Meninigiomas of the Craniocervical Junction--A Distinctive Subgroup of Meningiomas.

Meningioma of the cranio-cervical junction is a rare diagnosis and demand a thorough surgical planning as radical excision of these tumors is difficult. In this context recurrence is most likely due to regrowth of residual tumor. The aim of this study was to evaluate the clinical course of patients...

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Main Authors: Lasse Dührsen, Pedram Emami, Jakob Matschke, Tammam Abboud, Manfred Westphal, Jan Regelsberger
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2016-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC4829216?pdf=render
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author Lasse Dührsen
Pedram Emami
Jakob Matschke
Tammam Abboud
Manfred Westphal
Jan Regelsberger
author_facet Lasse Dührsen
Pedram Emami
Jakob Matschke
Tammam Abboud
Manfred Westphal
Jan Regelsberger
author_sort Lasse Dührsen
collection DOAJ
description Meningioma of the cranio-cervical junction is a rare diagnosis and demand a thorough surgical planning as radical excision of these tumors is difficult. In this context recurrence is most likely due to regrowth of residual tumor. The aim of this study was to evaluate the clinical course of patients operated for craniocervical meningioma (CCM) and to investigate the histological features of these tumors and their impact on recurrence rate.All patients who were operated for CCM at our institution between 2003 and 2012 were identified. Presenting symptoms, MRI findings, surgical approaches and recurrence rate were reviewed retrospectively using medical charts. Histological features of the included tumors were studied focusing on subtypes and MIB-1 immunoreactivity and compared with MIB-1 immunoreactivity in an age and gender-matched control group of patients with supratentorial meningioma.18 patients with CCM with a mean age of 56.2 years and median follow-up of 60 months were included in the study. Sensory or motor deficit was the most frequent presenting symptom followed by neck pain and lower cranial nerve palsy. Simpson grade II resection was achieved in 16 patients and Simpson grade III resection in two patients. Mortality, morbidity and recurrence rates were 16.7%, 5.5% and 5.5%, respectively. According to the WHO-grading all were found to be grade I meningiomas. Histological subtypes included meningotheliomatous (10), transitional (2), fibrillar (2), angiomatous (3) and secretory (1) meningioma. The mean MIB-1 labeling index in the study group was significantly higher than in the control group, (7.2% and 3.6%, respectively), p < 0.05. There was no correlation between MIB-1 levels and tumor recurrence.CCM seems to have a benign character. Despite a significantly higher MIB-1 index, a high rate of recurrence was not observed. Therefore, approaches with high morbidity are not justified. Nevertheless, in view of the challenging approaches with limited access to the lesion, CCM should be considered a distinctive clinical subgroup.
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spelling doaj.art-fd644d285ae74e91b9024e3a1f166de82022-12-22T00:59:44ZengPublic Library of Science (PLoS)PLoS ONE1932-62032016-01-01114e015340510.1371/journal.pone.0153405Meninigiomas of the Craniocervical Junction--A Distinctive Subgroup of Meningiomas.Lasse DührsenPedram EmamiJakob MatschkeTammam AbboudManfred WestphalJan RegelsbergerMeningioma of the cranio-cervical junction is a rare diagnosis and demand a thorough surgical planning as radical excision of these tumors is difficult. In this context recurrence is most likely due to regrowth of residual tumor. The aim of this study was to evaluate the clinical course of patients operated for craniocervical meningioma (CCM) and to investigate the histological features of these tumors and their impact on recurrence rate.All patients who were operated for CCM at our institution between 2003 and 2012 were identified. Presenting symptoms, MRI findings, surgical approaches and recurrence rate were reviewed retrospectively using medical charts. Histological features of the included tumors were studied focusing on subtypes and MIB-1 immunoreactivity and compared with MIB-1 immunoreactivity in an age and gender-matched control group of patients with supratentorial meningioma.18 patients with CCM with a mean age of 56.2 years and median follow-up of 60 months were included in the study. Sensory or motor deficit was the most frequent presenting symptom followed by neck pain and lower cranial nerve palsy. Simpson grade II resection was achieved in 16 patients and Simpson grade III resection in two patients. Mortality, morbidity and recurrence rates were 16.7%, 5.5% and 5.5%, respectively. According to the WHO-grading all were found to be grade I meningiomas. Histological subtypes included meningotheliomatous (10), transitional (2), fibrillar (2), angiomatous (3) and secretory (1) meningioma. The mean MIB-1 labeling index in the study group was significantly higher than in the control group, (7.2% and 3.6%, respectively), p < 0.05. There was no correlation between MIB-1 levels and tumor recurrence.CCM seems to have a benign character. Despite a significantly higher MIB-1 index, a high rate of recurrence was not observed. Therefore, approaches with high morbidity are not justified. Nevertheless, in view of the challenging approaches with limited access to the lesion, CCM should be considered a distinctive clinical subgroup.http://europepmc.org/articles/PMC4829216?pdf=render
spellingShingle Lasse Dührsen
Pedram Emami
Jakob Matschke
Tammam Abboud
Manfred Westphal
Jan Regelsberger
Meninigiomas of the Craniocervical Junction--A Distinctive Subgroup of Meningiomas.
PLoS ONE
title Meninigiomas of the Craniocervical Junction--A Distinctive Subgroup of Meningiomas.
title_full Meninigiomas of the Craniocervical Junction--A Distinctive Subgroup of Meningiomas.
title_fullStr Meninigiomas of the Craniocervical Junction--A Distinctive Subgroup of Meningiomas.
title_full_unstemmed Meninigiomas of the Craniocervical Junction--A Distinctive Subgroup of Meningiomas.
title_short Meninigiomas of the Craniocervical Junction--A Distinctive Subgroup of Meningiomas.
title_sort meninigiomas of the craniocervical junction a distinctive subgroup of meningiomas
url http://europepmc.org/articles/PMC4829216?pdf=render
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AT tammamabboud meninigiomasofthecraniocervicaljunctionadistinctivesubgroupofmeningiomas
AT manfredwestphal meninigiomasofthecraniocervicaljunctionadistinctivesubgroupofmeningiomas
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