Epidemiological features of meningiomas: a single Brazilian center's experience with 993 cases / Características epidemiológicas de meningiomas: experiência de um centro único brasileiro com 993 casos

ABSTRACT Background: Meningiomas are the most frequent primary central nervous system (CNS) tumors. Their geographical and ethnic characteristics need to be known, in order to enable rational treatment. Objective: To investigate clinical and epidemiological aspects in a series of patients with meningiomas. Methods: Retrospective analysis on the demographic profile, location and histopathology of 993 patients with meningiomas (768 operated and 225 not operated). Results: Meningiomas represented 43.8% of the primary CNS tumors; 6.8% were multiple tumors (14.7% with neurofibromatosis 2) and 0.6% were radiation-induced tumors. The mean ages were 53.0 and 63.9 years for operated and non-operated patients and the female/male ratios were 3.2:1 and 6.3:1. Diagnosis was made later among females. The peak incidences were in the 6th and 7th decades respectively for operated and non-operated patients. The incidence was low at early ages and higher among patients aged 70+ years. The meningiomas were intracranial in 96.5% and most were WHO grade I (88.9%) and transitional. In the spinal canal (3.5%), they occurred mainly in the dorsal region (all grade I; mostly transitional). The racial distribution was 1.0% in Asian-Brazilians, 87% in Caucasians and 12% in African-Brazilians. 83.4% and 51.6% of the patients were estimated to be recurrence-free at 10 and 20 years, and the mortality rate was 3%. Conclusions: Most of the demographic data were similar to what has been observed in other western centers. Differences were higher incidence of meningiomas, female and older predominance in non-operated patients, predominance in Caucasian, and higher association with neurofibromatosis 2.

RESUMO Antecedentes: Meningiomas são os tumores mais frequentes do sistema nervoso central (SNC). Suas características étnicas e geográficas precisam ser conhecidas para o seu tratamento racional. Objetivo: Investigar aspectos clínicos e epidemiológicos de uma série de pacientes com meningiomas. Métodos: Análise retrospectiva demográfica de 993 pacientes com meningiomas (768 operados e 225 tratados conservadoramente) Resultados: Meningiomas constituíram 43.8% dos tumores primários do SNC. 0.8% deles eram múltiplos (14,7% com neurofibromatose 2) e 0,6% eram radioinduzidos. A idade média e o índice mulheres/homens foram respectivamente 53,0 e 63,9 anos e 3.2:1 e 6.3:1 para pacientes operados e não operados. O diagnóstico foi mais tardio em mulheres. Ocorreram picos de incidências na 6ª e na 7ª décadas respectivamente para pacientes operados e não operados. A incidência foi menor na infância e maior após 70 anos. Meningiomas predominaram no crânio (96.5%), a maioria grau I da OMS, subtipo transicional. Do total, 3.5% ocorreram no canal raquídeo, principalmente na região torácica, todos grau I, a maioria transicional. Em relação à distribuição racial, 1.0% dos meningiomas ocorreu em amarelos, 87% em brancos e 12% em negros. As taxas de sobrevida sem recorrência foram 83.4% e 51.6% em 10 e 20 anos e a mortalidade operatória foi 3%. Conclusões: A maioria dos dados demográficos observados foi similar aos de outros centros ocidentais. As diferenças observadas foram maior incidência, predominância em mulheres e idosos nos pacientes não operados e em caucasianos, e maior associação com neurofibromatose 2.

Meningioma parasagital y hematoma subdural crónico, una asociación inusual / Parasagittal meningioma and chronic subdural hematoma, unusual association

RESUMEN En muchas ocasiones, los pacientes con tumores cerebrales tienen una variedad de síntomas psiquiátricos inespecíficos. Algunos de estos pueden constituir la primera o única manifestación del tumor, sin la presencia de ningún síntoma o signo neurológico. El diagnóstico ha de basarse en la anamnesis completa y en la exploración neurológica; la neuroimagen confirmará el diagnóstico clínico. Con el presente trabajo se describió la asociación inusual de hematoma subdural crónico y meningioma parasagital en un caso presentado. Se trató de un paciente de 68 años con antecedentes de esquizofrenia. Acudió a consulta con una hemiparesia izquierda. Se le realizó una tomografía axial computarizada de cráneo y arrojó un hematoma subdural crónico y un meningioma parasagital derecho. Se le aplicó tratamiento quirúrgico en dos tiempos operatorios. Su evolución posquirúrgica transcurrió sin complicaciones (AU).

ABSTRACT In many cases, patients with brain tumors have a variety of nonspecific psychiatric symptoms. Some of them can be the first or the only manifestation of the tumor, without presenting any neurological signs or symptoms. The diagnosis must be based on the complete anamnesis and on the neurological examination. The neuroimaging will confirm the clinical diagnosis. The unusual association of a chronic subdural hematoma and a parasagittal meningioma was described in a case presented in the current work. It dealt with a patient, aged 68 years with antecedents of schizophrenia. He assisted the consultation with left hemiparesis. A skull computed tomography showed a chronic subdural hematoma and a right parasagittal meningioma. He underwent a two-steps surgery. His post-surgery evolution ran without complications (AU).

Meningioma of the Fourth Ventricle: Literature Review

Meningiomas are among the most common central nervous system tumors, with an incidence that ranges from 15% to 40% of intracranial tumors. Of these, only 0.5% to 3% are intraventricular, and the rarest of them occurs in the fourth ventricle. Fourth-ventricle meningiomas originate generally fromthe choroid plexus and have no dural adhesions. Most often, they manifest in young patients, around 41 years of age, with a possible predominance in females, through intracranial hypertension and cerebellar syndromes. The treatment consists of surgical resection, which commonly presents good results due to the characteristics of the tumor. So, for better preoperative planning, the radiological differentiation of the most frequent tumors in this location is important. Themost common histologic subtypes are fibroblastic and meningothelial, both grade I according to the World Health Organization (WHO), although there are reports of tumors of grades II and III. We report a case ofmeningioma of the fourth ventricle operated in our institution, and we have conducted a literature review, through which we found that 57 cases have been reported so far, with the first one reported in 1938.

Chordoid Meningioma: Literature Review

Chordoid meningiomas (CMs) are a rare subgroup of tumors, accounting for 0.5% of all meningiomas. Chordoid meningioma tumors correspond to World Health Organization (WHO) Grade II lesions and behave aggressively, with an increased likelihood of recurrence. There are few genetic studies about CMs, but we understand that there is deletion at many chromosomal loci. Histologically, CMs are characterized by strands and cords of meningothelial cells arranged in a mucinous stroma. Morphologically, it can mimic other chondroid and myxoid tumors within the brain and its vicinity, thus posing a diagnostic challenge. Chordoid meningiomas have an aggressive clinical course and a propensity to recur compared with classical meningiomas. The goal of the treatment is surgery, with total resection of the tumor; however, due to its high degree of recurrence, radiotherapy is often necessary as an adjuvant treatment.

Meningiomas intracraneales. Experiencia de dos años en el servicio Neurocirugía de Matanzas / Intracranial meningiomas. Two-year experience in the service Neurosurgery of Matanzas

RESUMEN Introducción: los meningiomas constituyen la segunda causa de tumores cerebrales primarios, en el adulto. Representan hasta el 32 % del total de los mismos. Objetivo: describir el comportamiento del meningioma intracraneal en los pacientes investigados. Materiales y métodos: se realizó un estudio analítico, descriptivo, retrospectivo a los pacientes neurointervenidos con meningioma intracraneal, en el Servicio de Neurocirugía del Hospital Docente Universitario "Comandante Faustino Pérez Hernández", de la provincia Matanzas. En el período comprendido entre el 1ero de enero de 2017 al 1ero de enero del 2019. Los 15 pacientes intervenidos conformaron el universo de estudio. Resultados: la media poblacional fue de 55 años. Predominó el sexo femenino en un 73,3 %. La cefalea fue la manifestación clínica más frecuente, igualmente, que los meningiomas de la convexidad cerebral. En cuanto a la topografía, la media del tamaño de la lesión fue de 4,4 cm. La variedad meningotelial (40 %) fue la que predominó. El grado II de resección fue el que más se empleó. El edema cerebral postquirúrgico predominó en un 26,6 %. La puntuación de la escala de Karnofsky al egreso fue superior que al ingreso. Conclusiones: cuanto más precoz se realice el diagnóstico clínico y tratamiento quirúrgico en los pacientes portadores de meningioma, mejor será su calidad de vida al egreso (AU).

ABSTRACT Introduction: meningiomas are the second cause of primary brain tumors in adults, representing up to 32 % of the total. Objective: to describe the behavior of intracranial meningioma in the studied patients. Materials and methods: a retrospective, descriptive, analytical study was conducted on neurosurgery patients with intracranial meningioma in the Neurosurgery service of the University Teaching Hospital "Comandante Faustino Pérez Hernández" of the province of Matanzas, in the period from January 1st 2017 to January 1st, 2019. The 15 patients undergoing neurosurgery were the study universe. Results: the population mean was 55 years; female sex prevailed (73.3 %). Headache was the most frequent clinical manifestation as well as meningiomas of cerebral convexity in terms of topography. The average lesion size was 4.4 cm; the meningothelial variety (40 %) was the most commonly found; grade II resection was the most used one. Post-surgical cerebral edema (26.6%) predominated. Karnofsky scale score at discharge was higher than at admission. Conclusions: the earlier the clinical diagnosis and surgical treatment are performed in patients with meningioma the better will be their quality of life at discharge (AU).

Una imagen atípica para un tumor típico / An atypical imaging for the most typical intracranial tumor

Los meningiomas son los tumores intracraneales benignos más frecuentes en adultos, suponen el 20% de todos los tumores cerebrales. Solamente el 1-4% presentan cambios quísticos. La relación entre el componente quístico y sólido de los meningiomas mixtos fue utilizada por varios autores para crear hasta cuatro clasificaciones diferentes de este subtipo de meningiomas. El diagnóstico mediante TC resulta muy complejo ante este subtipo de meningiomas por la dificultad de discernir entre diferentes lesiones intracraneales que también presentan componente quístico asociado. Presentamos el caso de un paciente varón de 49 años que presenta episodios de amaurosis fugax. En la TC se identificó una lesión sólida en localización frontotemporal izquierda, con gran componente quístico que producía importante efecto de masa y desplazaba la línea media. Se completó estudio mediante RM y arteriografía y finalmente fue diagnosticado como meningioma mixto, que tras embolización tumoral desde arteria meníngea media, se resecó quirúrgicamente.

Meningiomas are the most common benign intracranial tumors in adults, accounting for 20% of all brain tumors. Only 1-4% have cystic changes. The relationship between the cystic and solid component of mixed meningiomas was used by several authors to create up to four different classifications of this subtype of meningiomas. CT diagnosis is challenging in this subtype of meningiomas because of the difficulty of distinguishing between different intracranial lesions that also have associated cystic component. We present the case of a 49-year-old male patient with episodes of amaurosis fugax. On CT, a solid lesion was identified in the left frontotemporal region, with a large cystic component that produced an important mass effect and midline displacement. A study was completed by MR and arteriography and finally was diagnosed as mixed meningioma, which after tumor embolization via the middle meningeal artery, was surgically resected.

Supervivencia libre de progresión en pacientes portadores de meningiomas vacunados con nimotuzumab / Progression free survival in patients with meningioma which got Nimotuzumab vaccine

Introducción: en los últimos años la biología de los meningiomas cerebrales ha comenzado a entenderse mejor. La inmunoterapia activa contra el factor de crecimiento epidérmico es un concepto emergente, en el que se propone manipular la respuesta inmune del individuo, para generar anticuerpos específicos contra el factor de crecimiento epidérmico, capaces de bloquear la unión ligando-receptor y por consiguiente la señalización a través de este último. El receptor del factor de crecimiento epidérmico está sobrexpresado en este tipo de tumor. Objetivo: estimar la sobrevida libre de progresión de la entidad clínica y su relación con algunas variables socio-demográficas y terapéuticas seleccionadas. Métodos: se realizó un estudio descriptivo, transversal, en 25 pacientes portadores de meningiomas, tratados con un anticuerpo monoclonal humanizado (AcM h-R3) (nimotuzumab), en el Hospital Provincial Docente Clínico Quirúrgico Saturnino Lora de Santiago de Cuba, en el período comprendido entre el 1 de diciembre del 2013 y el 30 de noviembre del 2015. Resultados: el conjunto de pacientes incluidos en el estudio (n= 25) se caracterizó por el predominio del sexo femenino (60 por ciento), edad de 50 y más años (68 por ciento), piel blanca (48 por ciento) y escala de Karnofsky de 100 puntos (84 por ciento). El tiempo medio libre de progresión fue de 17 ± 8,6 meses. Conclusiones: fueron identificadas las principales características de la supervivencia libre de progresión del meningiomas en pacientes vacunados con AcM h-R3 y el tiempo fue como promedio de alrededor de año y medio(AU)

Introduction: in recent years the biology of brain meningiomas has begun to be better understood. Active immunotherapy against epidermal growth factor is an emerging concept, in which it is proposed to manipulate the immune response of the individual, to generate specific antibodies against epidermal growth factor, capable of blocking the ligand / receptor binding and therefore signaling through the latter. The epidermal growth factor receptor is overexpressed in this type of tumor. Objective: to estimate the progression free survival and its relation with some selected socio-demographic and therapeutic variables. Methods: a descriptive, cross-sectional study was conducted in 25 patients with meningiomas, treated with a humanized monoclonal antibody (mAb h-R3) (Nimotuzumab), in the Provincial Clinical-Surgical Teaching Hospital Saturnino Lora of Santiago de Cuba, from December 1, 2013 to November 30, 2015. Results: the group of patients included in the study (n= 25), was characterized by the predominance of females (60 percent), age 50 and over (68 percent), white skin (48 percent) and Karnofsky scale of 100 points (84 percent). The mean progression-free time was 17 ± 8.6 months. Conclusions: the main characteristics of progression-free survival of meningiomas were identified in patients vaccinated with mAb h-R3 and the progression-free time reached almost of a year and a half(AU)

retrospective analysis of meningioma in Central Texas

Documented meningioma cases in Central Texas [USA] from 1976 to 2013 were studied utilizing the Scott and White Brain Tumor Registry. All the cases examined were historically diagnosed as meningiomas. Of the 372 cases, most were bening benign tumors [p < 0.05] A majority of the patients were females [p < 0.05]. Elderly individuals [>45 years of age] superseded the younger patients in meningioma incidence [p < 0.05]. Previous data regarding meningioma epidemiology in Texas showed a higher incidence in black patients when compared to white patients. By contrast, this study's findings of Central Texas meningioma demographics show increased incidence of meningiomas in white patients [p<0.05]. This interesting find in meningioma prevalence warrants further investigation with a larger sample size, in order to establish validity and further parse out possible causes of meningioma development among white individuals

Frequency of central nervous system tumors in delta region, Egypt.

Introduction and Aim of Work: Central nervous system (CNS) tumors represent a major public health problem, and their epidemiological data in Egypt have been rather incomplete except for some regional reports. There are no available frequency-based data on CNS tumors in our locality. The objective of this study was to estimate the frequency of CNS tumors in east delta region, Egypt. Materials and Methods: The data were collected during the 8-year period from January 1999 to December 2007 from Pathology Department, Mansoura University, and other referred pathology labs. Examination of HandE stained sections from retrieved paraffin blocks were done in all cases for histopathologic categorization of C.N.S. tumors. Immunohistochemical studies were applied to confirm final histopathologic diagnosis in problematic cases. Results: Intracranial tumors represented 86.7% of cases in comparison to only 13.3% for spinal tumors. Gliomas were the CNS tumors of the highest frequency (35.2%), followed by meningioma (25.6%), pituitary adenoma (11.6%) and nerve sheath tumors (6.6%). 10.25% of tumors were of children <15 years. Conclusion: This study provides the largest series of the relative frequency of CNS tumors in Delta region in Egypt till now and may help to give insight into the epidemiology of CNS tumors in our locality.

Meningioma maligno / Malignant meningioma

Los meningiomas intracraneales son tumores por lo general benignos, de crecimiento lento, y se originan en la capa de células aracnoideas, especialmente en las granulaciones aracnoideas. Los meningiomas anaplásicos o malignos representen solo el 1-3 por ciento. En ocasiones simulan lesiones tumorales neuroepiteliales malignas, por su crecimiento rápido y la frecuente invasión al tejido cerebral vecino; suelen recidivar con mayor frecuencia y muchas veces requieren terapia coadyuvante. Las imágenes topográficas de este tipo de tumores suelen ser hiperdensas, con muy buena captación del contraste, regulares y bien delimitadas con poco o ningún edema asociado, todo lo contrario a lo visto en el caso que se presenta, en el cual las imágenes parecían corresponder a las de un glioma maligno (glioblastoma multiforme)(AU)

The intracranial meningiomas are tumors in general of benign type of a slow growth originating in the arachnoid cells layer, especially in arachnoid granulations. The anaplastic or malignant meningiomas accounted for only the 1-3 percent. Sometimes they simulate malignant neuroepithelial lesions due to its fast growth and the frequent invasion of surrounding cerebral tissue with very frequent relapses and many times they required adjuvant therapy. The topographic images of this type of tumor are hyper-denses with a good contrast capture, regular and well defined with not much or not associated edema, quite the contrary that observed in present case where images seems to correspond with those of a malignant glioma (multiforme glioblastoma)(AU)

Tumores primarios del sistema nervioso central en Cartagena, 2001- 2006 / Primary central nervous system tumours reported in Cartagena, 2001-2006

Objetivos Determinar la frecuencia de los tumores primarios del sistema nervioso central, diagnosticados en Cartagena de Indias durante el periodo de 2001-2006 y, determinar las características demográficas, epidemiológicas y clínicas de los pacientes con tumores del sistema nervioso central de una institución de la ciudad, en el mismo periodo. Métodos Se realizó un estudio descriptivo de vigilancia epidemiológica pasiva. Se tomaron los reportes de patología con diagnóstico nuevo de tumor primario del sistema nervioso central de todos laboratorios de Cartagena y se analizaron las historias clínicas disponibles de estos casos. Se estimaron las tasas de incidencia general, por año, género, grupos de edad y tipo histológico con intervalos de confianza al 95 por ciento. Además se calcularon razones estandarizadas de morbilidad. Resultados Durante los años 2001 y 2006 se encontraron 390 casos. La tasa incidencia general fue de 6,91/100 000 personas-año. El tipo histológico más frecuente fue meningioma (3,46/100 000 personas-año). Sólo se determinó la procedencia en el 43,1 por ciento de los casos. Las razones estandarizadas de morbilidad fueron más altas en Cartagena con respecto a las de los Estados Unidos, el Instituto Nacional de Cancerología de Colombia y el Registro Poblacional de Cáncer de Cali. Conclusiones Hubo una frecuencia de tumores primarios del sistema nervioso central más elevada en Cartagena que en el resto del país. Se recomienda mejorar los sistemas de registro y vigilancia para determinar la magnitud real del problema y fomentar investigaciones en busca de factores de riesgo.

Objectives Determining the frequency of primary central nervous system tumours diagnosed in Cartagena; Colombia, from 2001-2006 and determining the demographic, epidemiological and clinical characteristics of patients having central nervous system tumours reported by a single institution in Cartagena between 2001 and 2006. Methods A passive epidemiological surveillance descriptive study was carried out. The pathology reports of new diagnosed central nervous system primary tumours from all laboratories in Cartagena were taken and the available clinical records regarding these cases were analysed. The overall incidence rate and incidence rates by year, gender, age and histological type were estimated, with 95 percent confidence intervals. Standardised morbidity rates were also calculated. Results There were 390 such cases during 2001-2006. The overall incidence rate was 6.91/100,000 people-year. Meningiomas were the most frequently occurring histological types (3.46/100,000 people-year). The provenance could only be determined in 43.1 percent of cases. Standardised morbidity rates were higher in Cartagena regarding those reported in the United States and by the Colombian National Cancer Institute and the Population-based Cali Cancer Registry. Conclusions There was a higher incidence of primary central nervous system tumours in Cartagena than in the rest of the country. Registry and surveillance systems should be improved and research into risk factors encouraged.

spectrum of intradural spinal tumors

To assess the spectrum of clinical, radiological and histological features of patients with intradural spinal tumors. This descriptive study was carried out in Department of Neurosurgery Lady Reading Hospital Peshawar, from April 2003 to March 2009. Medical records of patients with spinal tumors were reviewed and patients operated for intradural spinal tumors were identified. A total of 312 patients, out of 525 cases of spinal tumors, with different intradural spinal tumors were considered in this study. Their clinical features, radiological reports, peroperative findings and histological reports were analyzed in different aspects. There were total of 312 patients with age range from 2 years to 74 years, with median age of 38 years. Out of these 187 were males and 125 were female, overall male to female ratio of 1.5: 1. Backache, leg weakness, parasthesia and poor sphincters were the main clinical features. MRI spine [274 cases] was the main diagnostic tool along with plain X-rays and X-ray myelography in limited cases [35 cases]. CT myelogram was done only in 3 cases. The common site of involvement was dorsal spine followed by lumber and cervical spines respectively in 185, 80 and 47 cases. Histological report was suggestive of Neurofibroma in 166 Meningioma in 96, Ependymoma in 20, Dermoid in 12, Astrocytoma in 7, Hemangioblastom and Tuberculoma in 3 cases each and Hydatid cyst in one case. Neurofibroma and meningioma constituted majority of cases belonging to intradural extramedulary group, while ependymoma and astrocytoma were common intramedullary tumors. Third and 5[th] decade of life was the common age group for both Intramedulary and extramedulary tumors. Intramedulary lesions were common in 3[rd] decade of life

Cirugía de los meningiomas intracraneales en el Servicio de Neurocirugía del Hospital Provincial Docente "Manuel Ascunce Domenech" / Intracraneal meningiona surgery at the Neurosurgery Service of Provincial Academic Hospital Manuel Ascunce Domenech

Se realizó un estudio descriptivo observacional de todos los pacientes diagnosticados de meningiomas Intracraneales en el Servicio de Neurocirugía del Hospital provincial Docente "Manuel Ascunce Domenech". Se determinó que los meningiomas Intracraneales resultaron más frecuentes en mujeres de la cuarta y quinta décadas de la vida, la cefalea, el déficit motor y las alteraciones mentales fueron los signos y síntomas neurológicos de mayor incidencia. La localización más frecuente de la lesión fue la de la convexidad frontal y resultó ser la de mejor grado de resección quirúrgica. El meningioma meningotelial, seguido del psamomatoso fueron los tipos histológicos predominante y las complicaciones respiratorias, la fístula de LCR y la sepsis quirúrgica ocuparon el primer lugar en cuanto a complicaciones. Se discuten y comparan estos resultados con la literatura nacional e internacional.

A descriptive observational study was run on all patients with intracranial meningiomas diagnosis at the Neurosurgery Department of the Academic Hospital "Manuel Ascunce Domenech". The result was that intracranial meningiomas are more frequent in women in their forties and fifties, migraine, motor deficit and mental disturbances were the neurological signs and symptoms of main incidence. The most frequent location of the lesion was the frontal convexity and proved to be of the best level of surgical resection. The meningiothelial meningioma followed by the psammomatous were the predominant histological types as well as the respiratory complications. As for complications the CSV fistula and surgical sepsis were on the first place. These results are discussed and compared with national and international literature.

Meningeomas: breve revisão para orientação do médico generalista / Meningiomas: soon revision for orientation of the generalist doctor

Os autores pretendem fazer uma breve revisão sobre meningeomas, enfocando aspectos histopatológicos, clínicos, diagnósticos e cirúrgicos para orientação do médico generalista.

Tuberculum sellae meningiomas

This study was done to evaluate the importance of the size of the lesion and early identification of thesymptoms and their effect on the outcome in patients with tuberculum sellae meningiomas. Between 1999 and 2004, at the Department ofNeurosurgery, Alexandria University and other hospitals, 21patients with histopathologically identified tuberculum sellae meningiomas received surgical tumour removal. In thisstudy, the records and clinical data of these patients are retrospectively analyzed. All patients had preoperative plainX-ray, CTscan and MRI of the brain. Different surgical procedures were done. Unilateral subfrontal was done in 16patients. Bifrontal approach was used in one patient and pterional approach was done in 4 cases. Tuberculum sellae meningioma was most frequent in the fifth decade, with a clear predominance in women.Neurological and endocrine deficits were minimal, whereas ophthalmologic signs were always present. The duration ofsymptoms ranged from 3 months to 15 years, averaging 3.25 years. Tumor size ranged from 1.6 cm to 4.4 cm,averaging 3.4 cm. Sellae turcica was not enlarged in all cases. Computed tomography and MRI were the most reliablediagnostic tools. All patient underwent craniotomy using the operating microscope. Prognosis was evaluated accordingto the tumour size and duration of symptoms. Results showed the prognosis was favorably affected by a tumor size of 3cm or less and symptom duration of one year or less. In this series, patients with a tumor size of 3 cm or less and patients with a duration of symptoms for oneyear or less had a better visual outcome, higher total removal rates and lower recurrence rates

Meningiomas: report of a hospital-based registry.

This is a hospital-based epidemiologic study of meningiomas. Of 1321 central nervous system tumours, meningiomas constituted 21% of the cases, being the second largest category of a single histologic type after astrocytomas. Of the 267 meningiomas studied, 247 were intra-cranial (92.5%). The age of the patients varied between 6 to 84 years. Histological subclassification is presented and treatment schedules discussed. 261 (98%) meningiomas were histologically benign and 5 were malignant meningiomas (1.9%). A 5-year follow-up was available in most cases, with the help of which it was possible to understand the biological behaviour of various sub-types and the influence of other parameters such as location and treatment schedules. Of note was the fact, that out of 261 patients with benign meningiomas, 11 succumbed in the immediate post-operative period and in 8 of these cases, the tumour was located at the base of the skull.

Analytical study of 253 cases of central nervous system tumours

This is an analytical study of 253 cases of central nervous system space occupying lesions which were received and diagnosed histologically at the histopathology department at the laboratory section in the specialized surgical hospital at Saddam's Medical City for the period between June 1990 till the end of December 1992. Out of these 253 cases, 231 cases of intracranial and intraspinal tumours were confirmed histologically and 22 cases were miscellaneous. 109 cases were reported among male patients and 122 cases among female. The highest peak incidence was reported in the fifth decade. Of these tumours Glioma constituded the highest incidence [39.4%], and the majority were of high grade malignancy and poor prognosis. This was found to be similar to other previous Iraqi studies and other similar studies reported in literatures

Meningiomas: estudo epidemiológico e anátomo-patológico de 304 casos / Meningiomas: epidemiological and anatomopathological study of 304 cases

No presente estudo, foram pesquisados os tumores do sistema nervoso central (SNC) diagnosticados na cidade de Curitiba entre 1990 e 1994. Realizaram-se 2371 biópsias de SNC das quais 1340 casos eram neoplasias primárias. Dentre as neoplasias primárias de SNC 304 (22,6 por cento) eram meningiomas. Duzentos e nove meningiomas ocorreram em mulheres (68,7 por cento) e 95 ocorreram em homens (31,3 por cento). As idades variaram de 3 a 90 anos, com média de 45,8 anos. Duzentos e oitenta meningiomas localizavam-se no cérebro, 10 na medula espinhal, 9 no cerebelo e 5 na emergência de nervos cranianos. Na classificaçao histológica verificou-se que 294 (96,7 por cento) eram do tipo clássico, 6 malignos (ou anaplásicos), 3 atípicos e 1 papilar. No grupo dos meningiomas clássicos 267 eram meningoteliais, 10 psamomatosos, 5 fibroblásticos, 5 microcísticos, 5 transicionais e 2 angiomatosos. Os autores concluem que as neoplasias meníngeas representaram o grupo mais frequente de tumores primários do SNC e apresentaram características epidemiológicas e anátomo-patológicas similares às da literatura mundial, na qual é dada ênfase à dificuldade de estabelecer critérios biológicos e histológicos de malignidade neste grupo de tumores.