SURG-37. ONCOGENIC MUTATIONS AND TUMOR CHARACTERISTICS IN OLFACTORY GROOVE MENINGIOMAS: IMPLICATIONS FOR PERSONALIZED TREATMENT STRATEGIES

Abstract

Abstract OBJECTIVE To investigate the correlation between clinical and radiologic features of olfactory groove meningiomas (OGM) and their tumor molecular profiles, focusing on oncogenic mutations identified through genomic studies. METHODS Targeted next-generation sequencing analyses were conducted on 54 patients with OGM (37 females and 17 males) to determine the frequency of SMO, AKT1, PIK3CA, and other mutations. The molecular results were then correlated with clinical and radiographic tumor features. RESULTS Among the OGM patients, SMO mutations were found in 16 (29.6%) cases, AKT1 mutations in 13 (24.1%), and PIK3CA/PIK3R1 mutations in 9 (16.7%) cases. Less common mutations in POLR2A, SUFU, and NF1 were observed in 8 (14.8%) cases, while 8 OGM (14.8%) did not have identifiable driver mutations (Wild-type group, WT). The median age at first diagnosis was 64.1 years (25-87 years), with the youngest group represented by PIK3CA-mutant patients at 52 years (49-78 years). The sex distribution was similar across the SMO-, AKT1- and PIK3CA-mutant groups (F:M = 2.1:1). OGM with SMO mutations exhibited larger tumor volumes (329.4 ± 323.0 cm3) compared to AKT1-mutant tumors (283.3 ± 156.2 cm3). Tumor infiltration of the ethmoid cells was found in 10 cases (22.2%), with the highest rate observed in PIK3CA-mutant OGM (40%), followed by 25% in SMO-mutant OGM. Tumor-associated hyperostosis of the sphenoid planum was common in OGM (72.2%), with the highest rate in the SMO group (75.0%) and the lowest rate in the AKT1-mutant group (30.8%). The majority of cases (n = 45, 83.3%) were classified as WHO grade 1 meningioma, while the remaining nine cases were WHO grade 2 (n = 8) and 3 (n = 1). CONCLUSIONS Overall, our data demonstrate the presence of clinically actionable mutations in the majority of olfactory groove meningiomas, and suggest a correlation between molecular status and common clinical and radiologic tumor features.