Intracranial Meningioma; Assessment of Tumor Size and Clinical Feature on First Presentation

Authors

  • Haris Hamid Department of Neurosurgery, Jinnah Postgraduate Medical Center, Karachi-Pakistan
  • Iram Bokhari Department of Neurosurgery, Jinnah Postgraduate Medical Center
  • Arfa Qasim Department of Neurosurgery, Jinnah Postgraduate Medical Center, Karachi
  • Bushra Maqsood Department of Neurosurgery, Jinnah Postgraduate Medical Center, Karachi
  • Asra Aslam Department of Neurosurgery, Jinnah Postgraduate Medical Center, Karachi
  • Farrukh javed Department of Neurosurgery, Jinnah Postgraduate Medical Center, Karachi

DOI:

https://doi.org/10.36552/pjns.v28i2.972

Keywords:

meningioma, excision, Space Occupying Lesion, supratentorial, Clinical features

Abstract

Objective:  To assess the tumor size of intracranial meningioma on first presentation and their clinical features.

Materials & Methods:  A prospective review of patients undergoing meningioma resection at the Neurosurgery department, Jinnah Postgraduate Medical Center, Karachi was performed. The clinical records and imaging studies of 43 patients with intracranial meningiomas were analyzed. The data was collected for tumor size, location, first symptom, and clinical features.

Results:  There were 31 (72.1%) female and 12 (27.9%) male patients with a mean age of 45.6 years (std: 8.18 years). convexity and Parasagittal meningiomas had the highest frequency (32.6% and 30.2% respectively). The average tumor size was greater than 60mm (44.2%). Skull base tumors presented with a size of more than 60mm (60.0%), followed by convexity meningiomas (57.1%). The most common initial symptom was headache (46.5%) followed by seizures (11.6%). The patients presenting with a duration greater than 24 months (32.6%) had a size greater than 60mm (57.1%). Convexity and skull base meningiomas presented lately greater than 24 months of duration (50%), however, parasagittal meningioma generally presented earlier in less than 6 months of duration 53.8%.

Conclusion:  Tumor size location, and clinical features at the first presentation are interlinked. Larger tumors were found on the first presentation, with headache and seizure being the most common clinical features. The location also contributed to the early or late presentation of meningioma patients. The association shown between the size and first symptom may be explained by a symptom's tolerance, location, and ongoing medical treatment.

Keywords:  Meningioma, Excision, Space Occupying Lesion, Supratentorial, Clinical Features

References

Baumgartner JE, Sorenson JM. Meningioma in the pediatric population. J Neurooncol. 1996;29(3):223-8. Doi: 10.1007/BF00165652.

Rogers L, Barani I, Chamberlain M, Kaley TJ, McDermott M, Raizer J, et al. Meningiomas: knowledge base, treatment outcomes, and uncertainties. A RANO review. J Neurosurg. 2015;122(1):4-23. Doi: 10.3171/2014.7.JNS131644.

"Adult Central Nervous System Tumors Treatment". National Cancer Institute. 26 August 2016. Archived from the original on 28 July 2017. Available from: https://www.cancer.gov/types/brain/hp/adult-brain-treatment-pdq.

Rosenblum WI, Hadfleid MG. Neuropathology For Medical Students, Chapter 9-Tumors of the Nervous System." 2007. Available from:

https://web.archive.org/web/20090107042703/http://www.pathology.vcu.edu/WirSelfInst/neuro_medStudents/tumor-1.html

Wiemels J, Wrensch M, Claus EB. Epidemiology and etiology of meningioma. J Neurooncol. 2010;99(3):307-14. Doi: 10.1007/s11060-010-0386-3.

Ferri FF. Ferri's Clinical Advisor 2018 E-Book: 5 Books in 1. Elsevier Health Sciences. 2017;p. 809. ISBN 978-0-323-52957-0.

Anic GM, Madden MH, Nabors LB, Olson JJ, LaRocca RV, Thompson ZJ, et al. Reproductive factors and risk of primary brain tumors in women. J Neurooncol. 2014;118:297-304.

Doi: 10.1007/s11060-014-1427-0.

Niedermaier T, Behrens G, Schmid D, Schlecht I, Fischer B, Leitzmann MF. Body mass index, physical activity, and risk of adult meningioma and glioma: A meta-analysis. Neurology. 2015;85(15):1342-50. Doi: 10.1212/WNL.0000000000002020.

Ostrom QT, Cioffi G, Waite K, Kruchko C, Barnholtz-Sloan JS. CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2014–2018. Neuro-oncology. 2021;23(Supplement_3):iii1-05.

Kollová A, Liš?ák R, Novotný J, Vladyka V, Šimonová G, Janoušková L. Gamma Knife surgery for benign meningioma. Journal of neurosurgery. 2007;107(2):325-36. https://doi.org/10.3171/JNS-07/08/0325

Simpson D. The recurrence of intracranial meningiomas after surgical treatment. J Neurol Neurosurg Psychiatry. 1957;20(1):22-39.

Doi: 10.1136/jnnp.20.1.22.

Papic V, Lasica N, Jelaca B, Vuckovic N, Kozic D, Djilvesi D, Fimic M, Golubovic J, Pajicic F, Vulekovic P. Primary Intraparenchymal Meningiomas: A Case Report and a Systematic Review. World Neurosurg. 2021;153:52-62. Doi: 10.1016/j.wneu.2021.06.139.

Wahab M, Al-Azzawi F. Meningioma and hormonal influences. Climacteric. 2003;6(4):285-92.

https://doi.org/10.1080/cmt.6.4.285.292

Magill ST, Young JS, Chae R, Aghi MK, Theodosopoulos PV, McDermott MW. Relationship between tumor location, size, and WHO grade in meningioma. Neurosurg Focus. 2018;44(4):E4.

Doi: 10.3171/2018.1.FOCUS17752.

Brandis A, Mirzai S, Tatagiba M, Walter GF, Samii M, Ostertag H. Immunohistochemical detection of female sex hormone receptors in meningiomas: correlation with clinical and histological features. Neurosurgery. 1993;33(2):212-7; discussion 217-8. Doi: 10.1227/00006123-199308000-00005.

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Published

2024-06-13

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