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Youlin Ge, Dong Liu, Zhiyuan Zhang, Yanhe Li, Yiguang Lin, Guokai Wang, Yongqing Zong and Enhu Liu

and May 2015. The characteristics and clinical features of the patients are presented in Table 1 . Patients were excluded for follow-up time < 6 months or pathological grading ≥ WHO grade II—exceptional cases of death due to intracranial meningioma or patients with tumor recurrence were included in spite of a follow-up period < 6 months. All patients were diagnosed as harboring a benign meningioma based on the natural course of the disease, radiological features, and histopathology. The typical natural course of benign meningioma includes a long medical history

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Paul E. Fewings, Robert D. E. Battersby and Walter R. Timperley

macroscopically to be totally excised (including dural attachment and any abnormal bone) to 100% for tumors that have simply been debulked. 52 The site is considered relevant because the least accessible tumors and those intimately related to vital structures are less likely to be totally resected. 10 The histological subtype of benign meningiomas is not related to risk of recurrence. 33 The higher incidence of meningiomas in women (female/male preponderance 2:1), 48 the observation that in women these tumors may enlarge and become symptomatic during hormonal flux

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Andrew E. H. Elia, Helen A. Shih and Jay S. Loeffler

M eningiomas account for 15 to 25% of all primary brain tumors and have a reported annual incidence between one and 10 per 100,000. 47 Surgery is the preferred treatment for benign meningiomas whenever complete resection can be achieved with reasonable morbidity, resulting in 5-, 10-, and 15-year PFS rates of 93, 80, and 68%, respectively. 31 However, complete resection is not possible in 20 to 30% of presenting patients. 31 , 42 In these cases, subtotal resection has inferior results, with 5-, 10-, and 15-year PFS rates of 63, 45, and 9%, respectively

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Aurelia Kollová, Roman Liščák, Josef Novotný Jr., Vilibald Vladyka, Gabriela Šimonová and Ladislava Janoušková

equipment, improved imaging techniques, and advanced skull base approaches, surgical intervention for meningiomas has greatly evolved. Total excision is the determining factor for recurrence. 67 Even though total excision is usually achieved in almost 100% of convexity meningiomas, the rate has been reported to be 20 to 97.8% in meningiomas located in the skull base according to the latest published data. 3 , 8 , 9 , 11 , 13 , 19 , 21 , 48 , 50 , 58 , 59 , 61 , 62 , 77 Note, however, that there is evidence that even benign meningiomas invade brain tissue, blood vessels

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Jonathan M. Bledsoe, Michael J. Link, Scott L. Stafford, Paul J. Park and Bruce E. Pollock

with benign meningiomas > 10 cm 3 in volume. Methods Patient Population The institutional review board at the Mayo Clinic College of Medicine in Rochester, Minnesota, approved all aspects of this study. A prospectively maintained computer database was used to identify 562 patients with 679 intracranial meningiomas who had undergone radiosurgery at our institution between 1990 and 2007. Patients with tumors < 10 cm 3 (470 lesions), atypical meningiomas (20), malignant meningiomas (17), prior radiation therapy (21), neurofibromatosis (28), or follow-up < 12

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Ariel E. Marciscano, Anat O. Stemmer-Rachamimov, Andrzej Niemierko, Mykol Larvie, William T. Curry, Fred G. Barker II, Robert L. Martuza, Declan McGuone, Kevin S. Oh, Jay S. Loeffler and Helen A. Shih

M eningiomas are the most common primary brain tumors, representing approximately 36% of all primary central nervous system tumors and over half of all nonmalignant primary brain and central nervous system tumors. 19 World Health Organization (WHO) Grade I or benign meningiomas are generally regarded to have indolent behavior. However, patients with WHO Grade II (atypical) and WHO Grade III (anaplastic) meningiomas have worse prognosis and are at increased risk of recurrence even with definitive treatment. 9 , 12 , 13 , 21 There is a paucity of

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Laurence Davidson, Dawn Fishback, Jonathan J. Russin, Martin H. Weiss, Cheng Yu, Paul G. Pagnini, Vladimir Zelman, Michael L. J. Apuzzo and Steven L. Giannotta

neurological and imaging outcomes. Clinical Material and Methods Patient Population Between September 1994 and November 2004, 211 patients underwent GKS for intracranial meningiomas at University of Southern California University Hospital. Of these, 36 patients had had prior surgery for a benign meningioma of the cranial base and at least 2 years of follow-up; they form the population for this study. No patient received EBRT or chemotherapy prior to GKS. The median age of the patients was 55 years (range 22–73 years). There were 31 women and five men. Tumor

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Christina Pfister, Rainer Ritz, Heike Pfrommer, Antje Bornemann, Marcos S. Tatagiba and Florian Roser

exclusively in the cytoplasm of all meningiomas studied. In fact 60 (63%) of the 95 benign meningiomas, and 21 (88%) of the 24 atypical meningiomas exhibited Grade 4 staining ( Fig. 3D ). Samples from 30 benign meningiomas (32%) and three atypical tumors (12%) displayed Grade 3 staining, and only five benign tumors (5%) displayed Grade 2 staining. No Grade 0 or 1 stainings were noted. Normal cerebral cortex tissue stained for COX-2 displayed strong staining of the cytoplasm (Grade 4; Fig. 3C ). Meningioma tissue samples were also stained for COX-1, 5-LO ( Fig. 3F ), and

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Christopher Nutting, Michael Brada, Lucy Brazil, Ahmen Sibtain, Frank Saran, Charlotte Westbury, Anne Moore, David G. T. Thomas, Daphne Traish and Susan Ashley

M eningiomas account for 20% of primary intracranial tumors, 22 and 90% of these are benign. They may occur at any meningeal site, with approximately one half of benign intracranial meningiomas arising in the skull base. 22 Complete surgical excision is undoubtedly the treatment of choice for benign meningioma at an accessible site. There is no uniform agreement on the indications for radiotherapy in cases of benign meningioma because there have been no randomized clinical trials testing its efficacy. Nevertheless, radiotherapy is usually given after

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Warren P. Mason, Fred Gentili, David R. Macdonald, Subramanian Hariharan, Charlene R. Cruz and Lauren E. Abrey

infer that total removal of certain meningiomas (medial sphenoid wing, posterior parasagittal, orbital, tentorial, and clivus tumors) is difficult, and possible in only 30 to 40% of cases. The risk of recurrence postsurgery is related to the degree of resection. Even with complete resection, the recurrence rate of the benign meningiomas after 10 years is at least 9%; after subtotal resection without adjuvant radiotherapy, the 10-year recurrence rate is approximately 40%. 2, 21, 24 At recurrence, conventional treatment options have included additional surgery or