Forbes J Med. 2022; 3(3): 235-240 | DOI: 10.4274/forbes.galenos.2022.47855

Clinical Analysis and Surgical Management of Intracranial Meningiomas

Hüseyin Berk BENEK, Alaattin YURT
University of Health Sciences Turkey, Ýzmir Bozyaka Training and Research Hospital, Clinic of Neurosurgery, Ýzmir, Turkey

Objective: The current study analyses the patients who underwent surgical resection with intracranial meningiomas.
Methods: This study reviewed the data of eighty-four patients diagnosed and operated with intracranial meningioma. The study was conducted retrospectively by analyzing the clinical characteristics and the histopathological results of the patients. Age at surgery, gender, and tumor location according to World Health Organization (WHO) 2021 tumor classification criteria were determined. Brain computed tomography and cranial magnetic resonance imaging was used to assess the tumor before operation and presence of recurrence/residual lesion at follow-up. Surgical management was evaluated according to Simpson resection grade.
Results: Fifty-nine were women (70%) and 25 were men (30%). Female/male ratio was 2.36/1. The average age was 55.58 years (range: 28-79 years). The most common locations of surgical intracranial meningiomas were convexity, and parasagittal/falcine. Fifty-four (64.3%) patients with Simpson grade I and II, 26 (30.9%) with grade III, and 4 (4.8%) patients with grade IV resection were carried out. The most common histopathological results were transitional meningioma 28 (33.3%) patients, atypical 22 (26.2%) patients, meningothelial meningioma 21 (25.0%) patients. Sixty (71.4%) patients had WHO grade I tumor, 22 (26.2%) patients grade II tumor, and 2 (2.4%) patients grade III tumor.
Conclusion: Although meningiomas are more common in female patients, grade II and III meningiomas show gender equality. The main goal of surgery is to remove the meningioma completely, including dura and bone if needed. Maximal safe surgical resection should be performed in surgery and preserve the patient’s neurological functions.

Keywords: Intracranial meningioma, surgical resection, Simpson resection grade, WHO tumor classification

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Ýntrakraniyal Menenjiomlarýn Klinik Analizi ve Cerrahi Yönetimi

Hüseyin Berk BENEK, Alaattin YURT
Saðlýk Bilimleri Üniversitesi Ýzmir Bozyaka Eðitim ve Araþtýrma Hastanesi, Beyin ve Sinir Cerrahisi Kliniði, Ýzmir, Türkiye

Amaç: Bu çalýþmanýn amacý intrakraniyal menenjiom nedeniyle cerrahi rezeksiyon uygulanan hastalarý incelemektir.
Yöntem: Bu çalýþmada intrakraniyal menenjiom tanýsý konulan ve opere edilen seksen dört hastanýn verileri incelendi. Çalýþma, hastalarýn klinik özellikleri ve histopatolojik sonuçlarý retrospektif olarak incelenerek yapýldý. Dünya Saðlýk Örgütü (DSÖ) 2021 tümör sýnýflamasý göz önüne alýnarak hastalarýn ameliyat esnasýndaki yaþý, cinsiyeti ve tümör lokalizasyonlarý belirlendi. Ameliyat öncesi tümörün tesbitinde, ve sonraki takip sürecinde nüks/rezidü lezyon varlýðý için beyin bilgisayarlý tomografi ve kraniyal manyetik rezonans görüntüleme kullanýldý. Cerrahi tedavi Simpson rezeksiyon derecesine göre deðerlendirildi. Menenjiomlarýn histopatolojik alt tipleri ve DSÖ dereceleri belirlendi.
Bulgular: Hastalarýn 59’u kadýn (%70), 25’i erkekti (%30). Kadýn/erkek oraný 2,36/1 idi. Yaþ ortalamasý 55,58 (aralýk: 28-79) idi. Cerrahi intrakraniyal menenjiomlarýn en sýk yerleþim yeri konveksite ve parasagital/falks idi. 54 hastada (%64,3) Simpson grade I ve II, 26 hastada (%30,9) grade III, ve 4 hastada (%4,8) Simpson grade IV rezeksiyon yapýldý. En yaygýn histopatolojik sonuçlar; transizyonel menenjiom 28 (%33,3) hasta, atipik (grade II) menenjioma 22 (%26,2) hasta, ve meningotelyal menenjioma 21 (%25) hasta þeklindeydi. 60 (%71,4) hasta DSÖ grade I, 22 (%26,2) grade II, ve 2 (%2,4) hasta grade III menenjiom saptandý.
Sonuç: Menenjiomlar kadýn hastalarda iki kat oranýnda fazla görünse de, grade II ve III menenjiomlar cinsiyet eþitliði gösterirler. Cerrahinin temel amacý, gerekirse dura ve kemiði de içermek üzere, menenjiomun tamamen çýkarýlmasýdýr. Ameliyatta maksimum güvenli cerrahi rezeksiyon yapýlmalý ve hastanýn nörolojik fonksiyonlarý korunmalýdýr.

Anahtar Kelimeler: Ýntrakraniyal menenjiom, cerrahi rezeksiyon, Simpson rezeksiyon derecesi, DSÖ tümör sýnýflandýrmasý

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