Artikel
Tumourous infiltration of split calvarial bone graft after reconstruction in sphenoid wing meningioma
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Veröffentlicht: | 8. Juni 2016 |
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Objective: Operative treatment of sphenoid wing meningeomas with extensive osseous involvement is characterized by operative decompression comprising resection of the lateral and superior orbital wall. Split calvarial bone graft for reconstruction has become an established method to achieve a good functional as well as cosmetic outcome. Nevertheless, this technique harbors the risk of reinfiltration by recurring or regrowing meningioma. The aim of the present study was to elucidate the impact of infiltration of split calvarial bone graft during follow-up.
Method: We retrospectively reviewed the data of all patients operated in our institution due to sphenoid wing meningeomas with bony reconstruction using split calvarial bone graft between 2000 and 2015. All cases with recurring or regrowing meningeomas were identified. Basic clinical data, like age, sex and time of follow-up were evaluated using descriptive statistics.
Results: In 29 patients bony reconstruction using split calvarial bone graft was performed after tumor resection, comprising 6 male and 23 female patients. Mean age at diagnosis was 55.7 years. Median follow-up time was 44 months. In all patients histopathological workup revealed WHO grade I meningeoma. No patients received adjuvant radiation. Three (10,3%) patients revealed tumour recurrence after gross total resection involving hitherto tumor free bone graft. Time to recurrence ranged between 28 and 67 months. Patients that developed a recurrence were significantly younger (p=0.006) than those that didn't. Histopathological workup confirmed meningioma within the bone graft. Reoperation comprised removal of the bone graft and reconstruction by titan mesh if necessary.
Conclusions: One has to be aware of the possibility of tumorous infiltration of split calvarial bone graft used for reconstruction after sphenoid wing meningioma. In younger patients with longer life expectancy it might be reasonable not to use autologous bone material to prevent tumorous infiltration.