Clinicopathological study of Meningiomas in a tertiary care center

Abstract

Meningiomas are a group of common, predominantly benign and slow growing tumours of the meninges. The revised 4th edition of WHO classification of Central Nervous system tumours (2016) has classified them into Grades I, II and III based on their biological behaviour as well as proliferative potential. Recurrence and brain invasion are commonly considered to be found in higher grades. Recent studies have shown that high grade tumours have also been associated with clinical findings such as peri-tumoural brain edema. The purpose of the grading system is to aid in formulating an appropriate management plan. The aim of our study was to analyse the clinical and histomorphological features of meningiomas and evaluate the impact of the current grading system in tumour prognosis. A total of 60 cases were included in our study. They were seen predominantly in females and in the 5th and 6th decades of life, with a propensity to occur in the convexities. The commonest variant was meningothelial meningioma and the commonest grade was Grade I. However, we also noted an increase in Grade II meningiomas due to the definition of brain invasion as an atypical feature in the latest classification. Malignant phenotype such as recurrence was seen in all 3 grades. Hence, we conclude that constant revision of the grading system is necessary to maintain diagnostic accuracy and improve current treatment modalities.