Atypical meningiomas with multiple extracranial metastases: a case description.
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ABSTRACT:
SUBMITTER: Song Y
PROVIDER: S-EPMC10722037 | biostudies-literature | 2023 Dec
REPOSITORIES: biostudies-literature
Publications
Atypical meningiomas with multiple extracranial metastases: a case description.
Song Yipei Y Hu Mengyao M Wang Xiwen X Fang Qiming Q Xiao Xuan X Gong Lianggeng L
Quantitative imaging in medicine and surgery 20230918 12
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2014-05-08 | GSE50496 | GEO
Project description:Meningiomas represent the most common benign histological tumor of the central nervous system. Usually, meningiomas are intracranial, showing a typical dural tail sign on brain MRI with Gadolinium, but occasionally they can infiltrate the skull or be sited extracranially. We present a systematic review of the literature on extracranial meningiomas of the head and neck, along with an emblematic case of primary extracranial meningioma (PEM), which provides further insights into PEM management. A literature search according to the PRISMA statement was conducted from 1979 to June 2021 using PubMed, Web of Science, Google Scholar, and Scopus databases, searching for relevant Mesh terms (primary extracranial meningioma) AND (head OR neck). Data for all patients were recorded when available, including age, sex, localization, histological grading, treatment, possible recurrence, and outcome. A total of 83 published studies were identified through PubMed, Google Scholar, and Scopus databases, together with additional references list searches from 1979 to date. A total of 49 papers were excluded, and 34 manuscripts were considered for this systematic review, including 213 patients. We also reported a case of a 45-year-old male with an extracranial neck psammomatous meningioma with sizes of 4 cm × 3 cm × 2 cm. Furthermore, whole-body 68Ga-DOTATOC PET/CT was performed, excluding tumor spread to other areas. Surgical resection of the tumor was accomplished, as well as skin flap reconstruction, obtaining radical removal and satisfying wound healing. PEMs could suggest an infiltrative and aggressive behavior, which has never found a histopathological correlation with a malignancy (low Ki-67, <5%). Whole-body 68Ga-DOTATOC PET/CT should be considered in the patient's global assessment. Surgical removal is a resolutive treatment, and the examination of frozen sections can confirm the benignity of the lesion, reducing the extension of the removal of healthy tissue surrounding the tumor.
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Project description:This SuperSeries is composed of the SubSeries listed below. Refer to individual Series
2014-05-08 | E-GEOD-50496 | biostudies-arrayexpress
Project description:This SuperSeries is composed of the SubSeries listed below. Refer to individual Series
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Project description:Background Primary extracranial meningiomas (PEMs) of the sinonasal tract with no intracranial extension are rare. Our study presents the largest systematic review to date, providing a comprehensive overview and comparison of the characteristics, treatment, and prognosis of PEMs, with comparison to primary intracranial meningiomas (PIMs). Methods A systematic review was conducted according to the PRISMA guidelines on PubMed, Embase, and Google Scholar up to November 1, 2022. A total of 70 documented cases from 64 articles were included. Data analysis was performed to compare low-grade (World Health Organization [WHO] Grade I) and high-grade (Grade II, III) PEMs. Results Majority of patients were symptomatic with nasal symptoms (72.1%), followed by eye symptoms (41.2%) and facial swellings (41.2%). The nasal cavity was the most commonly affected site (70.0%). Most tumors were WHO Grade 1 (87.5%) with meningothelial histological subtype. PEMs have a predilection for involvement of surrounding structures, with more than half reporting erosion of sinonasal walls or orbital involvement (64.3%). Despite so, PEMs have a favorable prognosis, with high survival rates (95.3%) and low rate of recurrence (8.5%). Mainstay of treatment is surgical resection (98.6%). A total of 69/70 cases (98.6%) underwent surgical resection. Conclusions There are no clear defining clinical features of PEMs; hence, it is imperative for clinicians to prioritize histological diagnosis to guide further management. A conclusive diagnosis of PEMs, i.e., exclusion of PIMs, requires imaging and potential intraoperative assessment. Its prognosis is likely dependent on both WHO grading and the ability to achieve complete surgical extirpation. Endoscopic resection is recommended even in high-grade PEMs for localized and resectable disease. Radiotherapy may be reserved for unresectable or recurrent tumors as salvage therapy.
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Project description:Multiple extracranial metastases of recurrent glioblastoma are rare and often indicate a very poor prognosis. The main conventional treatments are chemotherapy, radiotherapy, chemoradiotherapy or antiangiogenic therapy. Median overall survival is 2.3 to 6 months after the detection of extracranial metastases, and to date, there is no effective treatment for these patients. Herein, we report a recurrent glioblastoma patient with lung metastasis treated with a combination therapy containing bevacizumab and pembrolizumab due to overexpression of PD-L1 and the absence of driver mutations. The progression-free survival was 11 months from lung metastases to bone metastases. This combination treatment was further used as maintenance therapy for another 11 months after bone metastasis and secondary dorsal metastasis because there was no suitable treatment alternative. The overall survival was 27 months after lung metastases, which is much longer than previously reported cases. To our knowledge, this was the first effective use of bevacizumab plus pembrolizumab in a glioblastoma patient with extracranial metastases. Furthermore, this was the first time that bevacizumab plus pembrolizumab was used as a maintenance treatment in glioblastoma, with 11 months of response. Importantly, we showed that such combination therapy may be a novel and effective therapy for glioblastoma patients with extracranial metastases.
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Project description:BackgroundAccounting for 15-20% of all meningiomas, WHO grade II meningiomas represent an intermediate group regarding risk of tumor recurrence. However, even within this subgroup varying clinical courses are observed with potential occurrence of multiple recurrences. Recently, DNA methylation profiles showed their value for distinguishing biological behaviors in meningiomas. Therefore, aim of this study was to investigate DNA methylation profiles in WHO grade II meningiomas.MethodsAll patients that underwent resection of WHO grade II meningiomas between 1993 and 2015 were screened for a dismal course clinical course with ≥2 recurrences. These were matched to control cases with benign clinical courses without tumor recurrence. DNA methylation was assessed using the Infinium Methylation EPIC BeadChip microarray. Unsupervised hierarchical clustering was performed for identification of DNA methylation profiles associated with such a dismal clinical course.ResultsOverall, 11 patients with WHO grade II meningiomas with ≥2 recurrences (Group dismal) and matched 11 patients without tumor recurrence (Group benign) were identified. DNA methylation profiles revealed 3 clusters-one comprising only patients of group dismal, a second cluster comprising mainly patients from group benign and a third cluster comprising one group dismal and one group benign patient. Based on differential methylation pattern associations with the Wnt and the related cadherin signaling pathway was observed.ConclusionDNA methylation clustering showed remarkable differences between two matched subgroups of WHO grade II meningiomas. Thus, DNA methylation profiles may have the potential to support prognostic considerations regarding meningioma recurrence and radiotherapeutic treatment allocation after surgical resection.
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