Research Article
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İntrakranial Menenjioma Olgularının Değerlendirilmesi: 72 Hastanın Analizi

Year 2018, Volume: 45 Issue: 3, 317 - 325, 05.09.2018
https://doi.org/10.5798/dicletip.419310

Abstract



Amaç: Kliniğimizde 2012–2018 yıllarında ameliyat olmuş ve
menenjiom tanısı almış olan 72 hasta retrospektif olarak klinik, radyolojik ve
patolojik bulgularıyla incelenerek literatür eşliğinde tartışıldı.

Yöntemler: Hastaların yaşları, cinsiyetleri, klinik
bulguları, radyolojik görüntüleri, yerleşim yerleri, ameliyat kayıtları ve
patolojik olarak aldıkları tanıları incelendi.

Bulgular: 72 intrakranial menenjiomalı hastanın 47 (%65,3)’i
kadın, 25 (%34,7)’i erkektir. Kadın/Erkek oranı: 1.88’dir. Olgular 19-78 yaş
aralığında olup, yaş ortalaması 44.7’dir. Sıklık sırasına göre başvurma
nedenleri ve nörolojik muayene bulguları: Baş ağrısı (%72,2), bulantı-kusma
(%37,5), epilepsi (%25,0), motor defisit (%20,8)’dir. En sık yerleştikleri
lokalizasyonlar: konvexite 17 (%23,7), parasagital 14 (%19,5), sfenoid kanat 9
(%12,59 bölgesidir. Cerrahi tedavideki rezeksiyonumuzun Simpson
klasifikasyonuna göre; hastaların 57 (%79,2)’i grade I, 8 (%11,1)’i grade II, 2
(%2,8)’i grade III, 4 (%5,5)’i grade IV ve 1 (%1,4)’i grade V olarak
değerlendirilmiştir. Histopatojik tanıları ise sıklık sırasına göre; 29 (%40,3)
meningotelyomatöz, 13 (%18,1) fibröz, 9 (%12,5) transisyonel, 6 (%8,3) oranında
psammomatöz tip şeklinde tespit edildi.

Sonuç: İntrakranial menenjiomalar malign tipleri dışında;
genellikle benign karekterde yavaş büyüyen, erken tanı konup, total
çıkarıldığında tam kür sağlanan, rekürrens oranı çok düşük olan tümörlerdir.
Menenjiomalarda cerrahi kararın verilmesinde ve sürvide; hastaların yaşı,
preoperatif performans skalası, tümörün lokalizasyonu, büyüklüğü, rezeksiyon
derecesi, histopatolojik özellikleri gibi birçok faktör rol oynamaktadır.
Asemptomatik, küçük boyutta, ameliyata uygun olmayan, yaşlı, kafa tabanı,
kavernöz sinüs gibi ulaşılması zor lokalizasyonlarda bulunan hastalarda seri
görüntülemelerle yakın takip ve radyocerrahi tercih edilebilir. MRG takibi 3.
ay, 6. ay ve sonrasında yıllık takipler şeklinde ve takipte gerek görülürse,
büyüme olursa cerrahi/radyocerrahi önerilir. Genç olan ve kalsifikasyonu
bulunmayanlarda hızlı büyüme riski nedeniyle cerrahi düşünülmelidir.

References

  • 1. Bondy M, Ligon BL. Epidemiology and etiology of intracranial meningiomas: a review. J Neurooncol. 1996;29:197-205.
  • 2. Longstreth WT, Jr., Dennis LK, McGuire VM, Drangsholt MT, Koepsell TD. Epidemiology of intracranial meningioma. Cancer. 1993;72:639-48.
  • 3. Nakasu S, Fukami T, Jito J, Nozaki K. Recurrence and regrowth of benign meningiomas. Brain Tumor Pathol. 2009;26:69-72.
  • 4. Wiemels J, Wrensch M, Claus EB. Epidemiology and etiology of meningioma. J Neurooncol. 2010;99:307-14.
  • 5. Colakoglu N, Demirtas E, Oktar N, Yuntem N, Islekel S, Ozdamar N. Secretory meningiomas. J Neurooncol. 2003;62:233-41.
  • 6. Niiro M, Yatsushiro K, Nakamura K, Kawahara Y, Kuratsu J. Natural history of elderly patients with asymptomatic meningiomas. J Neurol Neurosurg Psychiatry. 2000;68:25-8.
  • 7. Apra C, Peyre M, Kalamarides M. Current treatment options for meningioma. Expert Rev Neurother. 2018;18:241-9.
  • 8. Alexiou GA, Gogou P, Markoula S, Kyritsis AP. Management of meningiomas. Clin Neurol Neurosurg. 2010;112:177-82.
  • 9. Firsching RP, Fischer A, Peters R, Thun F, Klug N. Growth rate of incidental meningiomas. J Neurosurg. 1990;73:545-7.
  • 10. Black PM. Hormones, radiosurgery and virtual reality: new aspects of meningioma management. Can J Neurol Sci. 1997;24:302-6.
  • 11. Claus EB, Black PM, Bondy ML et al. Exogenous hormone use and meningioma risk: what do we tell our patients? Cancer. 2007;110:471-6.
  • 12. Kaba SE, DeMonte F, Bruner JM et al. The treatment of recurrent unresectable and malignant meningiomas with interferon alpha-2B. Neurosurgery. 1997;40:271-5.
  • 13. Chamberlain MC, Glantz MJ, Fadul CE. Recurrent meningioma: salvage therapy with long-acting somatostatin analogue. Neurology. 2007;69:969-73.
  • 14. Jhawar BS, Fuchs CS, Colditz GA, Stampfer MJ. Sex steroid hormone exposures and risk for meningioma. J Neurosurg. 2003;99:848-53.
  • 15. Newton HB, Slivka MA, Stevens C. Hydroxyurea chemotherapy for unresectable or residual meningioma. J Neurooncol. 2000;49:165-70.
  • 16. Phillips LE, Koepsell TD, van Belle G, Kukull WA, Gehrels JA, Longstreth WT, Jr. History of head trauma and risk of intracranial meningioma: population-based case-control study. Neurology. 2002;58:1849-52.
  • 17. Sanson M, Cornu P. Biology of meningiomas. Acta Neurochir (Wien). 2000;142:493-505.
  • 18. Rao S, Sadiya N, Doraiswami S, Prathiba D. Characterization of morphologically benign biologically aggressive meningiomas. Neurol India. 2009;57:744-8.
  • 19. Bollag RJ, Vender JR, Sharma S. Anaplastic meningioma: progression from atypical and chordoid morphotype with morphologic spectral variation at recurrence. Neuropathology. 2010;30:279-87.
  • 20. Bozkurt M, Göcmez C, Okçu M et al. Paraplegia due to missed thoracic meningioma after lumbar spinal decompression surgery: A case report and review of the literature. Dicle Medical Journal. 2014;41:210-3.
  • 21. Jaaskelainen J. Seemingly complete removal of histologically benign intracranial meningioma: late recurrence rate and factors predicting recurrence in 657 patients. A multivariate analysis. Surg Neurol. 1986;26:461-9.
  • 22. Braunstein JB, Vick NA. Meningiomas: the decision not to operate. Neurology. 1997;48:1459-62.
  • 23. Buhl R, Nabavi A, Wolff S et al. MR spectroscopy in patients with intracranial meningiomas. Neurol Res. 2007;29:43-6.
  • 24. Saloner D, Uzelac A, Hetts S, Martin A, Dillon W. Modern meningioma imaging techniques. J Neurooncol. 2010;99:333-40.
  • 25. Pereira-Filho Nde A, Soares FP, Chemale Ide M, Coutinho LM. Peritumoral brain edema in intracranial meningiomas. Arq Neuropsiquiatr. 2010;68:346-9.
  • 26. Louis DN, Perry A, Reifenberger G et al. The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol. 2016;131:803-20.
  • 27. Ichinose T, Goto T, Ishibashi K, Takami T, Ohata K. The role of radical microsurgical resection in multimodal treatment for skull base meningioma. J Neurosurg. 2010;113:1072-8.
  • 28. Landeiro JA, Goncalves MB, Guimaraes RD et al. Tuberculum sellae meningiomas: surgical considerations. Arq Neuropsiquiatr. 2010;68:424-9.
  • 29. Shukla D, Behari S, Jaiswal AK, Banerji D, Tyagi I, Jain VK. Tentorial meningiomas: operative nuances and perioperative management dilemmas. Acta Neurochir (Wien). 2009;151:1037-51.
  • 30. Paiva-Neto MA, Tella OI, Jr. Supra-orbital keyhole removal of anterior fossa and parasellar meningiomas. Arq Neuropsiquiatr. 2010;68:418-23.
  • 31. Hastürk AE, Basmacı M, Canbay S et al. Intracranial Meningiomas: Analysis of 56 Patients. Türk Nöroşirürji Dergisi 2011, Cilt: 21, Sayı: 1, 1-7 1. 2011;21:1-7.
  • 32. Lee JY, Niranjan A, McInerney J, Kondziolka D, Flickinger JC, Lunsford LD. Stereotactic radiosurgery providing long-term tumor control of cavernous sinus meningiomas. J Neurosurg. 2002;97:65-72.
  • 33. Ojemann SG, Sneed PK, Larson DA et al. Radiosurgery for malignant meningioma: results in 22 patients. J Neurosurg. 2000;93 Suppl 3:62-7.
  • 34. Kyritsis AP. Chemotherapy for meningiomas. J Neurooncol. 1996;29:269-72.
  • 35. Gupta V, Su YS, Samuelson CG et al. Irinotecan: a potential new chemotherapeutic agent for atypical or malignant meningiomas. J Neurosurg. 2007;106:455-62.
  • 36. Chamberlain MC, Tsao-Wei DD, Groshen S. Temozolomide for treatment-resistant recurrent meningioma. Neurology. 2004;62:1210-2.
  • 37. Chamberlain MC, Tsao-Wei DD, Groshen S. Salvage chemotherapy with CPT-11 for recurrent meningioma. J Neurooncol. 2006;78:271-6.
Year 2018, Volume: 45 Issue: 3, 317 - 325, 05.09.2018
https://doi.org/10.5798/dicletip.419310

Abstract

References

  • 1. Bondy M, Ligon BL. Epidemiology and etiology of intracranial meningiomas: a review. J Neurooncol. 1996;29:197-205.
  • 2. Longstreth WT, Jr., Dennis LK, McGuire VM, Drangsholt MT, Koepsell TD. Epidemiology of intracranial meningioma. Cancer. 1993;72:639-48.
  • 3. Nakasu S, Fukami T, Jito J, Nozaki K. Recurrence and regrowth of benign meningiomas. Brain Tumor Pathol. 2009;26:69-72.
  • 4. Wiemels J, Wrensch M, Claus EB. Epidemiology and etiology of meningioma. J Neurooncol. 2010;99:307-14.
  • 5. Colakoglu N, Demirtas E, Oktar N, Yuntem N, Islekel S, Ozdamar N. Secretory meningiomas. J Neurooncol. 2003;62:233-41.
  • 6. Niiro M, Yatsushiro K, Nakamura K, Kawahara Y, Kuratsu J. Natural history of elderly patients with asymptomatic meningiomas. J Neurol Neurosurg Psychiatry. 2000;68:25-8.
  • 7. Apra C, Peyre M, Kalamarides M. Current treatment options for meningioma. Expert Rev Neurother. 2018;18:241-9.
  • 8. Alexiou GA, Gogou P, Markoula S, Kyritsis AP. Management of meningiomas. Clin Neurol Neurosurg. 2010;112:177-82.
  • 9. Firsching RP, Fischer A, Peters R, Thun F, Klug N. Growth rate of incidental meningiomas. J Neurosurg. 1990;73:545-7.
  • 10. Black PM. Hormones, radiosurgery and virtual reality: new aspects of meningioma management. Can J Neurol Sci. 1997;24:302-6.
  • 11. Claus EB, Black PM, Bondy ML et al. Exogenous hormone use and meningioma risk: what do we tell our patients? Cancer. 2007;110:471-6.
  • 12. Kaba SE, DeMonte F, Bruner JM et al. The treatment of recurrent unresectable and malignant meningiomas with interferon alpha-2B. Neurosurgery. 1997;40:271-5.
  • 13. Chamberlain MC, Glantz MJ, Fadul CE. Recurrent meningioma: salvage therapy with long-acting somatostatin analogue. Neurology. 2007;69:969-73.
  • 14. Jhawar BS, Fuchs CS, Colditz GA, Stampfer MJ. Sex steroid hormone exposures and risk for meningioma. J Neurosurg. 2003;99:848-53.
  • 15. Newton HB, Slivka MA, Stevens C. Hydroxyurea chemotherapy for unresectable or residual meningioma. J Neurooncol. 2000;49:165-70.
  • 16. Phillips LE, Koepsell TD, van Belle G, Kukull WA, Gehrels JA, Longstreth WT, Jr. History of head trauma and risk of intracranial meningioma: population-based case-control study. Neurology. 2002;58:1849-52.
  • 17. Sanson M, Cornu P. Biology of meningiomas. Acta Neurochir (Wien). 2000;142:493-505.
  • 18. Rao S, Sadiya N, Doraiswami S, Prathiba D. Characterization of morphologically benign biologically aggressive meningiomas. Neurol India. 2009;57:744-8.
  • 19. Bollag RJ, Vender JR, Sharma S. Anaplastic meningioma: progression from atypical and chordoid morphotype with morphologic spectral variation at recurrence. Neuropathology. 2010;30:279-87.
  • 20. Bozkurt M, Göcmez C, Okçu M et al. Paraplegia due to missed thoracic meningioma after lumbar spinal decompression surgery: A case report and review of the literature. Dicle Medical Journal. 2014;41:210-3.
  • 21. Jaaskelainen J. Seemingly complete removal of histologically benign intracranial meningioma: late recurrence rate and factors predicting recurrence in 657 patients. A multivariate analysis. Surg Neurol. 1986;26:461-9.
  • 22. Braunstein JB, Vick NA. Meningiomas: the decision not to operate. Neurology. 1997;48:1459-62.
  • 23. Buhl R, Nabavi A, Wolff S et al. MR spectroscopy in patients with intracranial meningiomas. Neurol Res. 2007;29:43-6.
  • 24. Saloner D, Uzelac A, Hetts S, Martin A, Dillon W. Modern meningioma imaging techniques. J Neurooncol. 2010;99:333-40.
  • 25. Pereira-Filho Nde A, Soares FP, Chemale Ide M, Coutinho LM. Peritumoral brain edema in intracranial meningiomas. Arq Neuropsiquiatr. 2010;68:346-9.
  • 26. Louis DN, Perry A, Reifenberger G et al. The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol. 2016;131:803-20.
  • 27. Ichinose T, Goto T, Ishibashi K, Takami T, Ohata K. The role of radical microsurgical resection in multimodal treatment for skull base meningioma. J Neurosurg. 2010;113:1072-8.
  • 28. Landeiro JA, Goncalves MB, Guimaraes RD et al. Tuberculum sellae meningiomas: surgical considerations. Arq Neuropsiquiatr. 2010;68:424-9.
  • 29. Shukla D, Behari S, Jaiswal AK, Banerji D, Tyagi I, Jain VK. Tentorial meningiomas: operative nuances and perioperative management dilemmas. Acta Neurochir (Wien). 2009;151:1037-51.
  • 30. Paiva-Neto MA, Tella OI, Jr. Supra-orbital keyhole removal of anterior fossa and parasellar meningiomas. Arq Neuropsiquiatr. 2010;68:418-23.
  • 31. Hastürk AE, Basmacı M, Canbay S et al. Intracranial Meningiomas: Analysis of 56 Patients. Türk Nöroşirürji Dergisi 2011, Cilt: 21, Sayı: 1, 1-7 1. 2011;21:1-7.
  • 32. Lee JY, Niranjan A, McInerney J, Kondziolka D, Flickinger JC, Lunsford LD. Stereotactic radiosurgery providing long-term tumor control of cavernous sinus meningiomas. J Neurosurg. 2002;97:65-72.
  • 33. Ojemann SG, Sneed PK, Larson DA et al. Radiosurgery for malignant meningioma: results in 22 patients. J Neurosurg. 2000;93 Suppl 3:62-7.
  • 34. Kyritsis AP. Chemotherapy for meningiomas. J Neurooncol. 1996;29:269-72.
  • 35. Gupta V, Su YS, Samuelson CG et al. Irinotecan: a potential new chemotherapeutic agent for atypical or malignant meningiomas. J Neurosurg. 2007;106:455-62.
  • 36. Chamberlain MC, Tsao-Wei DD, Groshen S. Temozolomide for treatment-resistant recurrent meningioma. Neurology. 2004;62:1210-2.
  • 37. Chamberlain MC, Tsao-Wei DD, Groshen S. Salvage chemotherapy with CPT-11 for recurrent meningioma. J Neurooncol. 2006;78:271-6.
There are 37 citations in total.

Details

Primary Language Turkish
Journal Section Research Articles
Authors

Yahya Turan This is me 0000-0002-8048-6033

Tevfik Yılmaz This is me 0000-0002-1444-3246

Publication Date September 5, 2018
Submission Date April 27, 2018
Published in Issue Year 2018 Volume: 45 Issue: 3

Cite

APA Turan, Y., & Yılmaz, T. (2018). İntrakranial Menenjioma Olgularının Değerlendirilmesi: 72 Hastanın Analizi. Dicle Tıp Dergisi, 45(3), 317-325. https://doi.org/10.5798/dicletip.419310
AMA Turan Y, Yılmaz T. İntrakranial Menenjioma Olgularının Değerlendirilmesi: 72 Hastanın Analizi. diclemedj. September 2018;45(3):317-325. doi:10.5798/dicletip.419310
Chicago Turan, Yahya, and Tevfik Yılmaz. “İntrakranial Menenjioma Olgularının Değerlendirilmesi: 72 Hastanın Analizi”. Dicle Tıp Dergisi 45, no. 3 (September 2018): 317-25. https://doi.org/10.5798/dicletip.419310.
EndNote Turan Y, Yılmaz T (September 1, 2018) İntrakranial Menenjioma Olgularının Değerlendirilmesi: 72 Hastanın Analizi. Dicle Tıp Dergisi 45 3 317–325.
IEEE Y. Turan and T. Yılmaz, “İntrakranial Menenjioma Olgularının Değerlendirilmesi: 72 Hastanın Analizi”, diclemedj, vol. 45, no. 3, pp. 317–325, 2018, doi: 10.5798/dicletip.419310.
ISNAD Turan, Yahya - Yılmaz, Tevfik. “İntrakranial Menenjioma Olgularının Değerlendirilmesi: 72 Hastanın Analizi”. Dicle Tıp Dergisi 45/3 (September 2018), 317-325. https://doi.org/10.5798/dicletip.419310.
JAMA Turan Y, Yılmaz T. İntrakranial Menenjioma Olgularının Değerlendirilmesi: 72 Hastanın Analizi. diclemedj. 2018;45:317–325.
MLA Turan, Yahya and Tevfik Yılmaz. “İntrakranial Menenjioma Olgularının Değerlendirilmesi: 72 Hastanın Analizi”. Dicle Tıp Dergisi, vol. 45, no. 3, 2018, pp. 317-25, doi:10.5798/dicletip.419310.
Vancouver Turan Y, Yılmaz T. İntrakranial Menenjioma Olgularının Değerlendirilmesi: 72 Hastanın Analizi. diclemedj. 2018;45(3):317-25.