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. 1999;9(3):227–238. doi: 10.1055/s-2008-1058151

Huge Meningiomas

A Review of 93 Cases

Metin Tuna, A Iskender Göçer, Yurdal Gezercan, Akin Vural, Faruk Ildan, Sebahattin Haciyakupoǧlu, Aşkin Karadayi
PMCID: PMC1656733  PMID: 17171094

Abstract

Between 1972 and 1996, 450 consecutive patients with intracranial meningiomas were operated on at Çukurova University School of Medicine. By size, intracranial meningiomas were classified as huge (>6 cm minimum diameter when extrapolated to anatomic size) or not huge (<6 cm). The present study involves 93 patients who underwent 109 craniotomies for the removal of huge meningiomas. All patients are adult, with 31 men and 62 women or a 1:2 male to female ratio, with a mean age of 48.7 ± 2.3 years at the time of diagnosis. The average duration of observed survival in 85 patients followed in the computed tomography (CT) era was 4.8 years and that of 8 patients in the pre-CT era was 8.8 years. Eleven patients died by the last follow-up assessment. Seventy-nine patients were still alive at the last follow-up assessment. The overall postoperative mortality rate was 3.2%. The overall recurrence rate was 19%. In descending order of frequency, the first five anatomic locations of the huge meningiomas were the parasagittal region in 18 patients (19.3%), the cerebral convexity in 15 (16.1%), the olfactory groove in 15 (16.1%), the falx in 12 (12.9%), and the tuberculum sellae in 11 (11.8%). The overall results of surgical treatment in 93 patients were total removal in 59 (63.4%), radical subtotal in 18 (18.3%), and subtotal in 16 (17.2%), with good outcome in 69 (74.1%), fair in 16 (17.2%), and poor in 5 (5.3%). In conclusion, the huge size of meningiomas affects the extent of removal, recurrence rate, postoperative outcome, operative morbidity and mortality rates, and survival time negatively.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Andrews B. T., Wilson C. B. Suprasellar meningiomas: the effect of tumor location on postoperative visual outcome. J Neurosurg. 1988 Oct;69(4):523–528. doi: 10.3171/jns.1988.69.4.0523. [DOI] [PubMed] [Google Scholar]
  2. Bonnal J., Brotchi J. Surgery of the superior sagittal sinus in parasagittal meningiomas. J Neurosurg. 1978 Jun;48(6):935–945. doi: 10.3171/jns.1978.48.6.0935. [DOI] [PubMed] [Google Scholar]
  3. Chan R. C., Thompson G. B. Morbidity, mortality, and quality of life following surgery for intracranial meningiomas. A retrospective study in 257 cases. J Neurosurg. 1984 Jan;60(1):52–60. doi: 10.3171/jns.1984.60.1.0052. [DOI] [PubMed] [Google Scholar]
  4. Chan R. C., Thompson G. B. Morbidity, mortality, and quality of life following surgery for intracranial meningiomas. A retrospective study in 257 cases. J Neurosurg. 1984 Jan;60(1):52–60. doi: 10.3171/jns.1984.60.1.0052. [DOI] [PubMed] [Google Scholar]
  5. Ehlers N., Malmros R. The suprasellar meningioma. A review of the literature and presentation of a series of 31 cases. Acta Ophthalmol Suppl. 1973:1–74. [PubMed] [Google Scholar]
  6. Fine M., Brazis P., Palacios E., Neri G. Computed tomography of sphenoid wing meningiomas: tumor location related to distal edema. Surg Neurol. 1980 May;13(5):385–390. [PubMed] [Google Scholar]
  7. Finn J. E., Mount L. A. Meningiomas of the tuberculum sellae and planum sphenoidale. A review of 83 cases. Arch Ophthalmol. 1974 Jul;92(1):23–27. doi: 10.1001/archopht.1974.01010010027007. [DOI] [PubMed] [Google Scholar]
  8. Gregorius F. K., Hepler R. S., Stern W. E. Loss and recovery of vision with suprasellar meningiomas. J Neurosurg. 1975 Jan;42(1):69–75. doi: 10.3171/jns.1975.42.1.0069. [DOI] [PubMed] [Google Scholar]
  9. Guidetti B., Ciappetta P., Domenicucci M. Tentorial meningiomas: surgical experience with 61 cases and long-term results. J Neurosurg. 1988 Aug;69(2):183–187. doi: 10.3171/jns.1988.69.2.0183. [DOI] [PubMed] [Google Scholar]
  10. Kadis G. N., Mount L. A., Ganti S. R. The importance of early diagnosis and treatment of the meningiomas of the planum sphenoidale and tuberculum sellae: a retrospective study of 105 cases. Surg Neurol. 1979 Nov;12(5):367–371. [PubMed] [Google Scholar]
  11. King D. L., Chang C. H., Pool J. L. Radiotherapy in the management of meningiomas. Acta Radiol Ther Phys Biol. 1966;5:26–33. doi: 10.3109/02841856609139540. [DOI] [PubMed] [Google Scholar]
  12. Quest D. O. Meningiomas: an update. Neurosurgery. 1978 Sep-Oct;3(2):219–225. doi: 10.1227/00006123-197809000-00016. [DOI] [PubMed] [Google Scholar]
  13. Rosenstein J., Symon L. Surgical management of suprasellar meningioma. Part 2: Prognosis for visual function following craniotomy. J Neurosurg. 1984 Oct;61(4):642–648. doi: 10.3171/jns.1984.61.4.0642. [DOI] [PubMed] [Google Scholar]
  14. SIMPSON D. The recurrence of intracranial meningiomas after surgical treatment. J Neurol Neurosurg Psychiatry. 1957 Feb;20(1):22–39. doi: 10.1136/jnnp.20.1.22. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Symon L., Rosenstein J. Surgical management of suprasellar meningioma. Part 1: The influence of tumor size, duration of symptoms, and microsurgery on surgical outcome in 101 consecutive cases. J Neurosurg. 1984 Oct;61(4):633–641. doi: 10.3171/jns.1984.61.4.0633. [DOI] [PubMed] [Google Scholar]
  16. Wara W. M., Sheline G. E., Newman H., Townsend J. J., Boldrey E. B. Radiation therapy of meningiomas. Am J Roentgenol Radium Ther Nucl Med. 1975 Mar;123(3):453–458. doi: 10.2214/ajr.123.3.453. [DOI] [PubMed] [Google Scholar]
  17. Yamashita J., Handa H., Iwaki K., Abe M. Recurrence of intracranial meningiomas, with special reference to radiotherapy. Surg Neurol. 1980 Jul;14(1):33–40. [PubMed] [Google Scholar]

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