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60th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Benelux countries and Bulgaria

German Society of Neurosurgery (DGNC)

24 - 27 May 2009, Münster

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The determination of specific clinical and surgical risk factors in patients with secretory meningiomas: experience from a series of 11 patients

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  • M. Kamp - Neurochirurgische Klinik, Heinrich-Heine-Universität, Düsseldorf
  • K. Beseoglu - Neurochirurgische Klinik, Heinrich-Heine-Universität, Düsseldorf
  • P. Slotty - Neurochirurgische Klinik, Heinrich-Heine-Universität, Düsseldorf
  • S. Eicker - Neurochirurgische Klinik, Heinrich-Heine-Universität, Düsseldorf
  • H.-J. Steiger - Neurochirurgische Klinik, Heinrich-Heine-Universität, Düsseldorf
  • D. Hänggi - Neurochirurgische Klinik, Heinrich-Heine-Universität, Düsseldorf

Deutsche Gesellschaft für Neurochirurgie. 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien. Münster, 24.-27.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocP12-10

doi: 10.3205/09dgnc384, urn:nbn:de:0183-09dgnc3844

Published: May 20, 2009

© 2009 Kamp et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: Secretory meningiomas are known as a rare and benign histological subtype within the meningioma family. Radiologically these tumors tend to develop extensive peritumoral edema. The goal of the present study was to determine specific clinical and surgical risk factors in patients with secretory meningiomas.

Methods: All patients treated for a meningioma at our department from January 2003 to November 2008 were retrospectively reviewed for the histological diagnosis of a secretory meningioma. In patients with a confirmed secretory meningioma the clinical, radiological, histopathological, and postoperative course was analyzed.

Results: Out of 808 meningioma cases which underwent surgical treatment 11 patients showed a histologically confirmed secretory meningioma. The female:male ratio was 8:3, the mean age 65y (range 41–74y). Tumors were located at the convexity (n=4), the sphenoid wing (n=3), the orbital roof (n=1), the tuberculum sellae (n=1) and infratentorial (n=2). Histologically, all tumors showed PAS-positive pseudopsammoma bodies. The MIB-1 antibody staining index was <5% in 10 tumors. One meningioma had a higher proliferative activity and an infiltrative growth pattern. Complete resection (Simpson °I or II) could be achieved in 8 cases. Interestingly, in contrast to meningiomas of the convexity, postoperative complications occurred in most patients with basal or posterior fossa secretory meningiomas. The patient with an infiltrative, highly proliferative meningioma of the orbital roof developed extensive postoperative edema and needed a decompressive craniectomy. The other patients with complications had diplopia (n=4, 2 patients with a pterional, 1 with an infratentorial and 1 with the orbital roof meningioma) or temporary aphasia (n=1; pterional meningioma). At the time of discharge, the neurological deficits of all patients had recovered except for 3 patients who had persistent slight diplopia. The postoperative stay was significantly shorter for patients with a secretory meningioma of the convexity than for other localizations.

Conclusions: The present study demonstrates that basal secretory meningiomas are frequently associated with postoperative complications due to an extensive edema. Therefore careful preoperative radiological analysis and anti-edematous therapy followed by close monitoring on an intensive care unit seem to be necessary to reduce severe complications.