PROGNOSIS ACCORDING TO TREATMENT IN MALIGNANT MENINGIOMAPROGNOSIS ACCORDING TO TREATMENT IN MALIGNANT MENINGIOMAPrognosis according to treatment for malignant meningioma

Abstract

Objective : Malignant meningiomas comprise less than 10 % of all intracranial meningiomas and show atypical features in comparison with their benign counter part. Author investigated clinical characteristics, treatment modality and prognosis of pathologically proven malignant intracranial meningiomas and reviewed them with the relevant literatures. Methods : The author retrieved six cases of malignant meningiomas for recent six years which were operated and pathologically proved by way of medical records, radiological films, and pathological reports. Results : Six cases (5.6%) of malignant meningiomas were included in this study among a whole of 108 intracranial meningiomas. The average age was higher compared with the whole patients (60.6±2.71 vs. 47.2±1.52) and male to female ratio was 3 : 3. All tumors were found in supratentorial location (parasagittal : 4, convexity : 2). These showed radiologically specific features such as, indistinct margin, intratumoral necrosis, and severe peritumoral edema, unexceptionally. Gross total resection was achieved in 4 cases, whereas 2 cases was not due to sinus invasion. Four patients received postoperative irradiation and their mean follow-up period has been 52.1±1.25 months. Those who were not irradiated expired at postoperative 12th and 32th months. Conclusions : Radiological findings, such as, intratumoral necrosis and severe peritumoral edema as well as clinical features of rapid growth, high recurrence rate, and intractability to treatment strongly suggest the possibility of malignant tumor. Under these circumstances, surgeons should endeavor to total resection and close surveillance. Aggressive management with postoperative radiation to the residual / recurrent tumor could lengthen the patients' survival.