ABSTRACT
The World Health Organization [WHO] reclassified atypical meningiomas in 2000, creating a more clear and broadly accepted definition. We evaluated the pathological and clinical management for atypical meningioma patients according to the new WHO grading system at Cairo University Hospital. A total of 30 atypical meningiomas occurring in 30 patients between 2005 and 2007 were prospectively reviewed to determine diagnosis, postoperative treatment trends and early outcomes. In the 3-year period, 371 meningiomas were operated on at Cairo University Hospital; of these, 320 [86.5%] were benign, 30 [8%] atypical and 21 [5.6%] malignant. The histological parameters permit an accurate identification of atypical and malignant meningiomas with high growth potential and recurrence rates that far exceed that of benign meningiomas. We hope that the use of these relatively simple histological criteria will help to further the understanding of the biology of this important group of tumours
ABSTRACT
In this study, we report the clinical and radiological outcomes of patients with sacral masses. Ten patients presented to Neurosurgery Department in Kasr EI-Einy Hospital from January 2006 -December 2008 with sacral masses. Surgical resection using posterior approach with or without spinopelvic fixation by using Modified Galveston Technique if the sacroiliac joints are involved more than 50% by the tumour. The pathological diagnosis was giant cell tumour in 2 cases, aneurysmal bone cyst in 3 cases, chordoma 3 cases and neurofibroma in 2 cases. Total resection was done in 9 cases [90%]. Low back and leg pain recovered well in 8 cases while remained for about 5 months in the 2 cases with giant cell tumours in which there were instability and fixation was used but fusion did not happen except after 6 months. Sphincteric disturbance recovered after 3 months in 4 cases [40%], 3 of them were aneurysmal bone cyst and one case of neurofibroma. The surgical management of sacral tumours requires partial or total sacrectomy and spinopelvic reconstruction. These lesions present a great surgical challenge because most spine surgeons are unfamiliar with the techniques required for these procedures