Ahead of Print: Intracranial Papillary Meningioma

Screen Shot 2013-09-10 at 11.31.11 AMBackground: Papillary meningioma (PM) is an uncommon meningioma subtype and the clinical characteristics remain unclear.

Objective: To determine the clinical characteristics and prognosis of PM.

Methods: The clinical data of thirty PM patients were collected, the samples were re-examined, and their prognoses were based on clinical observations and were calculated according to the Kaplan-Meier method.

Results: The 30 patients included 16 males and 14 females (median: 34.0 years upon initial diagnosis). Of the 48 intracranial operations in the 30 patients, total removal (TR) was attained in 34 surgeries, and subtotal removal (STR) in 14 surgeries. Radiotherapy was provided in 20 patients. In 40 specimens with follow-up, 29 attained the positive aggressive factors. Six tumours showed positive PR combined with negative Bcl-2. The median follow-up period was 39.0 months. Tumour recurrence occurred in 18 patients (median: 17.0 months); the recurrence rates following TR and STR were 57.1% and 100%, respectively. Fourteen patients died from the recurrence. In the univariate analyses, positive aggressive factors (p=0.021), positive PR combined with negative Bcl-2 immunoreactivity (p=0.011), the extent of resection (p=0.001), and radiotherapy (p=0.002) were significantly related to progress-free survival (PFS). The MIB-1 LI was not significantly related to PFS (p=0.88).

Conclusion: PM is a rare subtype of meningioma with a tendency of recurrence. The extent of resection is an important prognosis factor. The presence of positive histopathological index increases the recurrence risk. Positive PR combined with negative Bcl-2 immunoreaction might predict a good prognosis. Postoperative radiotherapy may play a vital role in prolonging time to tumour recurrence.

From: Intracranial Papillary Meningioma: A Clinicopathologic Study of 30 Cases at a Single Institution by Wang et al.

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