gms | German Medical Science

Objective: Meningioma of the cranio-cervical junction demands thorough surgical planning as the radical excision of these tumors, especially of the anterior portions, may be limited. Recurrence is therefore believed to be most likely due to the regrowth of residual tumor. By now histological analyses for this subgroup have not been correlated with their clinical course and this probably explains an unusual high recurrence rate.

Methods: From our single institution databank 20 patients with cranio-cervical meningioma (foramen magnum and C0-C2) operated on between 1997 and 2009 were found and analyzed for their clinical data, histology and MIB-1 immunoreactivity.

Results: There were 15 female and 5 male patients aged 26–79 years (mean 58.8yrs). According to the WHO-grading, all tumors were found to be grade I. Histological subtypes included meningotheliomatous (15), transitional (3) and fibrocytic (2) meningiomas. MIB-1 labeling index (range between 1.5–31%) was found to be elevated (15.3%) significantly when compared to an age and gender matched control group (4.6%). Recurrence was seen in two cases after 3 and 8 years but was not related to incomplete resection, their histological results and MIB-1 data.

Conclusions: High MIB-1 levels in meningiomas of the cranio-cervical junction are striking in our study group. Therefore immunochemistry and incomplete resection may both be important factors influencing the clinical course. We regard cranio-cervical meningiomas as a distinctive subgroup of meningioma due to their high MIB-1 levels and their surgically challenging location.