open access
Trigone ventricular meningiomas — clinical characteristics, histopathology and results of surgical treatment
- Department of Neurosurgery, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland
- Department of Experimental and Clinical Neuropathology, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland
open access
Abstract
Aim of the study. Intraventricular meningiomas (IVMs) are rare tumours accounting for 0.5–3.0% of all meningiomas. IVMs require different surgical approaches and preparation in deep brain areas. The aim of our study was to present the clinico-
-histopathological characteristics and treatment outcomes of trigone IVMs in a series of 15 patients.
Materials and methods. Eight women and seven men (mean age 52) with 15 trigone IVMs were retrospectively analysed. Patients presented with headache (47%), psychoorganic syndrome (40%), hemianopsia (33%) or paresis (20%), including three (20%) patients with Karnofsky Performance Scale (KPS) < 80. Mean tumour size was 55.2 mm (range: 30–100 mm).
Results. Gross total tumour resection was performed in 14 (93%) cases, and subtotal in one (7%). A new deficit appeared in 83% (5/6) following a transparietal approach, in 14% (1/7) following a transtemporal approach, and in none of two patients following a transoccipital approach. Postoperative complications occurred in six (40%) patients; no patient died, but in two (13%) the new deficit was permanent. Tumour re-growth was found in two (13%) patients after 14 and 31 months. Meningiomas of WHO grade I occurred in 12, grade II in three, and grade III in one tumour recurrence. In long-term follow-up (mean: 60.8 months), including
the results of revision operations, KPS: 80–100 was in 13 (87%) patients, KPS: 50 in one (severe hemiparesis after revision) and one patient was lost to follow-up (KPS: 100 on discharge).
Conclusions. 20% of IVMs in our series were atypical. The results of surgery for IVMs, although satisfactory in general, require further improvement by reducing the rate of focal deficits resulting from a surgical approach.
Abstract
Aim of the study. Intraventricular meningiomas (IVMs) are rare tumours accounting for 0.5–3.0% of all meningiomas. IVMs require different surgical approaches and preparation in deep brain areas. The aim of our study was to present the clinico-
-histopathological characteristics and treatment outcomes of trigone IVMs in a series of 15 patients.
Materials and methods. Eight women and seven men (mean age 52) with 15 trigone IVMs were retrospectively analysed. Patients presented with headache (47%), psychoorganic syndrome (40%), hemianopsia (33%) or paresis (20%), including three (20%) patients with Karnofsky Performance Scale (KPS) < 80. Mean tumour size was 55.2 mm (range: 30–100 mm).
Results. Gross total tumour resection was performed in 14 (93%) cases, and subtotal in one (7%). A new deficit appeared in 83% (5/6) following a transparietal approach, in 14% (1/7) following a transtemporal approach, and in none of two patients following a transoccipital approach. Postoperative complications occurred in six (40%) patients; no patient died, but in two (13%) the new deficit was permanent. Tumour re-growth was found in two (13%) patients after 14 and 31 months. Meningiomas of WHO grade I occurred in 12, grade II in three, and grade III in one tumour recurrence. In long-term follow-up (mean: 60.8 months), including
the results of revision operations, KPS: 80–100 was in 13 (87%) patients, KPS: 50 in one (severe hemiparesis after revision) and one patient was lost to follow-up (KPS: 100 on discharge).
Conclusions. 20% of IVMs in our series were atypical. The results of surgery for IVMs, although satisfactory in general, require further improvement by reducing the rate of focal deficits resulting from a surgical approach.
Keywords
Intraventricular meningioma, surgical approach, morbidity, tumour recurrence
Title
Trigone ventricular meningiomas — clinical characteristics, histopathology and results of surgical treatment
Journal
Neurologia i Neurochirurgia Polska
Issue
Article type
Research Paper
Pages
34-42
Published online
2019-01-10
Page views
1271
Article views/downloads
1211
DOI
Pubmed
Bibliographic record
Neurol Neurochir Pol 2019;53(1):34-42.
Keywords
Intraventricular meningioma
surgical approach
morbidity
tumour recurrence
Authors
Kamil Leśniewski
Przemysław Kunert
Ewa Matyja
Tomasz Czernicki
Katarzyna Wójtowicz
Jakub Wojciechowski
Andrzej Marchel
- Shaw A. Fibrous tumor in the lateral ventricle of the brain, bony deposits in the arachnoid membrane of the right hemisphere. Transactions of the Pathological Society of London 1853. ; 5: 18–21.
- M'Dowall TW. Large Calcareous Tumour, Involving Chiefly the Inner and Middle Portions of the Left Temporo-Sphenoidal Lobe, and Pressing upon the Left Crus and Optic Thalamus. Edinb Med J. 1881; 26(12): 1088–1093.
- Meningiomas: Their Classification, Regional Behavior, Life History, and Surgical End Results. Archives of Neurology And Psychiatry. 1939; 41(3): 657.
- Pereira BJ, de Almeida AN, Paiva WS, et al. Natural history of intraventricular meningiomas: systematic review. Neurosurg Rev. 2018 [Epub ahead of print].
- Jennett B, Bond M. Assessment of outcome after severe brain damage. Lancet. 1975; 1(7905): 480–484.
- Karnofsky D, Burchenal J. The Clinical Evaluation of Chemotherapeutic Agents in Cancer. in: MacLeod C.M. Evaluation of Chemotherapeutic Agents. New York: Columbia University Press. ; 1949: 196–196.
- Fornari M, Savoiardo M, Morello G, et al. Meningiomas of the lateral ventricles. Neuroradiological and surgical considerations in 18 cases. J Neurosurg. 1981; 54(1): 64–74.
- Kloc W, Imieliński BL, Wasilewski W, et al. Meningiomas of the lateral ventricles of the brain in children. Childs Nerv Syst. 1998; 14(8): 350–353.
- Ødegaard KM, Helseth E, Meling TR. Intraventricular meningiomas: a consecutive series of 22 patients and literature review. Neurosurg Rev. 2013; 36(1): 57–64; discussion 64.
- Byard RW, Bourne AJ, Clark B, et al. Clinicopathological and radiological features of two cases of intraventricular meningioma in childhood. Pediatr Neurosci. 1989; 15(5): 260–264.
- Mircevski M, Mircevska D, Bojadziev I, et al. Surgical treatment of intraventricular meningiomas in childhood. Acta Neurochir Suppl (Wien). 1985; 35: 89–91.
- Bhatoe HS, Singh P, Dutta V. Intraventricular meningiomas: a clinicopathological study and review. Neurosurg Focus. 2006; 20(3): E9.
- Criscuolo GR, Symon L. Intraventricular meningioma. A review of 10 cases of the National Hospital, Queen Square (1974-1985) with reference to the literature. Acta Neurochir (Wien). 1986; 83(3-4): 83–91.
- Liu M, Wei Y, Liu Y, et al. Intraventricular meninigiomas: a report of 25 cases. Neurosurg Rev. 2006; 29(1): 36–40.
- Nakamura M, Roser F, Bundschuh O, et al. Intraventricular meningiomas: a review of 16 cases with reference to the literature. Surg Neurol. 2003; 59(6): 491–503; discussion 503.
- Zanini MA, Faleiros AT, Almeida CR, et al. Trigone ventricular meningiomas: surgical approaches. Arq Neuropsiquiatr. 2011; 69(4): 670–675.
- Ma J, Cheng L, Wang G, et al. Surgical management of meningioma of the trigone area of the lateral ventricle. World Neurosurg. 2014; 82(5): 757–769.
- Bertalanffy A, Roessler K, Koperek O, et al. Intraventricular meningiomas: a report of 16 cases. Neurosurg Rev. 2006; 29(1): 30–35.
- Lyngdoh BT, Giri PJ, Behari S, et al. Intraventricular meningiomas: a surgical challenge. J Clin Neurosci. 2007; 14(5): 442–448.
- Fu Z, Xu K, Xu B, et al. Lateral ventricular meningioma presenting with intraventricular hemorrhage: a case report and literature review. Int J Med Sci. 2011; 8(8): 711–716.
- Romeike BFM, Joellenbeck B, Skalej M, et al. Intraventricular meningioma with fatal haemorrhage: clinical and autopsy findings. Clin Neurol Neurosurg. 2007; 109(10): 884–887.
- Guidetti B, Delfini R, Gagliardi FM, et al. Meningiomas of the lateral ventricles. Clinical, neuroradiologic, and surgical considerations in 19 cases. Surg Neurol. 1985; 24(4): 364–370.
- Kawashima M, Li X, Rhoton AL, et al. Surgical approaches to the atrium of the lateral ventricle: microsurgical anatomy. Surg Neurol. 2006; 65(5): 436–445.
- Menon G, Nair S, Sudhir J, et al. Meningiomas of the lateral ventricle - a report of 15 cases. Br J Neurosurg. 2009; 23(3): 297–303.
- Frati A, Pesce A, D'Andrea G, et al. A purely functional Imaging based approach for transcortical resection of lesion involving the dominant atrium: Towards safer, imaging-guided, tailored cortico-leucotomies. J Clin Neurosci. 2018; 50: 252–261.
- Eliyas JK, Glynn R, Kulwin CG, et al. Minimally Invasive Transsulcal Resection of Intraventricular and Periventricular Lesions Through a Tubular Retractor System: Multicentric Experience and Results. World Neurosurg. 2016; 90: 556–564.