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Current standing and frontiers of gene therapy for meningiomas

Rafael De la Garza-Ramos, Jessica V. Flores-Rodríguez, Juan Carlos Martínez-Gutiérrez, Alejandro Ruiz-Valls, and Enrique Caro-Osorio

M eningiomas are typically slow-growing tumors of the central nervous system (CNS) that originate from arachnoid cap cells, which belong to the outermost layer of the arachnoid mater. Meningiomas are the second most common primary adult neoplasm of the CNS after glioblastoma multiforme (GBM), with an annual estimated incidence of 2.3 cases per 100,000 persons. 71 , 72 Most of these tumors are considered benign, but although 5-year survival rates reach 90%, 20-year survival rates are approximately 53%. 80 Intracranial meningiomas represent 98% of all CNS

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Foreign-body granuloma simulating recurrence of falx meningioma

Case report

Shinichi Shimosaka and Shiro Waga

R ecurrence of meningioma is well known, 1, 5, 8, 9 and since the advent of computerized tomography (CT) diagnosis of recurrence has become much easier. On the other hand, foreign-body granuloma is a very rare intracranial mass lesion. Here we report a pitfall into which we have fallen, in which we misdiagnosed a foreign-body granuloma as recurrence of meningioma on CT scan. Case Report This 51-year-old housewife was aware of awkwardness in putting on her left shoe in August, 1978, followed by slowly progressing difficulty in walking for 3 years

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Surgical management of suprasellar meningioma

Part 2: Prognosis for visual function following craniotomy

Jacob Rosenstein and Lindsay Symon

S uprasellar meningiomas are uncommon tumors of the central nervous system. Representing approximately 4% to 10% of all intracranial meningiomas, 1, 12, 16, 17 they often involve the anterior visual pathways and present commonly with vision failure. 2, 8, 10 Despite this, few reports have dealt directly with their prognosis as regards vision. 6, 7, 9, 11–13, 17 The need to consider the many variables involved, such as visual fields, visual acuity, or monocular or binocular involvement, has made analysis somewhat difficult. In some patients, vision may

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Surgical management of suprasellar meningioma

Part 1: The influence of tumor size, duration of symptoms, and microsurgery on surgical outcome in 101 consecutive cases

Lindsay Symon and Jacob Rosenstein

experience with these lesions to assess what effect, if any, tumor size, duration of symptoms, and use of microsurgery had on surgical outcome. Clinical Material and Methods Patient Population Over the past 35 years (January, 1948, to March, 1983), 940 patients have undergone treatment for intracranial meningiomas in our unit. The records of these patients were examined and cases with suprasellar tumors were selected for review. Only cases with tumor arising from the tuberculum sellae, planum sphenoidale, diaphragma sellae, and/or anterior clinoid processes were

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Predicting meningioma consistency and brain-meningioma interface with intraoperative strain ultrasound elastography: a novel application to guide surgical strategy

Giuseppe Maria Della Pepa, Grazia Menna, Vito Stifano, Angelo Maria Pezzullo, Anna Maria Auricchio, Alessandro Rapisarda, Valerio Maria Caccavella, Giuseppe La Rocca, Giovanni Sabatino, Enrico Marchese, and Alessandro Olivi

M eningiomas are brain tumors arising from the arachnoid cells and represent the most common primary intracranial neoplasm. Despite the survival benefit associated with novel therapeutic approaches, surgery currently remains the mainstay of treatment. In this context, two factors are crucial in determining surgical strategy: meningioma-brain interface and meningioma consistency. 1 Only a few imaging methods are used to predict these two determinants, mainly in a preoperative setting. CT and MRI are routinely used, but may only provide an approximate assessment

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DNA methylation profiling of a lipomatous meningioma: illustrative case

Zeel Patel, Justin Z. Wang, Zamir Merali, Vikas Patil, Farshad Nassiri, Qingxia Wei, Julio Sosa, Claire Coire, and Gelareh Zadeh

Meningiomas are the most common primary intracranial tumor, comprising approximately one-third of all brain tumors. Symptoms can vary depending on the size and anatomical location of the tumor but can include headaches, seizures, neurological deficits, and behavioral changes. 1 These tumors are identified usually through magnetic resonance imaging (MRI) or computed tomography (CT), often following the development of neurological symptoms or incidentally in asymptomatic patients on imaging obtained for other clinical purposes. 2 While molecular profiling

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Histologically benign metastatic meningioma: morphological and cytogenetic study

Case report

Miguel Cerdá-Nicolás, Concha Lopez-Gines, Miguel Perez-Bacete, Pedro Roldan, Fernando Talamantes, and José Barberá

M alignant meningiomas account for fewer than 5% of all meningiomas and exhibit recurrence and nervous tissue invasion. Cumulative morphological features such as nuclear anaplasia, nucleolar prominence, multifocal micronecrosis, five or more mitoses, and more than 10% proliferating cell nuclear antigen or Ki-67 LI define malignancy. 12, 13, 25, 27 Cytogenetic features such as a complex karyotype with deletion of 1p and other numerical and structural alterations, in addition to monosomy of chromosome 22, have been considered criteria for biological

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Surgically resected skull base meningiomas demonstrate a divergent postoperative recurrence pattern compared with non–skull base meningiomas

Alireza Mansouri, George Klironomos, Shervin Taslimi, Alex Kilian, Fred Gentili, Osaama H. Khan, Kenneth Aldape, and Gelareh Zadeh

M eningiomas are the second most common primary intracranial tumors in adults. 32 These tumors tend to exhibit a slow growth rate and minimal invasion of the brain parenchyma; therefore, they are typically considered benign. The optimal management of meningiomas is complete resection of the tumor along with the associated dura and bone, traditionally recognized as a Simpson Grade I resection. 30 However, this goal cannot always be achieved safely. This is particularly true for meningiomas in regions that are associated with critical neurovascular

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Gamma Knife surgery for convexity, parasagittal, and falcine meningiomas

Clinical article

Toshinori Hasegawa, Yoshihisa Kida, Masayuki Yoshimoto, Hiroshi Iizuka, Dai Ishii, and Kouta Yoshida

T o date, it has been reported that stereotactic radiosurgery is a safe and effective treatment for patients with pathologically benign meningiomas not only as an adjuvant therapy but also as an initial treatment. 4 , 6–9 , 11–16 , 21 , 23–25 , 27 , 28 , 30 , 34 Complete resection is the preferred treatment for benign meningiomas, as they are generally encapsulated. However, complete tumor resection is not always possible, particularly in skull base lesions, because some lesions are not only located close to adjacent critical neurovascular structures but

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The management of optic nerve meningiomas and gliomas

Gabib A. Gabibov, Samuil M. Blinkov, and Vasiliy A. Tcherekayev

O ptic nerve gliomas and meningiomas have been subjects of controversy for many years. Optic nerve gliomas grow inside the optic nerve sheath without infiltrating adjacent structures. 8 Primary optic nerve meningiomas arise from the arachnoid sheath of the intraorbital portion of the optic nerve. 9 These neoplasms have been called “optic nerve sheath meningiomas.” Clinically, it is difficult to differentiate an optic nerve glioma from a meningioma in adults. 4, 5 Opinions differ as to the management of optic nerve tumors. The two main approaches to