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Multiple meningiomas following radiation therapy for medulloblastoma

Case Report

Robert P. Iacono, Michael L. J. Apuzzo, Richard L. Davis, and Fong Y. Tsai

T he concept that radiotherapy may be an etiological factor for benign meningiomas remains unproven, although this relationship is suggested in many reports. 2, 4, 12, 23–25, 29, 31, 33 We describe a case that is similar to those previously reported with respect to the radiation dosage and the induction period involved, but unique in regard to the size, number, and distribution of the meningiomas. The patient also suffered from a set of unusual maladies. The idiosyncracies of this case and the statistical data of the 38 cases reviewed tend to support

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Invading meningiomas of the sphenoid ridge

Joël Bonnal, André Thibaut, Jacques Brotchi, and Jacques Born

T he progress made in diagnosis and operative techniques enables us to approach invading meningiomas of the base of the skull 3 in a more hopeful frame of mind from that of Grant 13 or of Castellano, et al. 4 One of the contributions of Derome and Guiot 9, 10, 14 was the description of a technique for a very wide removal of these lesions. Various opinions have been expressed by different authors, 2, 5, 6, 11, 12, 15, 17–19, 21–23 showing that there is not yet agreement about the classification and treatment of these meningiomas. We report our

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The natural history of intracranial meningiomas

Clinical article

Soichi Oya, Seon-Hwan Kim, Burak Sade, and Joung H. Lee

M eningiomas are the most common benign brain tumor. 5 The recent increase in access to CT and MR imaging to evaluate minor head injury, nonspecific neurological symptoms, or paranasal sinus symptoms has led to the increased detection of small or incidental meningiomas. With increased detection of these meningiomas, clinicians including neurosurgeons, neurologists, and primary care physicians today are commonly faced with the management dilemma as to when and what treatment should be given. To solve this dilemma, we need to know the natural history of

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Evidence of meningioma infiltration into cranial nerves: clinical implications for cavernous sinus meningiomas

Jeffrey J. Larson, Harry R. van Loveren, M. Gregory Balko, and John M. Tew Jr.

these studies, patients have been free from recurrence at short-term follow up. However, long-term recurrence and regrowth rates of cavernous sinus meningiomas must be determined. In our experience of treating patients who have cavernous sinus meningiomas, tumor infiltration into a cranial nerve was documented in two cases in which a cranial nerve was resected during the cavernous sinus dissection. This previously unreported condition raises concern about the resectability of cavernous sinus meningiomas. The clinical implications of this finding are discussed

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Regression of a presumed meningioma with the antiestrogen agent mepitiostane

Case report

Shoji Oura, Takeo Sakurai, Goro Yoshimura, Takeshi Tamaki, Teiji Umemura, Yozo Kokawa, Osamu Masuo, and Yasuaki Naito

M eningiomas are benign tumors that arise from cranial and spinal arachnoid cells. For most of these lesions, surgery provides effective and sufficient clinical results. However, some meningiomas recur or are resected subtotally because of anatomical problems such as their location at the skull base. To date, the only effective treatment for such recurrent and/or subtotally resected meningiomas has been limited to radiotherapy. 4, 16 Meningiomas occur predominantly in women, and often contain steroid receptors such as estrogen and progesterone receptors. 2, 19

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Stereotactic radiosurgery for cerebellopontine angle meningiomas

Clinical article

Seong-Hyun Park, Hideyuki Kano, Ajay Niranjan, John C. Flickinger, and L. Dade Lunsford

C erebellopontine angle (CPA) meningiomas are a relatively rare anatomical subgroup of meningiomas and comprise 6%–15% of all tumors in the region of the CPA. 15 , 20 , 23 , 24 , 27 Complete resection has often proved difficult because of the relationship of the tumor to critical neurovascular structures in the posterior fossa. 1 , 16 , 20 , 22 Stereotactic radiosurgery (SRS) has become an alternative frequently used management option for such tumors and is reported to lead to high tumor control rates and low complication rates. 13 , 18 In the present

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Falcotentorial meningioma: surgical outcome in 14 patients

Takeo Goto, Kenji Ohata, Michiharu Morino, Toshihiro Takami, Naohiro Tsuyuguchi, Akimasa Nishio, and Mitsuhiro Hara

outcome. Clinical Material and Methods Patient Population and Tumor Characteristics During the years between 1984 and 2004, 14 patients with falcotentorial junction meningiomas were surgically treated at our institution by the two senior surgeons (A. Hakuba and K.O.). Pineal region meningiomas that did not have a dural base in the falcotentorial region were not included in this series. There were seven men and seven women whose ages ranged from 34 to 79 years (mean 57 years; Table 1 ). The chief presenting symptoms included severe headache in five, memory

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Epidural meningioma of the sacral canal

Case report

Scott A. Rutherford, Kim M. Linton, Jonathan M. Durnian, and Richard A. Cowie

M eningiomas account for 25% of all intraspinal neoplasms and are the second most common primary intraspinal tumor. Meningiomas located at the caudal end of the spine are rare; only a few cases have been reported. Epidural meningiomas represent a small minority, whether occurring wholly or partially in the epidural space. To the best of our knowledge, we report the first case of a primary epidural meningioma arising in the sacral region. The clinical course of the patient was also unusual, with a benign histological appearance belying the aggressive

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Radiation therapy for incompletely resected meningiomas

Albert M. Petty, Larry E. Kun, and Glenn A. Meyer

M eningiomas are benign intracranial neoplasms which constitute approximately 15% of all primary brain tumors. Surgical removal is the treatment of choice for these lesions; the role of radiation therapy, either as a primary or postoperative modality, remains to be established. Several investigators have been impressed with the relative insensitivity of meningiomas to irradiation and thus have concluded that radiation therapy has little value in the management of these tumors. 4, 8, 11, 14 In contrast, recent reports, including those of Bouchard, 2 Wara, et

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Tuberculoma presenting as an en plaque meningioma

Case report

Jerry Bauer, Roger F. Johnson, Joseph M. Levy, Donald V. Pojman, and John R. Ruge

radiographic features leading us to suspect an en plaque meningioma. Tuberculomas occur in up to 30.5% of intracranial mass lesions in India. 7 These lesions are much less common in the United States. Despite this, tuberculomas should be considered in the differential diagnosis of intracranial mass lesions in patients with human immunodeficiency virus and those who have emigrated from high-risk regions of the world. 9, 14, 16 Case Report History and Diagnostic Workup This patient is a 34-year-old man of Indian descent. He had moved to the United States