Meningioma surgery: Difference between revisions
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Revision as of 16:38, 22 April 2019
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Meningioma Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Meningioma surgery On the Web |
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American Roentgen Ray Society Images of Meningioma surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Haytham Allaham, M.D. [2]
Overview
The predominant therapy for meningioma is surgical resection. Adjunctive radiation therapy may be required among certain patients.[1] The Simpson criteria for meningioma correlates the degree of surgical resection completeness with the probability of post-surgical tumor recurrence.[1][2][3] Surgical resection is not recommended among patients with asymptomatic stable meningioma.[1]
Surgery
- Surgery is the preferred method for treating a symptomatic meningioma.[4]
- The decision to undergo surgery is based on age, symptoms, radiological features, postoperative morbidity, and patient preference.[4]
- The surgery is successful if the tumor is completely removed. This is considered curative.[5]
- When treating meningiomas, the prediction of possible recurrence and survival for malignant or transient types of meningiomas is the most important prognostic factor.[6]
- As an alternative to surgery, stereotactic radiosurgery can be used either as a first line treatment or at recurrence.[5]
- In situations where complete resection (with low morbidity) can be achieved, and/or to decompress tumors associated with pressure symptoms, surgery is highly appropriate.[7]
- Radiotherapy is an option that can be used in the treatment of meningioma but, surgery is usually preferred. This is based on symptoms, age, radiological features, postoperative morbidity, patient preference and when a definite diagnosis is necessary.[4]
- Preoperative embolization of a meningioma may be done to help in reducing blood loss and surgical time during meningioma resection. This can cause some changes in the histology of the tumor which may lead to over grading of the tumor by the pathologist. The histological changes include: macronucleoli, necrosis, and compensatory proliferation with increased numbers of mitotic figures [8][9]
- Surgical resection procedures of meningioma include:[1][2][3]
- Complete meningioma resection, with excision of any involved bone, venous sinuses, and dural attachments
- Complete meningioma resection and coagulation of dural attachment
- Partial meningioma resection sparing the dura
- Subtotal meningioma resection
- Surgical resection is not recommended among patients with asymptomatic stable meningioma.[1]
- The Simpson criteria for meningioma correlates the degree of surgical resection completeness with the probability of post-surgical tumor recurrence:[1][2][3]
| Simpson Grade | Completeness of Resection | 10-Year Recurrence |
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9% |
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19% |
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29% |
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40% |
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- Grade 5
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- Simple decompression (biopsy)
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References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 Meningioma. Wikipedia(2015) https://en.wikipedia.org/wiki/Meningioma Accessed on September, 25 2015
- ↑ 2.0 2.1 2.2 Simpson grade. Radiopaedia(2015) http://radiopaedia.org/articles/simpson-grade Accessed on September, 25 2015
- ↑ 3.0 3.1 3.2 Simpson Grading System. Neurosurgic.com(2015) http://www.neurosurgic.com/index.php?option=com_content&view=article&id=846:simpson-grading-system-for-removal-of-meningeomas&catid=152:usefulinfo&Itemid=603 Accessed on September, 25 2015
- ↑ 4.0 4.1 4.2 Gurcay AG, Bozkurt I, Senturk S, Kazanci A, Gurcan O, Turkoglu OF; et al. (2018). "Diagnosis, Treatment, and Management Strategy of Meningioma during Pregnancy". Asian J Neurosurg. 13 (1): 86–89. doi:10.4103/1793-5482.181115. PMC 5820904. PMID 29492130.
- ↑ 5.0 5.1 Alexiou GA, Gogou P, Markoula S, Kyritsis AP (2010). "Management of meningiomas". Clin Neurol Neurosurg. 112 (3): 177–82. doi:10.1016/j.clineuro.2009.12.011. PMID 20056312.
- ↑ Sumkovski R, Micunovic M, Kocevski I, Ilievski B, Petrov I (2019). "Surgical Treatment of Meningiomas - Outcome Associated With Type of Resection, Recurrence, Karnofsky Performance Score, Mitotic Count". Open Access Maced J Med Sci. 7 (1): 56–64. doi:10.3889/oamjms.2018.503. PMC 6352459. PMID 30740161.
- ↑ Smee R, Williams J, Kotevski D, Schneider M (2019). "Radiotherapy as a means of treating meningiomas". J Clin Neurosci. 61: 210–218. doi:10.1016/j.jocn.2018.10.006. PMID 30782319.
- ↑ Chen L, Li DH, Lu YH, Hao B, Cao YQ (2019). "Preoperative embolization versus direct surgery of meningiomas: A meta-analysis". World Neurosurg. doi:10.1016/j.wneu.2019.02.223. PMID 30954743.
- ↑ Commins, Deborah L.; Atkinson, Roscoe D.; Burnett, Margaret E. (2007). "Review of meningioma histopathology". Neurosurgical Focus. 23 (4): E3. doi:10.3171/FOC-07/10/E3. ISSN 1092-0684.