جستجوی مقالات مرتبط با کلیدواژه « meningioma » در نشریات گروه « پزشکی »

 Meningiomas constitute a significant proportion of primary intracranial tumors, demanding a nuanced understanding of their radiological features for informed clinical decisions. This prospective study aimed to explore the intricate relationship between magnetic resonance imaging (MRI) findings and the pathological grade of meningiomas to provide insights into their diverse characteristics.

 A cohort of 52 meningioma patients underwent comprehensive MRI evaluations. The study encompassed various aspects of tumor radiology, including location, peritumoral edema severity, tumor margin distinctiveness, bone infiltration, adjacent bone reaction, apparent diffusion coefficient (ADC) patterns, intratumoral calcifications, bleeding within the tumor, vascularization, and tumor enhancement.

 The analysis revealed that 73.1% of patients presented with grade 1 meningioma, while 26.9% exhibited grade 2 tumors, with no grade 3 cases detected. Intriguingly, while age and gender did not significantly differ between grades, several MRI findings demonstrated noteworthy distinctions. Grade 2 meningiomas were associated with moderate to severe peritumoral edema, indistinct tumor margins, increased vascularization, and heterogeneous tumor enhancement patterns. Notably, logistic regression analysis indicated that none of the investigated radiological parameters independently predicted the pathological grade of meningioma.

 These findings emphasize the need for a comprehensive meningioma assessment approach, integrating radiological insights into clinical decision-making and prognosis for enhanced patient care.

The perioperative management of brain tumors can be significantly impacted by the presence of another intracranial tumor at a distinct location. We report a rare case of an adult who developed two primary brain tumors, a frontal convexity meningioma and a cerebellopontine angle (CPA) tumor at anatomically disparate locations. In our patient, it was unambiguously decided to address the CPA tumor first as it had led to multiple cranial nerve palsies and obstructive hydrocephalus. The relevant literature helped us better extrapolate the patient presentation and management of this disastrous presentation swiftly.

Background and Importance: 

Meningiomas are usually benign tumors. Depending on their location and size, dealing with them can be problematic. We report an exceptional case of gigantic frontal meningioma. Its diagnosis was misleading and the excision laborious. 

A 29-year-old patient who presented gradually over 5 years, developed behavioral disorders then swelling of the vertex at the frontal level and decreased visual acuity. Physical examination on admission revealed a median frontal swelling slightly lateralized to the left axis of approximately 10 cm, hard, covered with the healthy, severe frontal syndrome, and decreased visual acuity. Computerized tomography (CT) scan showed a voluminous medial frontal lesion lateralized to the left, with irregular limits, superior sagittal sinus invasion, brain engagement under the scythe, heterogeneous contrast taking, and significant osteolysis first evoking tumor metastasis. Magnetic resonance imaging (MRI) suggested a meningioma. The resection was macroscopically complete. Dural and cranial plasty was performed. The postoperative follow-up was simple. Histology concluded that the meningioma was grade 1 based on the world health organization (WHO) classification.

Late-diagnosis meningiomas can take on very large proportions and pose management problems while seriously engaging the patient functional and vital prognosis.

Background and Importance: 

Movement disorders caused by meningiomas in the Cerebellopontine Angle (CPA) region are yet to be reported. This case report emphasizes the importance of careful imaging studies and examinations for patients presenting with movement disorders, even for benign tumors and less common etiologies.

A 45-year-old woman presented with irregular, involuntary, shortterm, transient, and unpredictable movements in the right upper and lower limbs since several months before, which conformed to the hemispheric pattern of the hemichoreahemiballismus type. Despite these issues, the main complaints of the patient were severe headaches, convulsions, blurred vision, and intermittent altered consciousness. Upon physical examination, abnormal movements of the right face and right upper and lower limbs were apparent. Dystonia was noted in the patient’s upper limbs. On brain MRI, a homogeneous mass 3.5 cm in diameter was found in the patient's right CPA, with compressive effects on the pons and medulla. The diagnosis of meningioma was made, and an excellent outcome was achieved following resection.

Although meningiomas are usually considered benign tumors, they can, as noted in this case report, exert mechanical mass effects on adjacent structures following gradual enlargement. This can lead to various movement disorders, even in unusual locations. Hence, all patients with movement disorders must be examined thoroughly, with the neurological examination being of utmost importance. The present case itself illustrates the variety of causes and manifestations of movement disorders, particularly dystonia and hemiballismus secondary to benign meningioma, even in less common site

Background and Importance: 

Distant extracranial metastasis of meningioma is rare, and the pathophysiology of metastasis in meningioma remains a topic of debate. This study aimed to describe a patient who suffered from multiple pulmonary metastases of meningioma.

This report introduced a rare case of a 47-year-old female who presented with right hemiparesis. Cranial Computed Tomography (CT) demonstrated a homogeneously enhanced tumor in the left temporal lobe. The patient underwent tumor resection; the pathological result was found to be World Health Organization (WHO) grade I meningothelial meningioma. Recurrence of the tumor transpired after two years and a second operation was performed. WHO grade II atypical meningioma was diagnosed.Subsequently, the patient developed a chronic cough and her chest x-ray showed multiple lung masses. CT-guided biopsy of the right lung mass was performed. Finally, pulmonary metastatic meningioma was diagnosed.

Distant extracranial metastasis and malignant transformation of meningioma involve the genetic alteration of a tumor, which should be studied further.

Cystic meningiomais a rare subtype of meningioma. Various brain tumors may mimic cystic meningioma in imaging appearances.

Herein, we reported a series of cases with cystic meningiomas primarily misdiagnosed as pilocytic astrocytoma due to a similar radiological appearance.

This case-series study included 20 patients with cystic meningiomas admitted to the Ghaem Hospital, Mashhad, Iran, between 2012 and 2019. The findings of magnetic resonance imaging (MRI), computed tomography, and neurological examination were recorded preoperatively. All patients underwent surgery, and biopsies were obtained, confirming the histopathological diagnosis of thetumor.

The patients’ mean age was obtained at 40.7±12.5 years, and 11 and 9 subjects were men and women, respectively. Most of the patients presented with headaches (50.0%), and hemiparesis (60.0%) was the most found in the neurological examination. The results of all neuroimaging studies revealed solid-cystic supratentorial tumors, in which cysts were intratumoral, larger than solid components, and eccentric relative to them. Most of the cysts were located in the frontal lobe. The signal intensity of T2-weighted MR images showed hypointense lesions in 25.0% of the cases; however, 45.0% of the patients were hyperintense and 30.0% of them were isointense to grey matter. After contrast injection, the tumor’s solid and periphery experienced a homogeneous enhancement. The most common histopathological finding was meningothelial cells (30.0%) followed by fibroblastic cells (25.0%).

Cases with an initially diagnosed pilocytic astrocytoma in the imaging can turn out to show cystic meningioma after pathological assessments, which deserves clinicians’ notice

Meningioma is the most common, extra-axial, non-glial intracranial tumor with an incidence of 2.3-5.5/100 000, accounting for 20%-30% of all primary brain tumor diagnoses in adults. Meningiomas associated with intratumoral hemorrhage are very rare occurring in 0.5%-2.4%. of individuals. Herein, we report a rare case of hemorrhagic meningioma with the symptom of convulsion. The case was a 68-year-old woman admitted to the hospital with severe headache and convulsions. Computed tomography revealed an increase in heterogeneous lesion measuring 4 × 3 × 2.5 cm at the right parietal lobe. Brain magnetic resonance imaging (MRI) showed a grossly stable homogeneously enhancing extra-axial mass measuring 43 × 33 × 28 mm, small calcified peripheral, intratumoral hemorrhage. Histopathology showed a multi-celled meningioma with bleeding areas (WHO grade I).

The primary and definitive diagnosis of meningioma is based on histological assessment; however, employing imaging methods, like Magnetic Resonance Imaging (MRI) is very helpful to describe lesion’s characteristics. Accordingly, we decided to study the effect of imaging factors, like MRI data on the volume of hemorrhage (estimated blood loss) during meningioma surgery.

This was a cross-sectional, retrospective, and analytical study. The eligible patients were those with meningioma who were candidates for surgery. A total of 40 patients with meningioma were selected and assessed. The preoperative imaging findings were recorded, then estimated blood loss during the surgery was determined

A reverse association was revealed between the degree of proximity to the nearest sinus and the rate of bleeding. Furthermore, the size of the mass was positively associated with the rate of bleeding; however, there was no significant correlation between the volume of bleeding and other parameters, including the degree of edema, the volume of mass, the site of the tumor in the brain, and the histological subtype of the tumor. The mean time of operation was strongly correlated with blood loss. The rate of bleeding was more expected in hypertensive versus normotensive patients.

Bleeding in various volumes could be a frequent finding in intracranial meningioma surgery. Overall, tumor size, the duration of surgery, a history of hypertension, and distance to the nearest sinuses were the main determinants for the severity of hemorrhage in patients undergoing meningioma surgery.

Meningioma is the second most common brain tumor. The extent of peritumoral brain edema (PTBE) is one of the important prognostic factors in patients with meningioma.A 55-year-old female patient suffering from a progressive severe headache and mild left hemiparesis was referred to the Department of Neurosurgery, Rasool Akram Hospital (Tehran, Iran). The preoperative imaging revealed a 2×2 cm solid extra-axial mass with bright enhancement at the outer third of the right sphenoid wing. In addition, there was a disproportionately extensive peritumoral brain edema in the right cerebral hemisphere that even involved the right internal capsule. The patient was operated through the right pterional approach and the mass was totally resected. Twenty-one days after surgery, the brain CT scan surprisingly showed only mild frontal edema and the patient was asymptomatic 1 year after the surgical treatment. According to the literature, the size and extension of the PTBE are correlated with the prognosis of meningioma. A larger edema is associated with a larger tumor, higher grade, and a more invasive meningioma with a higher recurrence rate. Our patient had a very large hemispheric PTBE which was disproportionate to the small size of the meningioma and the tumor had not directly invaded the adjacent brain tissue. We believe that the visible compression of the tumor on major veins of the Sylvian fissure was the reason for the PTBE in our patient. The presence of a large PTBE concomitant with a meningioma does not necessarily indicate a poor prognosis. Hence, we recommend a preoperative venogram to be performed in such patients.

Human brain tumors are the leading cause of cancer induced death owing to the late diagnosis in higher grades and failure to be successfully controlled. Determining the main risk factors toward higher grades of the tumor can dramatically decrease the mortality rate of benign brain tumor patients. The present study was conducted to compare the dietary habits between benign and malignant brain tumor patients. Three demographic, physical activity and dietary regimen’s specific questionnaires were filled for 50 high grade glioma and 50 meningioma patients. Obtained data were analyzed using SPSS 22.0 (SPSS Inc, IL, USA). A p-value less than 0.05 was considered as significant. There was a significant association between using of fast foods and high-grade glioma tumors (p-value=0.007). In contrast, the frequency of using dairy products, sea foods, fruits, and vegetables besides physical activity was not meaningfully different between two malignant and benign patient groups. Finding of this study regarding the association of fast foods with malignant brain tumors is further support on the role of Trans and saturated fatty acids in the rate of cancer evolution. However, further investigations are required to determine whether disruption in blood brain barrier induced by frequent consumption of saturated fatty acids enriched food occurs before or after malignant cellular transformation.

  Apparent diffusion coefficient (ADC) measured by diffusion-weighted MRI and first-order histogram (FOH) extracted features, as markers of tumor heterogeneity, have been implicated in differentiating grade of the intracranial tumors. To examine whether ADC, normalized ADC (NADC), and FOH features such as entropy, kurtosis, and uniformity can differentiate benign vs. malignant meningioma. Patients and MRI with diffusion-weighted (DW) imaging sequence of 62 patients with histologically-proven meningioma (37 benign and 25 malignant/atypical) were included. After co-registration of ADC maps to their corresponding anatomical MRI (post-contrast T1-weighted [T1C] images) and delineation of the tumors border by selecting regions of interest (ROIs) on T1C images, a mask of tumor was created and overlaid on the corresponding ADC map. Then, FOH features were extracted. Mean (± standard deviation [SD]) ADC values in benign and malignant subgroups were respectively 1.05 (± 0.23) and 0.99 (± 0.29) 10-3 mm2/s, and P = 0.69. NADC ratios were not statistically significant between benign (0.5 ± 0.09) and malignant (0.5 ± 0.07) meningioma groups (P = 0.89). Mean values of entropy (6.36 vs. 6.44), kurtosis (5.77 vs. 5.45), and uniformity (536.8 vs. 304.18) were comparable between benign and malignant meningioma subgroups. Receiver operating characteristic (ROC) curve analysis did not yield the significant area under the curve results to show acceptable diagnostic accuracy for any of the measured variables. ADC, NADC, and statistical features of tumor heterogeneity by FOH method measured by DW-MRI were not able to differentiate benign vs. malignant/atypical meningiomas.

A 73-year-old man with history of prostatic adenocarcinoma radical prostatectomy underwent 99mTc-MDP whole-body bone scan and subsequent 68Ga-labeled prostate-specific membrane antigen (PSMA) ligand PET/CT for restaging due to a gradual rise of prostate-specific antigen levels. Whole-body bone scan showed two focal zones of slightly increased uptake in the right fronto-parietal and temporal bones. 68Ga-PSMA PET/CT scan showed local recurrence in the prostatic bed and two foci of slightly increased uptake in the right temporal and fronto-parietal lobes. A brain CT scan, with IV contrast confirmed that foci of increased uptake in the temporal and parietal lobes were consistent with typical meningioma.

Primary central nervous system lymphoma (PCNSL) is a rare cancer confined to the brain, spinal cord, leptomeninges and eyes. The origin of this type of lymphoma is often type B lymphocytes, and because the central nervous system (CNS) has no lymph nodes or lymphatic vessels, the cause of PCNSL is still unclear. But its source appears to be from lymphocytes located in the CNS. This type of lymphoma has been reported in the context of congenital or acquired immune deficiency such as Wiskott Aldrich syndrome, kidney transplantation, and in particular AIDS. Frontal lobes are the most common sites of involvement in CNS.

The patient was a 55-year-old man who had been referred to the Emergency Department of Al-Zahra Hospital, Isfahan, Iran due to recurrent headaches, nausea, and vomiting since 6 months ago.

Meningiomas are often benign and slowly growing tumors that originate from the arachnoid cap cell of meninges. Due to the rarity of concomitance of primary cerebral lymphoma and meningioma, there is no possibility of epidemiological studies in these patients.

We reported a 71 years old woman, with history of rest and postural tremor, bradykinesia and memory problems. In her dynamic MRI, a contrastenhanced tumor in the cerebellopontine (CP) angle was found which was compatible with a meningioma. 99mTc-TRODAT SPECT showed decreased activity in the left putamen, indicating idiopathic Parkinson disease. There was also a focus of increased activity on the right side of the skull base, which was compatible with meningioma in MRI.

Meningiomas are one of the most common primary brain tumors and the most common intradural spinal tumors. Vascular endothelial growth factor has been demonstrated to play an important role in the stimulation of angiogenesis in many types of cancers. Agents that block the vascular endothelial growth factor pathway, such as bevacizumab, have the capability to decrease vascular permeability. The aim of this study is to evaluate vascular endothelial growth factor expression in meningioma patients. This retrospective, cross-sectional study used an immunohistochemical method to assess vascular endothelial growth factor expression in meningioma. We randomly chose 83 paraffin-embedded tissue blocks of meningiomas diagnosed during 2015 from the files of the Pathology Laboratory of Al-Zahra Hospital, affiliated with Isfahan University of Medical Sciences, Iran. All of the meningioma samples (100%) were vascular endothelial growth factor-immunoreactive. There was a vascular endothelial growth factor score of 1 in 6 (7.2%) cases, a score of 2 in 54 (65.1%) cases, and score of 3 in 23 (27.7%) cases. A correlation existed between vascular endothelial growth factor score and tumor grade. However, there was no correlation between vascular endothelial growth factor score and age and sex of patients. Our study demonstrated a significant role of vascular endothelial growth factor expression in the pathogenesis of peritumoral brain edema in low- and high-grade meningiomas as well as in recurrence or malignant transformation. Thus, anti-vascular endothelial growth factor agents such as bevacizumab might be useful as a treatment of this condition.

Breast cancer metastases to the central nervous system are more commonly multiple intracranial lesions. Rarely, in the case of single extradural metastasis, it is clinically and radiologically challenging and important to differentiate other solitary extradural masses such as meningioma. Moreover, according to the literature, it seems that there is a relationship between breast cancer and meningioma.
We report a 54-year-old female presenting with a sudden onset of headache and seizure whose MRI showed an extra-axial intracranial mass in her brain. The patient underwent operative removal of the tumor with the clinical and radiologic diagnosis of meningioma. The pathological finding was suspected to be breast cancer metastasis. Future evaluation of her breast showed tissue distortion in the left breast and the pathologic diagnosis of the breast lesion was invasive ductal carcinoma. In a follow-up CT scan, there were multiple liver and lung metastases.
It is crucial for physicians with various specialties to be aware of different possibilities in the setting of a single extra-axial brain mass.

To report on the medical management of meningioma with compression of the optic chiasm associated with the use of cyproterone acetate (CA).
Case Report: A 65-year-old woman who was being treated with CA presented with a recent decrease in visual function, leading to discovery of a giant olfactory groove meningioma with compression of the optic chiasm. CA was discontinued immediately, and her visual function improved dramatically. At 13 months, in addition to a significant improvement in visual and neurocognitive symptoms, the tumor volume was reduced by 50%.
In meningiomas associated with CA, treatment cessation may result in prompt improvement in symptoms and a reduction in tumor volume, even if the tumor is large and causing neurologic impairments.