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67th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Korean Neurosurgical Society (KNS)

German Society of Neurosurgery (DGNC)

12 - 15 June 2016, Frankfurt am Main

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Secretory meningiomas: Increased prevalence of seizures due to edema formation in a rare histological subtype

Meeting Abstract

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  • Malte Mohme - Department of Neurosurgery, University Medical Center Hamburg Eppendorf, Hamburg, Germany
  • Pedram Emami - Department of Neurosurgery, University Medical Center Hamburg Eppendorf, Hamburg, Germany
  • Jan Regelsberger - Department of Neurosurgery, University Medical Center Hamburg Eppendorf, Hamburg, Germany
  • Jakob Matschke - Institute for Neuropathology, University Medical Center Hamburg Eppendorf, Hamburg, Germany
  • Manfred Westphal - Department of Neurosurgery, University Medical Center Hamburg Eppendorf, Hamburg, Germany
  • Sven Oliver Eicker - Department of Neurosurgery, University Medical Center Hamburg Eppendorf, Hamburg, Germany

Deutsche Gesellschaft für Neurochirurgie. 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS). Frankfurt am Main, 12.-15.06.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocMI.18.06

doi: 10.3205/16dgnc347, urn:nbn:de:0183-16dgnc3476

Published: June 8, 2016

© 2016 Mohme et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: Secretory meningioma (SM) is a rare histological subtype known to cause disproportional peritumoral brain edema. Although meningiomas are defined by slow-growth and mostly present with benign clinical symptoms, SM can cause life-threatening symptoms. The aim of this study is to characterize the potential pitfalls in treatment of SM by illustrating their characteristic clinical features.

Method: We analyzed sixty-nine SM patients operated at our institution between 1988 and 2015 and compared them to a matched non-secretory meningioma (nonSM) cohort of fifty patients. Retrospective data were analyzed for frequency of seizures as first presenting symptom, maximum corticosteroid use, intensive care unit- and hospital stay. In addition, histological and radiographic data were evaluated for extent of peritumoral brain edema formation, tumor location and -size, in correlation to clinical presentation.

Results: Seizures were seen at a significantly higher rate as first presenting symptom leading to clinical admission in patients with SM (33.3%), compared to the matched nonSM cohort (14%, p = 0.019). In SM patients seizures were associated with increased edema formation, while seizures in nonSM rather correlated with tumor size. The clinically complicated course in SM patients was reflected by increased demand for corticosteroids and an increase intensive care unit stay (5.73 vs 1.16 days, p = < 0.001). SM further showed a higher recurrence rate of 35.9%, compared to a 13.4% recurrence rate in a non-matched cohort of 320 WHO °I meningiomas resected at our institution.

Conclusions: Our results illustrate the complicated clinical course of this rare histological meningioma subtype. The increased frequency of seizures may enable raised awareness early at clinical admission and sensitize for potential complications and treatment adjustments pre- and postoperatively.