Meningeome

Zusammenfassung

Meningeome repräsentieren die größte Gruppe intrakranieller Tumore bei Erwachsenen. In den vergangenen Jahren ergaben sich für diese klinisch und morphologisch sehr heterogene Entität neue epidemiologische, radiologische, pathologische und genetische Erkenntnisse sowie diagnostische Möglichkeiten, welche die Therapiemodalitäten beeinflusst haben. Mikrochirurgische Resektion ist noch immer die Therapie der Wahl, obgleich die strahlentherapeutischen Möglichkeiten gerade bei inkomplett resezierten, rekurrierenden oder höhergradigen Meningeomen sehr gute Ergebnisse vorweisen können. Die meisten Meningeome haben eine gute Langzeitprognose, jedoch verbleiben Fälle, bei denen trotz wiederholten Resektionen, Strahlentherapien und chemotherapeutischen Heilversuchen, Rezidive auftreten. Wir beleuchten die klinisch-neuroradiologischen, pathologischen, epidemiologischen und biologischen Erscheinungsbilder der Meningeome und diskutieren die therapeutischen Möglichkeiten. Im inter-disziplinären Konsens, mit Vernetzung grundlagenwissenschaftlicher Daten und klinischen Erfahrungen wird es gelingen, das Management der Meningeome zu optimieren.

Summary

Meningiomas are the most common intracranial primary neoplasm in adults. Over recent years, interest in this clinically diverse group of tumours has intensified, bringing new questions and challenges to the front, particularly in the fields of epidemiology, radiology, pathology, genetics, and treatment. Surgery remains the primary treatment of choice, although the use of fractionated radiotherapy or stereotactic single-dose radiosurgery is increasing for meningiomas that are incompletely excised, surgically inaccessible, or recurrent and either atypical or anaplastic. Although most meningiomas have good long-term prognosis after treatment, some cases remain complicated as repeated recurrencies occur. We review various features of meningioma biology, diagnosis, and treatment and provide an overview of the current rationale for various therapeutic approaches. A team approach, linking laboratory-based research and multidisciplinary clinical practice, will be an essential element to lead meningioma management forward and beyond 2011.

Schlüsselwörter

Meningeom - Mikrochirurgie - Strahlentherapie - Chemotherapie

Keywords

Meningioma - microsurgery - radiosurgery - chemotherapy

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