong>Methods and Material:</strong> In the last two decades, a total of 35 patients with cerebral meningioma who received radiotherapy in our clinic were evaluated statistically in terms of survival, toxicity and prognostic factors. The records of patients diagnosed with cerebral meningioma who underwent postoperative radiotherapy were retrospectively analyzed. Statistical analysis used: Statistical comparisons were made using IBM SPSS v24.0. Kaplan-Meier method was used to compare survival times. <strong>Results:</strong> Five of the patients had grade I meningioma showing recurrence, 18 were grade II meningioma and 12 were grade III meningioma. Patients were treated with 54 or 60 Gy adjuvant radiotherapy with 2 Gy daily fractions according to histopathological grade and operation type. Three and five-year overall survival rates were 56% and 40%, respectively and median overall survival was 36 months. Progression was observed in 15 of the 35 patients included in the study. Three and five-year progression-free survival (PFS) rates of the patients were 56% and 50%, respectively. There was a statistically significant correlation between histopathological grade and overall survival among patients. However;no statistical difference found in overall survival of patients in terms of tumor location, operation type and age. <strong>Conclusions:</strong> In the treatment of cerebral meningiomas, changes in radiotherapy dose and field designs can be predicted according to the tumor grade and operation type. In addition, it is thought that large scale studies are needed to determine prognostic factors more meticulously.
文摘Meningiomas, the most common intracranial primary tumors, are always benign. Extracranial and distant metastases can occur in malignant meningiomas. This case report describes a male in his 50 s with malignant meningioma and metastases to the subcutaneous soft tissue. Preoperative color Doppler ultrasound showed that the tumor had an abundant blood flow. Intraoperative pathological examination revealed a malignant tumor. Postoperative pathological examination revealed malignant tumors in the forehead;thus, malignant meningiomas were suspected. Immunohistochemistry revealed grade Ⅲ malignant meningioma. Malignant meningiomas have the ability to readily spread and metastasize;however, cases of malignant meningiomas disintegrating the bone and metastasizing to the subcutaneous part of the head have not been reported.
文摘An 83-year-old woman had been diagnosed with a left frontal apex mass for more than 20 years without any symptoms. Recently, the rate of protrusion of the perceived mass increased rapidly. Malignant lesions were considered by CT/MR, not excluding metastatic lesions;malignant lesions were also considered by PET-CT, and no other tumor lesions were found in the whole body. The histopathological diagnosis was WHO grade 3 anaplastic meningioma. The patient underwent gross total resection (GTR) with no postoperative abnormalities.
文摘Objective: To evaluate the clinical and radiological factors that affect therecurrence of the meningioma patient so as to effectively prevent and cure recurrence of meningiomapatients more earlier. Methods: The clinical features and radiological aspects in 145 cases ofmeningiomas undergoing operation during 1993-1997 were retrospectively studied. The data of only 83cases of all 145 cases were available. The factors were evaluated with univariate and multivariateanalysis. Results: With univariate analysis, 7 factors showed highly significance to recurrence ofmeningiomas: tumor size, tumor location, tumor shape, edema, extent of resection, pathologicalgrade, CT enhancement. With multivariate analysis, 4 factors showed significant danger to recurrenceof meningiomas: pathological grade, extent of resection, tumor shape and CT enhancement.Conclusion: The main factors that affect the recurrence of meningioma patients are pathologicalgrade, extent of resection, tumor shape and CT enhancement.
文摘Introduction: Meningiomas are tumors formed by arachnoid cells, typically attached to the inner surface of the dura mater. Malignant forms are rare and no case has been reported in the Malagasy literature. The objective of our study is to report two Malagasy cases of malignant meningioma and to discuss the epidemiological and anatomical-clinical particularities of this tumor. Observation: The first patient, a 41-year-old woman, presented with a rapidly progressive intracranial hypertension syndrome. The patient had undergone surgery two years earlier for a grade II meningioma and had no family history of meningioma, neurofibromatosis, or personal history of brain irradiation or head trauma. Her brain scan showed a heterogeneous polylobed left parieto-occipital mass with a meningeal implantation base. The anatomopathological examination of the samples revealed a malignant meningioma. The second patient was a 33-year-old man, operated for grade I meningioma eleven months before admission, with no other personal or family history. The patient was hospitalized for tumor recurrence with signs of intracranial hypertension. The brain computed tomography (CT) scan showed a heterogeneous extra-axial tumor in right temporo-parietal lobe. Surgical excision was performed. On histological examination, a proliferation of tumor cells of meningothelial appearance with papillary architecture was observed, leading to the diagnosis of malignant meningioma. Conclusion: Malignant meningioma is a rare and serious entity. The clinical manifestations are nonspecific and imaging may mimic a low-grade meningioma. The diagnosis of certainty is histological and is based on essentially morphological criteria. The latter condition the overall survival of the patient and the therapeutic conduct.
文摘This case is a 49-year-old female patient who presented with suspected eustachian tube dysfunction symptoms that were refractory to medical treatment. She presented with conductive hearing loss and aural fullness on the left. A physical exam revealed an epitympanic fleshy mass in the middle ear with effusion. Imaging with MRI and CT showed opacification of the epitympanum with surrounding bony demineralization bilaterally left greater than right and significant thinning versus dehiscence of the tegmen mastoideum and tympani on the left with only thinning of the tegmen on the right. An MR temporal bone with and without contrast, demonstrated enhancement of the left middle ear extending to the tegmen and corresponding enhancement of the dura along the floor of the left middle cranial fossa as well as extending along foramen ovale into the infratemporal fossa. There was to a lesser degree similar appearance on the right. A biopsy of the middle ear mass on the left revealed meningioma. This case highlights the need to widen your differential with common symptoms when they are refractory to treatment.
文摘Meningiomas are the most common extra-axial central nervous system tumours and often discovered in the middle to late adult life and especially in women. About 85%-90% of meningiomas are benign, 5%-10% are intermediate-grade, and 3%-5% are malignant. Metaplastic meningioma is a rare subtype of WHO Grade I meningioma histologically characterized by the presence of mesenchymal components. The presence of pure and extensive cartilaginous differentiation in meningiomas is extremely rare and remains a diagnostic dilemma. We report, perhaps the first case of this entity in a 52-year-old woman and discuss the pathogenesis, the imaging features and the histopathologicals data.
基金supported by Natural Science Foundationof Hannan Province(808246)
文摘Objective:To discuss the role of 3D-computed tomography angiography(3D-CTA) technology in reducing injuries of large meningioma surgery.Methods:3D-CTA preoperative examinations were done in 473 patients with large meningioma(simulated group).The images were analyzed by 30 post-processing workstation.By observing the major intracranial blood vessels,venous sinus,and the compression and invasion pattern in the nerve region,assessing risk level of the surgery,simulating the surgical procedures,the surgical removal plan,surgical routes and tumor blood-supplying artery embolisation plan were performed.Two hundred and fifty seven large meningioma patients who didn’t underwent 3D-CTA preoperative examination served as control group.The incidence of postoperative complications,intraoperative blood transfusion and the operation time were compared between these two groups.Results:Compared with the control group,the Simpson’s grade 1 and 11 resection rate was 80.3%(380/473),similar with that of the control(81.3%,209/257).The incidence of postoperative complications in 3D-CTA simulated group was 37.0%which was significantly lower than that(48.2%) of the control(P【0.01). The intraoperative blood supply for simulated group and the control was(523.4±208.1) mL and (592.0±263.3) mL,respectively,with significant difference between two groups(P【0.01).And the operation time[(314.8±106.3)]min was significantly lower in simulated group than that in the control[(358.4±147.9) min](P【0.01).Conclusions:Application of 3D-CTA imaging technology in risk level assessment before large-scaled meningioma resection could assist in the rational planning of tumor resectin,surgical routes,and is helpful in reducing injuries and complications and enhancing the prognosis of the patients.
基金supported by National Natural Science Foundation of China(81200936,30872675,30901549)Shanghai Committee of Science and Technology (12JC1401800)2011 Shanghai Medical College Young Scientist Fund of Fudan University(11L-24)
文摘Objective： Metaplastic meningioma is a rare subtype of benign meningiomas, classified as WHO grade I with well prognosis. Here we presented our experiences on 15 cases of metaplastic meningioma, to investigate the clinicopathological features, therapies and prognosis of these cases. Methods： 15 patients underwent surgical treatment for intracranial metaplastic meningioma between 2001 and 2010 at Neurosurgery Department of Huashan Hospital, Shanghai, China. The clinical data, radiological manifestation, treatment strategy, pathological findings and prognosis of all patients were analyzed retrospectively. Results： Among the 15 cases （10 males and 5 females）, the age ranged from 22 to 74 years old （the mean age was 50.67-year old）. The clinical manifestations include headache, dizziness, seizure attack, vision decrease, and weakness of bilateral lower limbs. All the patients received surgical treatment, combined with radiotherapy in some cases. In the follow-up period, recurrence occurred in 2 cases, of which 1 patient died of other system complications. Conclusions： Metaplastic meningiomas are characterized by focal or widespread mesenchymal differentiation with formation of bone, cartilage, fat, and xanthomatous tissue elements. Surgical removal is the optimal therapy, and the overall prognosis is well. But recurrence may occur in some cases, thus radiotherapy is necessary for such kind of patients.
文摘Objective:Meningiomas are neoplasms that arise from the meninges of the central nervous system(CNS).They constitute about25.6%of CNS tumors diagnosed in Egypt.Some morphological variants of meningiomas display aggressive behavior,leading to brain-invasive growth pattern.Although meningiomas are usually treated by complete surgical excision,the risk of postoperative recurrence remains.Hence,additional biomarkers for predicting aggressive behavior must be discovered.This study aims to explore the clinical and biological relevance of the protein expression levels ofβ-catenin and galectine-3 in meningioma and to understand the pathobiology of this neoplasm.Methods:This retrospective study was carried out on 153 cases of meningioma by using tissue microarrays and immunohistochemistry forβ-catenin and galectine-3.Results:Highβ-catenin expression was significantly associated with transitional and meningiotheliomatous meningiomas,low tumor grade,low recurrence rate,and low incidence of brain invasion.Meanwhile,high galectin-3 expression was associated with brain invasion,recurrence,high tumor grade,and tumor type.Logistic regression analysis indicated that among all variables included in the model,β-catenin and galactin-3 expression levels were significant predictors of tumor recurrence(P<0.001).Conclusions:Galectin-3 andβ-catenin are involved in meningioma recurrence but not in brain invasion.These molecules could be important potential therapeutic targets and predictors for meningiomas.
文摘AIM：To investigate clinical features of optic nerve sheath meningioma（ONSM） that was misdiagnosed,and to find methods to reduce the misdiagnoses.METHODS：Retrospective series study.Twenty-five misdisgnosed patients with unilateral ONSM were collected from Jan.2008 to Jan.2015 and the clinical records reviewed.RESULTS：Patients were misdiagnosed with acute papillitis most frequently（P=17）,immediately followed by optic atrophy（P=8）,ischemic optic neuropathy（P=5）,acute retrobulbar optic neuritis（P=5）,optic disc vasculitis（P =3）.For each patient,the minimum frequency of misdiagnoses was once and the maximum was 4 times.As for the lasting time of being misdiagnosed,the shortest was 1.5mo and the longest was 45 mo.Twentyone cases（84%） were once treated with glucocorticoids,and its side effects was found in seventeen patients.Twenty patients（80%） complained with varying degree of vision loss.When a definite diagnosis was made,sixteen cases（64%） showed slight exophthalmos and eighteen cases（72%） had the tubular ONSM.CONCLUSION：ONSM without loss obvious exophthalmos is easily misdiagnosed in clinic,and for most of these ONSMs are tubular.
基金the Science and Technology Projects in Liaoning Province, No. 2010225036
文摘Angioarchitecture plays an important role in the malignant development of intracranial hemangiopericytoma. It remains poorly understood whether high frequency of hemorrhage during clinical surgery for intracranial hemangiopericytoma is associated with angioarchitecture. The present study utilized hematoxylin-eosin staining, and immunohistochemical staining with epithelial membrane antigen, vimentin, CD34, von Willebrand factor （vWF） and CD133 to observe characteristics of angioarchitecture. In addition, silver stains were used to demonstrate changes in reticular fibers in the wall of vessel channels in intracranial hemangiopericytoma and meningioma. Five patterns of angioarchitecture were identified in intracranial hemangiopericytoma, namely tumor cell islands, vasculogenic mimicry, mosaic blood vessels, sprouting angiogenesis, and intussusceptive angiogenesis. Several CD133＋ tumor cells were found to form tumor cell islands. A connection between vWF ^＋ and vWF channels was detected in the pattern of intussusceptive angiogenesis, and some vimentin^＋ tumor cells were embedded in the periodic acid-Schiff positive channel wall. Incomplete threads of reticular fibers formed the walls of larger pseudo-vascular channels and some tumor clumps or scattered tumor cells were detected ＂floating＂ in them. The angioarchitecture, specific markers and reticular fibers of intracranial hemangiopericytoma were significantly different from meningioma. Angioarchitecture provides a functional vascular network for vascular evolution in intracranial hemangiopericytoma and contributes to significant intra-operative bleeding.
基金supported by National Natural Science Foundation of China (81200936, 30872675, 30901549)Shanghai Committee of Science and Technology(12JC1401800)2011 Shanghai Medical College Young Scientist Fund of Fudan University (11L-24)
文摘Objective： Intracranial meningiomas, especially those located at anterior and middle skull base, are difficult to be completely resected due to their complicated anatomy structures and adjacent vessels. It＇s essential to locate the tumor and its vessels precisely during operation to reduce the risk of neurological deficits. The purpose of this study was to evaluate intraoperative ultrasonography in displaying intracranial meningioma and its surrounding arteries, and evaluate its potential to improve surgical precision and minimize surgical trauma. Methods： Between December 2011 and January 2013, 20 patients with anterior and middle skull base meningioma underwent surgery with the assistance of intraoperative ultrasonography in the Neurosurgery Department of Shanghai Huashan Hospital. There were 7 male and 13 female patients, aged from 31 to 66 years old. Their sonographic features were analyzed and the advantages of intraoperative ultrasonography were discussed. Results： The border of the rneningioma and its adjacent vessels could be exhibited on intraoperative ultrasonography. The sonographic visualization allowed the neurosurgeon to choose an appropriate approach before the operation. In addition, intraoperative ultrasonography could inform neurosurgeons about the location of the tumor, its relation to the surrounding arteries during the operation, thus these essential arteries could be protected carefully. Conclusions： Intraoperative ultrasonography is a useful intraoperative technique. When appropriately applied to assist surgical procedures for intracranial meningioma, it could offer very important intraoperative information （such as the tumor supplying vessels） that helps to improve surgical resection and therefore might reduce the postoperative morbidity.
文摘The expression of basic fibroblast growth factor (bFGF) and fibroblast growth factor receptor-1 (FGFR-1) in human meningiomas and the relationships between their expression and the tumors' histological features and angiogenesis were investigated by means of immunohistochemical technique. The expression of bFGF and FGFR-1 was detected by antibody of bFGF or FGFR-1. The tumors' angiogenesis was evaluated by microvascular density (MVD) and, which was observed by use of CD34-antibody immunohistochemically. The results showed that there were varied degrees of the expression of bFGF and FGFR-1 proteins in meningiomas. The expression was correlated with the tumors' histological characters and angiogenesis. It was concluded that bFGF and FGFR-1 might play important roles in meningiomas' angiogenesis and proliferation. The expression positive rate of bFGF and FGFR-1 may provide an indication of evaluating the histological and malignant degree of the tumor.
文摘BACKGROUND Primary pulmonary meningioma(PPM)is a rare disease that is usually benign.The most common presentation of PPM is isolated pulmonary nodules or masses,so the disease can mimic any other lung tumor on imaging,especially lung cancer or metastasis.CASE SUMMARY A 47-year-old asymptomatic woman presented with a well-defined,lobulated pulmonary mass with calcification in the left lower lobe.The mass measured 69 mm×57 mm×61 mm and was found during a chest computed tomography(CT)performed for physical examination.Contrast-enhanced CT and positron emission tomography(PET)/CT revealed mild enhancement of the mass,with accumulation of 18-fluoro-2-deoxy-D-glucose(18F-FDG).Transbronchial biopsy suggested a provisional diagnosis of low-grade neuroendocrine tumor.Subsequent enhanced head magnetic resonance imaging revealed no positive lesions.An open cuff resection of the left lower lobe and wedge resection of the lingual segment were performed.Histopathological and immunohistochemical examination revealed that the mass was a PPM.CONCLUSION PPM should be considered in the differential diagnosis of isolated pulmonary masses found incidentally on CT and should be diagnosed based on a combination of radiological and histological features.Surgical resection is currently the main treatment strategy.No recurrence of benign PPMs has been reported after complete resection.
文摘BACKGROUND Entrapment of the temporal horn (ETH) is a rare pathologic condition. It is a kind of focal hydrocephalus caused by obstruction of flow pathway of cerebrospinal fluid. It is caused by various conditions, but ETH secondary to postoperative gamma-knife radiosurgery (GKS) is extremely rare. CASE SUMMARY A 52-year old previously healthy woman underwent resection of a large intraventricular meningioma. A small fragment of residual tumor with no obvious enlargement of the temporal horn was observed 3 mo after surgery, and she was referred for GKS. Two months after GKS, she complained of headache and progressive paralysis of the left limb. Magnetic resonance imaging revealed enlargement of the temporal horn. There was a second procedure to resect the residual tumor 8 mo after GKS. After the second procedure, she recovered smoothly. As of the date of this writing, she has remained in good condition. CONCLUSION This case reminds us that ETH should be considered in the treatment of intraventricular meningiomas, especially before GKS.
基金Supported by the LiaoNing Revitalization Talents Program,No.XLYC1807253the National Natural Science Foundation of China,No.81772653。
文摘BACKGROUND The coexistence of meningioma and other intracranial primary benign tumors is rare,especially in non-neurofibromatosis type 2,and there is limited guidance for the management of such patients.Here,we report a series of 5 patients with concomitant meningioma and other intracranial benign tumors,including subependymoma and pituitary adenoma.CASE SUMMARY Five non-neurofibromatosis type 2 patients with simultaneous occurrence of meningioma and other intracranial benign tumors were retrospectively reviewed.The patients had no history of previous irradiation.The clinical features,pre-and postoperative imaging,surgical procedure and pathological findings were extracted from electronic medical records.There were 4 female patients(80%)and 1 male patient(20%).The mean age was 42.8 years(range:29-52 years).The coexisting tumors included subependymoma in 1 case(20%)and pituitary adenoma in 4 cases(80%).The most common clinical symptom was headache(3/5,60%).Four patients(80%)underwent craniotomy.One patient(20%)underwent transsphenoidal surgery followed by transcranial operation.All tumor diagnoses were confirmed by histopathological examination.The mean follow-up was 38.8 mo(range:23-96 mo),and all 5 patients were in a stable condition at the last follow-up.CONCLUSION The simultaneous occurrence of meningioma and other intracranial benign tumors is a rare clinical event.Histological examination is necessary for the accurate diagnosis.Neurosurgeons should select the appropriate surgical strategy according to the clinical features of each patient,which may provide a more favorable prognosis for individual patients.
