Retrospective Analysis and Comparison of 48 Intracranial Meningioma Cases As Two Groups According to Their Size.

Hasan Burak Gündüz,Murad Asiltürk,Mustafa Levent Uysal,Orhun Mete Çevik,Özden Erhan Sofuoğlu,Seda Yağmur Karataş Okumuş,Müslüm Güneş,Talat Cem Ovalıoğlu,Ayşegül Esen Aydın,Erhan Emel

doi:10.7759/cureus.19709

Abstract

ObjectiveThis study aims to examine the possible demographic, clinical, and surgical differences between giant and smaller meningiomas.Materials and MethodsForty-eight meningioma patients who were operated on in our clinic between 2016-2020 were included in our study. Fourteen meningiomas larger than 5 cm in diameter were defined as giant meningiomas and placed in group 1. Thirty-four remaining meningiomas, with sizes less than 5 cm, were placed in group 2. These patients were evaluated regarding age, sex, localization, symptoms and neurological findings, surgical results, histopathology, and postoperative results.ResultsThe most common localization in group 1 was falcine-parasagittal, whereas in group 2 it was convexity. Simpson’s grade I resection rate in group 1 was 35.71%, while in group 2 this rate was 67.65%. In histopathological examination, transitional type meningiomas (35.71%) were the most common in group 1, whereas fibrous type meningiomas (32.35%) were seen the most in group 2. Group 1 Karnofsky Performance Scale score average was 75.71 preoperatively and 85.71 postoperatively. In group 2, the preoperative and postoperative average was 97.35 and 96.76, respectively. The comparative statistical analysis reflects that: A) Resection rates were significantly lower in the giant meningioma group. B) Similarly, Karnofsky Performance Scale scores were also lower than group 2. C) When statistical comparisons were made according to sex, age, localization, histopathological results, postoperative complications, and recurrence rates, no significant differences were observed.ConclusionThe term “Giant Meningioma” is a type of distinction that is frequently made in the literature. However, the single major difference we see in our study was the surgical results. The general condition of patients before and after surgery may be more critical than others in giant meningiomas. Although surgical resection is the main form of treatment in giant meningiomas, the risks arising from the size of the tumor should be taken into account, and necessary plans should be made for a successful surgical intervention.

Highlights

Meningiomas are usually benign and slow-growing tumors of the central nervous system
The comparative statistical analysis reflects that: A) Resection rates were significantly lower in the giant meningioma group
We evaluated and compared meningiomas, which we classified into two groups according to their dimensions, in terms of age, sex, localization, complaints, neurological findings, resection rates, histopathological classification, complications, and postoperative performance status

Summary

Introduction

Meningiomas are usually benign and slow-growing tumors of the central nervous system. They are the second most common tumors in the central nervous system in adults. The annual incidence of meningiomas is 2.3 per 100,000. They mainly originate from arachnoid cap cells. They are more common in women with a 2:1 ratio. Most meningiomas have a good prognosis [1,2,3,4,5]. Since radiation therapy is limited to neurotoxicity, tumor size is one of the major factors in the remaining treatment of aggressive, inoperable, residual, or recurrent meningiomas. Meningiomas over 5-6 cm are considered under a separate category with the term “giant” or “huge” [2,3,6,7]

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Discussion

Conclusion