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Nervenheilkunde 2024; 43(01/02): 16-24
DOI: 10.1055/a-2106-0371
Übersichtsarbeit

Cystic meningioma of the brain

Diagnosis, surgical treatment, histological and postoperative complicationsZystisches Meningeom des GehirnsDiagnose, chirurgische Behandlung, histologische und postoperative Komplikationen
Jiang Long
1   Department of Extracerebral Tumors No. 3, State University “The State Institution Romodanov Neurosurgery Institute National Academy of Medical Sciences of Ukraine”, Str, Kyiv, Ukraine
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ABSTRACT

Meningiomas with a cystic component are quite rare and account for 1.7–7.3 % of all intracranial meningiomas. The incidence of cystic meningioma in adults is 2–4 % of all meningiomas. Women have a higher incidence rate in comparison to men. Between 2014 and 2019, at the State Institution Romodanov Neurosurgery Institute of the National Academy of Medical Sciences of Ukraine, we collected data for a database of cystic meningioma cases. The data included preoperative imaging, surgery notes, and pathology reports. Over the course of 6 years, 1408 meningioma cases have been observed, and 1326 of those instances have undergone surgical treatment for intracranial meningioma. 73 (5.5 %) cases of cyst-associated meningiomas have been analyzed: 26 (2.0 %) of true cysts (primary), 47 (3.5 %) cases of pseudocysts (secondary). Nauta type IV was the most common cyst type accounting for 52.1 %, whereas atypical (27.4 %) and anaplastic (17.8 %) meningioma types were the most common histological subtypes. All patients were monitored for 24 months; only 73 patients had access to long-term monitoring, which lasted for an average of 49 months (range 36–96 months). The majority of atypical (2.7 %) and anaplastic (5.5 %) types of pseudocystic meningioma relapsed after radical tumor surgery removal. The preoperative diagnosis needs to be integrated with the examination performance, the surgical treatment is selected based on the Nauta classification, and most of the surgical operations can result in the complete resection of the tumor.

ZUSAMMENFASSUNG

Meningeome mit einer zystischen Komponente sind selten und machen 1,7–7,3 % aller intrakraniellen Meningeome aus. Die Inzidenz von zystischen Meningeomen bei Erwachsenen liegt bei 2–4 % aller Meningeome. Frauen haben im Vergleich zu Männern eine höhere Inzidenzrate. Zwischen 2014 und 2019 haben wir am Staatlichen Romodanov-Institut für Neurochirurgie der Nationalen Akademie der Medizinischen Wissenschaften der Ukraine Daten für eine Datenbank mit Fällen von zystischen Meningeomen gesammelt. Die Daten umfassten präoperative Bildgebung, Operationsnotizen und Pathologieberichte. Im Laufe von 6 Jahren wurden 1408 Meningeom-Fälle beobachtet, von denen 1326 Fälle einer chirurgischen Behandlung wegen eines intrakraniellen Meningeoms unterzogen wurden. 73 (5,5 %) Fälle von zystenassoziierten Meningeomen wurden analysiert: 26 (2,0 %) echte Zysten (primär), 47 (3,5 %) Fälle von Pseudozysten (sekundär). Der Nauta-Typ-IV war mit 52,1 % der häufigste Zystentyp, während atypische (27,4 %) und anaplastische (17,8 %) Meningeome die häufigsten histologischen Subtypen darstellten. Alle Patienten wurden 24 Monate überwacht; nur 73 Patienten hatten Zugang zu einer Langzeitüberwachung, die durchschnittlich 49 Monate dauerte (Spanne 36–96 Monate). Die Mehrzahl der atypischen (2,7 %) und anaplastischen (5,5 %) Typen von pseudozystischen Meningeomen erlitt nach radikaler Entfernung des Tumors einen Rückfall. Die präoperative Diagnose muss mit der Untersuchungsleistung integriert werden, die chirurgische Behandlung wird auf der Grundlage der Nauta-Klassifikation ausgewählt, und die meisten chirurgischen Eingriffe können zu einer vollständigen Resektion des Tumors führen.

Schlüsselwörter

Histopathology - surgery - MRI - Nauta classification - aseptic meningitis syndrome - intracranial hypotension syndrome

Key words

Histopathologie - Operation - MRT - Nauta-Klassifikation - aseptisches Meningitis-Syndrom - intrakranielles Hypotonie-Syndrom


Publication History

Article published online:
19 February 2024

© 2024. Thieme. All rights reserved.

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