Angiomatous Meningiomas Have a Very Benign Outcome Despite Frequent Peritumoral Edema at Onset

World Neurosurg. 2017 Dec:108:465-473. doi: 10.1016/j.wneu.2017.08.096. Epub 2017 Aug 24.

Abstract

Objective: Angiomatous meningioma (AM) is a rare subtype of meningioma characterized by highly vascular tumor tissue comprising predominantly variable sized hyalinized blood vessels. The aim of this study is to evaluate the clinical radiologic features of AM and the long-term prognosis in a single neurosurgical center.

Methods: A total of 93 patients who underwent surgical resection of AMs between 2003 and 2008 were enrolled for analysis. Clinical information, treatment, and radiologic images were collected and analyzed; follow-up was carried out as well. Expression of estrogen receptor, progesterone receptor, and vascular endothelial growth factor was analyzed by immunohistochemistry.

Results: Forty-eight females and 45 males were identified. Forty-four patients (47.31%) manifested as hypersignal in T1-weighted imaging sequences and 68 (73.12%) as hypersignal in T2-weighted imaging, and a characteristic ringlike signal was observed in 28 patients (30.11%). Eighty-one cases (87.10%) showed different degrees of peritumor brain edema and it was significantly correlated with the vascular endothelial growth factor expression (P < 0.001). Simpson I resection was achieved in 63 patients (67.74%), grade II in 27 patients (29.03%), and grade III in 3 patients (3.23%). The extent of resection was not associated with the postoperative neurologic function (P = 0.546). Only 4 patients experienced recurrences during the follow-up and these 4 patients were stable until the last follow-up.

Conclusions: AMs were a special subtype of meningioma with distinctive radiologic features. AMs manifest benign behavior with a satisfying outcome, which makes Simpson grade II resection an option.

Keywords: Angiomatous meningioma; Clinical characteristic; Prognosis; Radiology.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Brain Edema / diagnostic imaging*
  • Brain Edema / etiology
  • Female
  • Follow-Up Studies
  • Humans
  • Immunohistochemistry
  • Magnetic Resonance Imaging
  • Male
  • Meningeal Neoplasms / complications
  • Meningeal Neoplasms / diagnostic imaging*
  • Meningeal Neoplasms / pathology
  • Meningeal Neoplasms / surgery*
  • Meningioma / complications
  • Meningioma / diagnostic imaging*
  • Meningioma / pathology
  • Meningioma / surgery*
  • Middle Aged
  • Prognosis
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Vascular Endothelial Growth Factor A / metabolism
  • Young Adult

Substances

  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A