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Published in: Acta Neurochirurgica 3/2011

01-03-2011 | Clinical Article

Secretory meningiomas: systematic analysis of epidemiological, clinical, and radiological features

Authors: Marcel Alexander Kamp, Kerim Beseoglu, Sven Eicker, Hans-Jakob Steiger, Daniel Hänggi

Published in: Acta Neurochirurgica | Issue 3/2011

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Abstract

Background

Secretory meningiomas are known as a rare histological subtype within the meningioma family. In contrast to benign intracranial meningiomas, they are dreaded for causing an extensive perifocal cerebral tumor edema and life-threatening complications. The objective of the present study is a systematic, retrospective analysis of epidemiological, clinical, and radiological features of secretory meningiomas to predict potential patterns prior to surgery to reduce associated morbidity.

Material and methods

A systematic database search of PubMed with review of the literature was performed to identify clinical studies analyzing epidemiological, clinical, and radiological features of secretory meningiomas. Additionally, we supplemented our series of 17 patients with secretory meningiomas. Studies with available information for each patient were statistically metaanalyzed.

Results

In summary, seven large series with a total number of 120 patients were identified, containing detailed information about epidemiological, clinical, and radiological features of secretory meningiomas. Epidemiologically, female predominance was a characteristic. Peritumoral brain edema occurred in about 70% of patients and holohemispheric in more than 50% of patients. Life-threatening complications and severe neurological deficits frequently occur potentially due to extensive peritumoral brain edema. At last, frontal location and age older than 66 years significantly correlated with the development of peritumoral brain edema.

Conclusion

Secretory meningiomas are histologically benign tumors and are therefore associated with an excellent prognosis. Nevertheless, frequently life-threatening complications due to the development of an extensive peritumoral brain edema are documented. Predictive risk factors are frontal tumor location, increasing age, and visible pial tumor vessel supply. A careful preoperative evaluation, identification of risk factors, and a specific therapy might reduce perioperative morbidity.
Literature
1.
go back to reference Abe T, Black PM, Ojemann RG, Hedley-White ET (1994) Cerebral edema in intracranial meningiomas: evidence for local and diffuse patterns and factors associated with its occurrence. Surg Neurol 42(6):471–475CrossRefPubMed Abe T, Black PM, Ojemann RG, Hedley-White ET (1994) Cerebral edema in intracranial meningiomas: evidence for local and diffuse patterns and factors associated with its occurrence. Surg Neurol 42(6):471–475CrossRefPubMed
2.
go back to reference Alguacil-Garcia A, Pettigrew NM, Sima AA (1986) Secretory meningioma. A distinct subtype of meningioma. Am J Surg Pathol 10(2):102–111CrossRefPubMed Alguacil-Garcia A, Pettigrew NM, Sima AA (1986) Secretory meningioma. A distinct subtype of meningioma. Am J Surg Pathol 10(2):102–111CrossRefPubMed
3.
go back to reference Assi A, Declich P, Iacobellis M, Cozzi L, Tonnarelli G (1999) Secretory meningioma, a rare meningioma subtype with characteristic glandular differentation: an histological and immunohistochemical study of 9 cases. Adv Clin Pathol 3(3):47–53 Assi A, Declich P, Iacobellis M, Cozzi L, Tonnarelli G (1999) Secretory meningioma, a rare meningioma subtype with characteristic glandular differentation: an histological and immunohistochemical study of 9 cases. Adv Clin Pathol 3(3):47–53
4.
go back to reference Bitzer M, Wockel L, Luft AR, Wakhloo AK, Petersen D, Opitz H, Sievert T, Ernemann U, Voigt K (1997) The importance of pial blood supply to the development of peritumoral brain edema in meningiomas. J Neurosurg 87(3):368–373CrossRefPubMed Bitzer M, Wockel L, Luft AR, Wakhloo AK, Petersen D, Opitz H, Sievert T, Ernemann U, Voigt K (1997) The importance of pial blood supply to the development of peritumoral brain edema in meningiomas. J Neurosurg 87(3):368–373CrossRefPubMed
5.
go back to reference Bitzer M, Topka H, Morgalla M, Friese S, Wockel L, Voigt K (1998) Tumor-related venous obstruction and development of peritumoral brain edema in meningiomas. Neurosurgery 42(4):730–737CrossRefPubMed Bitzer M, Topka H, Morgalla M, Friese S, Wockel L, Voigt K (1998) Tumor-related venous obstruction and development of peritumoral brain edema in meningiomas. Neurosurgery 42(4):730–737CrossRefPubMed
6.
go back to reference Boviatsis EJ, Bouras TI, Kouyialis AT, Themistocleous MS, Sakas DE (2007) Impact of age on complications and outcome in meningioma surgery. Surg Neurol 68(4):407–411CrossRefPubMed Boviatsis EJ, Bouras TI, Kouyialis AT, Themistocleous MS, Sakas DE (2007) Impact of age on complications and outcome in meningioma surgery. Surg Neurol 68(4):407–411CrossRefPubMed
7.
go back to reference Bright R (1831) Reports of medical cases, selected with a view of illustrating the symptoms and cure of disease by a reference to morbid anatomy, volume 2. Longman, London Bright R (1831) Reports of medical cases, selected with a view of illustrating the symptoms and cure of disease by a reference to morbid anatomy, volume 2. Longman, London
8.
go back to reference Buhl R, Hugo HH, Mehdorn HM (2001) Brain oedema in secretory meningiomas. J Clin Neurosci 8(Suppl 1):19–21CrossRefPubMed Buhl R, Hugo HH, Mehdorn HM (2001) Brain oedema in secretory meningiomas. J Clin Neurosci 8(Suppl 1):19–21CrossRefPubMed
9.
go back to reference Buhl R, Hugo HH, Mihajlovic Z, Mehdorn HM (2001) Secretory meningiomas: clinical and immunohistochemical observations. Neurosurgery 48(2):297–301CrossRefPubMed Buhl R, Hugo HH, Mihajlovic Z, Mehdorn HM (2001) Secretory meningiomas: clinical and immunohistochemical observations. Neurosurgery 48(2):297–301CrossRefPubMed
10.
go back to reference Colakoglu N, Demirtas E, Oktar N, Yuntem N, Islekel S, Ozdamar N (2003) Secretory meningiomas. J Neurooncol 62(3):233–241CrossRefPubMed Colakoglu N, Demirtas E, Oktar N, Yuntem N, Islekel S, Ozdamar N (2003) Secretory meningiomas. J Neurooncol 62(3):233–241CrossRefPubMed
11.
go back to reference Constantini S, Tamir J, Gomori MJ, Shohami E (1993) Tumor prostaglandin levels correlate with edema around supratentorial meningiomas. Neurosurgery 33(2):204–210CrossRefPubMed Constantini S, Tamir J, Gomori MJ, Shohami E (1993) Tumor prostaglandin levels correlate with edema around supratentorial meningiomas. Neurosurgery 33(2):204–210CrossRefPubMed
12.
go back to reference Cushing H, Eisenhardt L (1938) Meningiomas: their classification, regional behaviour, life history and surgical end results. Charles C. Thomas, Springfield Cushing H, Eisenhardt L (1938) Meningiomas: their classification, regional behaviour, life history and surgical end results. Charles C. Thomas, Springfield
13.
go back to reference de Vries J, Wakhloo AK (1993) Cerebral oedema associated with WHO-I, WHO-II, and WHO-III-meningiomas: correlation of clinical, computed tomographic, operative and histological findings. Acta Neurochir (Wien) 125(1-4):34–40CrossRef de Vries J, Wakhloo AK (1993) Cerebral oedema associated with WHO-I, WHO-II, and WHO-III-meningiomas: correlation of clinical, computed tomographic, operative and histological findings. Acta Neurochir (Wien) 125(1-4):34–40CrossRef
14.
go back to reference Go KG, Wilmink JT, Molenaar WM (1988) Peritumoral brain edema associated with meningiomas. Neurosurgery 23(2):175–179CrossRefPubMed Go KG, Wilmink JT, Molenaar WM (1988) Peritumoral brain edema associated with meningiomas. Neurosurgery 23(2):175–179CrossRefPubMed
15.
go back to reference Go KG, Kamman RL, Wilmink JT, Mooyaart EL (1994) A study on peritumoral brain edema around meningiomas by MRI and contrast CT. Acta Neurochir Suppl (Wien) 60:365–368 Go KG, Kamman RL, Wilmink JT, Mooyaart EL (1994) A study on peritumoral brain edema around meningiomas by MRI and contrast CT. Acta Neurochir Suppl (Wien) 60:365–368
16.
go back to reference Gurkanlar D, Er U, Sanli M, Ozkan M, Sekerci Z (2005) Peritumoral brain edema in intracranial meningiomas. J Clin Neurosci 12(7):750–753CrossRefPubMed Gurkanlar D, Er U, Sanli M, Ozkan M, Sekerci Z (2005) Peritumoral brain edema in intracranial meningiomas. J Clin Neurosci 12(7):750–753CrossRefPubMed
17.
go back to reference Inamura T, Nishio S, Takeshita I, Fujiwara S, Fukui M (1992) Peritumoral brain edema in meningiomas–influence of vascular supply on its development. Neurosurgery 31(2):179–185CrossRefPubMed Inamura T, Nishio S, Takeshita I, Fujiwara S, Fukui M (1992) Peritumoral brain edema in meningiomas–influence of vascular supply on its development. Neurosurgery 31(2):179–185CrossRefPubMed
18.
go back to reference KEPES J (1961) Observations on the formation of psammoma bodies and pseudopsammoma bodies in meningiomas. J Neuropathol Exp Neurol 20:255–262CrossRefPubMed KEPES J (1961) Observations on the formation of psammoma bodies and pseudopsammoma bodies in meningiomas. J Neuropathol Exp Neurol 20:255–262CrossRefPubMed
19.
go back to reference Kilic T, Bayri Y, Ozduman K, Acar M, Diren S, Kurtkaya O, Ekinci G, Bugra K, Sav A, Ozek MM, Pamir MN (2002) Tenascin in meningioma: expression is correlated with anaplasia, vascular endothelial growth factor expression, and peritumoral edema but not with tumor border shape. Neurosurgery 51(1):183–192CrossRefPubMed Kilic T, Bayri Y, Ozduman K, Acar M, Diren S, Kurtkaya O, Ekinci G, Bugra K, Sav A, Ozek MM, Pamir MN (2002) Tenascin in meningioma: expression is correlated with anaplasia, vascular endothelial growth factor expression, and peritumoral edema but not with tumor border shape. Neurosurgery 51(1):183–192CrossRefPubMed
20.
go back to reference Lee KJ, Joo WI, Rha HK, Park HK, Chough JK, Hong YK, Park CK (2008) Peritumoral brain edema in meningiomas: correlations between magnetic resonance imaging, angiography, and pathology. Surg Neurol 69(4):350–355CrossRefPubMed Lee KJ, Joo WI, Rha HK, Park HK, Chough JK, Hong YK, Park CK (2008) Peritumoral brain edema in meningiomas: correlations between magnetic resonance imaging, angiography, and pathology. Surg Neurol 69(4):350–355CrossRefPubMed
21.
go back to reference Li XJ, Zhang HY, Lang ZQ, Wei B, Chen HJ, Bu H (2006) [Analysis of clinical and pathological features of secretory meningiomas]. Sichuan Da Xue Xue Bao Yi Xue Ban 37(3):488–491PubMed Li XJ, Zhang HY, Lang ZQ, Wei B, Chen HJ, Bu H (2006) [Analysis of clinical and pathological features of secretory meningiomas]. Sichuan Da Xue Xue Bao Yi Xue Ban 37(3):488–491PubMed
22.
go back to reference Lobato RD, Alday R, Gomez PA, Rivas JJ, Dominguez J, Cabrera A, Madero S, Ayerbe J (1996) Brain oedema in patients with intracranial meningioma. Correlation between clinical, radiological, and histological factors and the presence and intensity of oedema. Acta Neurochir (Wien) 138(5):485–493CrossRef Lobato RD, Alday R, Gomez PA, Rivas JJ, Dominguez J, Cabrera A, Madero S, Ayerbe J (1996) Brain oedema in patients with intracranial meningioma. Correlation between clinical, radiological, and histological factors and the presence and intensity of oedema. Acta Neurochir (Wien) 138(5):485–493CrossRef
23.
go back to reference Nakasu S, Nakasu Y, Nakajima M, Matsuda M, Handa J (1999) Preoperative identification of meningiomas that are highly likely to recur. J Neurosurg 90(3):455–462CrossRefPubMed Nakasu S, Nakasu Y, Nakajima M, Matsuda M, Handa J (1999) Preoperative identification of meningiomas that are highly likely to recur. J Neurosurg 90(3):455–462CrossRefPubMed
24.
go back to reference Nishio S, Morioka T, Suzuki S, Hirano K, Fukui M (2001) Secretory meningioma: clinicopathologic features of eight cases. J Clin Neurosci 8(4):335–339CrossRefPubMed Nishio S, Morioka T, Suzuki S, Hirano K, Fukui M (2001) Secretory meningioma: clinicopathologic features of eight cases. J Clin Neurosci 8(4):335–339CrossRefPubMed
25.
go back to reference Paek SH, Kim CY, Kim YY, Park IA, Kim MS, Kim DG, Jung HW (2002) Correlation of clinical and biological parameters with peritumoral edema in meningioma. J Neurooncol 60(3):235–245CrossRefPubMed Paek SH, Kim CY, Kim YY, Park IA, Kim MS, Kim DG, Jung HW (2002) Correlation of clinical and biological parameters with peritumoral edema in meningioma. J Neurooncol 60(3):235–245CrossRefPubMed
26.
go back to reference Park KJ, Kang SH, Chae YS, Yu MO, Cho TH, Suh JK, Lee HK, Chung YG (2009) Influence of interleukin-6 on the development of peritumoral brain edema in meningiomas. J Neurosurg 112:73–80 Park KJ, Kang SH, Chae YS, Yu MO, Cho TH, Suh JK, Lee HK, Chung YG (2009) Influence of interleukin-6 on the development of peritumoral brain edema in meningiomas. J Neurosurg 112:73–80
27.
go back to reference Philippon J, Foncin JF, Grob R, Srour A, Poisson M, Pertuiset BF (1984) Cerebral edema associated with meningiomas: possible role of a secretory-excretory phenomenon. Neurosurgery 14(3):295–301CrossRefPubMed Philippon J, Foncin JF, Grob R, Srour A, Poisson M, Pertuiset BF (1984) Cerebral edema associated with meningiomas: possible role of a secretory-excretory phenomenon. Neurosurgery 14(3):295–301CrossRefPubMed
28.
go back to reference Probst-Cousin S, Villagran-Lillo R, Lahl R, Bergmann M, Schmid KW, Gullotta F (1997) Secretory meningioma: clinical, histologic, and immunohistochemical findings in 31 cases. Cancer 79(10):2003–2015CrossRefPubMed Probst-Cousin S, Villagran-Lillo R, Lahl R, Bergmann M, Schmid KW, Gullotta F (1997) Secretory meningioma: clinical, histologic, and immunohistochemical findings in 31 cases. Cancer 79(10):2003–2015CrossRefPubMed
29.
go back to reference Radley MG, di Sant’Agnese PA, Eskin TA, Wilbur DC (1989) Epithelial differentiation in meningiomas. An immunohistochemical, histochemical, and ultrastructural study—with review of the literature. Am J Clin Pathol 92(3):266–272PubMed Radley MG, di Sant’Agnese PA, Eskin TA, Wilbur DC (1989) Epithelial differentiation in meningiomas. An immunohistochemical, histochemical, and ultrastructural study—with review of the literature. Am J Clin Pathol 92(3):266–272PubMed
30.
go back to reference Regelsberger J, Hagel C, Emami P, Ries T, Heese O, Westphal M (2008) Secretory meningiomas: a benign subgroup causing life-threatening complications. Neuro Oncol 11:819–824CrossRef Regelsberger J, Hagel C, Emami P, Ries T, Heese O, Westphal M (2008) Secretory meningiomas: a benign subgroup causing life-threatening complications. Neuro Oncol 11:819–824CrossRef
31.
go back to reference Rohringer M, Sutherland GR, Louw DF, Sima AA (1989) Incidence and clinicopathological features of meningioma. J Neurosurg 71(5 Pt 1):665–672PubMed Rohringer M, Sutherland GR, Louw DF, Sima AA (1989) Incidence and clinicopathological features of meningioma. J Neurosurg 71(5 Pt 1):665–672PubMed
32.
go back to reference Salpietro FM, Alafaci C, Lucerna S, Iacopino DG, Todaro C, Tomasello F (1994) Peritumoral edema in meningiomas: microsurgical observations of different brain tumor interfaces related to computed tomography. Neurosurgery 35(4):638–641CrossRefPubMed Salpietro FM, Alafaci C, Lucerna S, Iacopino DG, Todaro C, Tomasello F (1994) Peritumoral edema in meningiomas: microsurgical observations of different brain tumor interfaces related to computed tomography. Neurosurgery 35(4):638–641CrossRefPubMed
33.
go back to reference Shivane AG, Chakrabarty A, Baborie A, Thiryayi W, Donaldson MH, Ross S (2006) A rare case of recurrent secretory meningioma with malignant transformation. Br J Neurosurg 20(4):250–253CrossRefPubMed Shivane AG, Chakrabarty A, Baborie A, Thiryayi W, Donaldson MH, Ross S (2006) A rare case of recurrent secretory meningioma with malignant transformation. Br J Neurosurg 20(4):250–253CrossRefPubMed
34.
go back to reference Simis A, Pires de Aguiar PH, Leite CC, Santana PA Jr, Rosemberg S, Teixeira MJ (2008) Peritumoral brain edema in benign meningiomas: correlation with clinical, radiologic, and surgical factors and possible role on recurrence. Surg Neurol 70(5):471–477CrossRefPubMed Simis A, Pires de Aguiar PH, Leite CC, Santana PA Jr, Rosemberg S, Teixeira MJ (2008) Peritumoral brain edema in benign meningiomas: correlation with clinical, radiologic, and surgical factors and possible role on recurrence. Surg Neurol 70(5):471–477CrossRefPubMed
35.
go back to reference Tamiya T, Ono Y, Matsumoto K, Ohmoto T (2001) Peritumoral brain edema in intracranial meningiomas: effects of radiological and histological factors. Neurosurgery 49(5):1046–1051CrossRefPubMed Tamiya T, Ono Y, Matsumoto K, Ohmoto T (2001) Peritumoral brain edema in intracranial meningiomas: effects of radiological and histological factors. Neurosurgery 49(5):1046–1051CrossRefPubMed
36.
go back to reference Tanaka M, Imhof HG, Schucknecht B, Kollias S, Yonekawa Y, Valavanis A (2006) Correlation between the efferent venous drainage of the tumor and peritumoral edema in intracranial meningiomas: superselective angiographic analysis of 25 cases. J Neurosurg 104(3):382–388CrossRefPubMed Tanaka M, Imhof HG, Schucknecht B, Kollias S, Yonekawa Y, Valavanis A (2006) Correlation between the efferent venous drainage of the tumor and peritumoral edema in intracranial meningiomas: superselective angiographic analysis of 25 cases. J Neurosurg 104(3):382–388CrossRefPubMed
37.
go back to reference Tirakotai W, Mennel HD, Celik I, Hellwig D, Bertalanffy H, Riegel T (2006) Secretory meningioma: immunohistochemical findings and evaluation of mast cell infiltration. Neurosurg Rev 29(1):41–48CrossRefPubMed Tirakotai W, Mennel HD, Celik I, Hellwig D, Bertalanffy H, Riegel T (2006) Secretory meningioma: immunohistochemical findings and evaluation of mast cell infiltration. Neurosurg Rev 29(1):41–48CrossRefPubMed
38.
go back to reference Tsuzuki N, Nakau H, Sugaya M, Hashizume K, Matsukuma S, Wada R, Kuwabara N (1997) Secretory meningioma with severe perifocal edema–case report. Neurol Med Chir (Tokyo) 37(8):620–623CrossRef Tsuzuki N, Nakau H, Sugaya M, Hashizume K, Matsukuma S, Wada R, Kuwabara N (1997) Secretory meningioma with severe perifocal edema–case report. Neurol Med Chir (Tokyo) 37(8):620–623CrossRef
39.
40.
go back to reference Wolfsberger S, Doostkam S, Boecher-Schwarz HG, Roessler K, van Trotsenburg M, Hainfellner JA, Knosp E (2004) Progesterone-receptor index in meningiomas: correlation with clinico-pathological parameters and review of the literature. Neurosurg Rev 27(4):238–245CrossRefPubMed Wolfsberger S, Doostkam S, Boecher-Schwarz HG, Roessler K, van Trotsenburg M, Hainfellner JA, Knosp E (2004) Progesterone-receptor index in meningiomas: correlation with clinico-pathological parameters and review of the literature. Neurosurg Rev 27(4):238–245CrossRefPubMed
41.
go back to reference Yoshioka H, Hama S, Taniguchi E, Sugiyama K, Arita K, Kurisu K (1999) Peritumoral brain edema associated with meningioma: influence of vascular endothelial growth factor expression and vascular blood supply. Cancer 85(4):936–944CrossRefPubMed Yoshioka H, Hama S, Taniguchi E, Sugiyama K, Arita K, Kurisu K (1999) Peritumoral brain edema associated with meningioma: influence of vascular endothelial growth factor expression and vascular blood supply. Cancer 85(4):936–944CrossRefPubMed
Metadata
Title
Secretory meningiomas: systematic analysis of epidemiological, clinical, and radiological features
Authors
Marcel Alexander Kamp
Kerim Beseoglu
Sven Eicker
Hans-Jakob Steiger
Daniel Hänggi
Publication date
01-03-2011
Publisher
Springer Vienna
Published in
Acta Neurochirurgica / Issue 3/2011
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-010-0914-0

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