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CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2022; 41(02): e137-e144
DOI: 10.1055/s-0042-1742427
Review Article

Peculiarities of Atypical Meningiomas: Literature Review

Peculiaridades dos meningiomas atípicos: Revisão da literatura
Rafael Rodrigues Pinheiro dos Santos  ‡   *
1   Department of Neuroscience, Pontifícia Universidade Católica do Paraná, Londrina, Paraná, Brazil
,
Ana Carla Mondek Rampazzo  ‡   *
1   Department of Neuroscience, Pontifícia Universidade Católica do Paraná, Londrina, Paraná, Brazil
,
Carlos Alexandre Martins Zicarelli 
2   Department of Neurosurgery, Hospital Evangélico de Londrina, Londrina, Paraná, Brazil
3   Medical Internship, Pontifícia Universidade Católica do Paraná, Londrina, Paraná, Brazil
4   Rehabilitation Science Program, Universidade Estadual de Londrina, Londrina, Paraná, Brasil
5   Department of Health and Rehabilitation, Universidade Norte do Paraná, Londrina, Paraná, Brazil
,
Leonardo Valente de Camargo 
6   Neurology Residency Program, Hospital Evangélico de Londrina Londrina, Brazil
7   Department of Neurology, Pontifícia Universidade Católica do Paraná, Londrina, Paraná, Brazil
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Abstract

Introduction Meningiomas are common tumors of the central nervous system that represent around 30% of primary tumors. However, the incidence of atypical meningiomas (AMs) is lower, of approximately 15% of all meningiomas, and they present high rates of relapse and mortality.

Aim To review peculiarities of AMs.

Methodology A literature review of articles published in English between 2009 and 2020 on the PubMed and Biblioteca Virtual em Saúde (BVS) databases using the terms meningioma and atypical.

Results Atypical meningiomas are rare and more prevalent in older males. The clinical condition depends on the site of the tumor, and a definitive diagnosis of AM is only possible via anatomical pathology. Moreover, prominent studies have indicated a relationship between the presence of the anti-Ki67 antibody/mindbomb (Ki-67/MIB1) marker as an aid in the definition of AM and one of the determinants of tumor aggressiveness. Imaging studies have also advanced in terms of seeking criteria using magnetic resonance that may suggest the malignancy of a lesion. As far as treatment is concerned, total resection remains the main therapeutic option, and it has a direct relationship with survival and time until disease progression. Lastly, there are many factors involved in the prognosis of AM.

Conclusion Atypical meningiomas continue to be a challenge, requiring further and more specific studies to provide a better understanding of it.

Resumo

Introdução Os meningiomas são tumores comuns do sistema nervoso central, representando cerca de 30% dos tumores primários. Contudo, a incidência de meningiomas atípicos (MA) é menor, cerca de 15% do total dos meningiomas, e eles apresentam altas taxas de recidiva e mortalidade.

Metodologia Revisão da literatura, nas bases de dados PubMed e Biblioteca Virtual em Saúde (BVS), utilizando os termos “meningioma” e “atypical”, publicados em língua inglesa entre 2009 e 2020.

Objetivo Revisar as particularidades dos MA.

Resultados MA são raros, mais prevalentes em homens de idade avançada. O quadro clínico depende da localização do tumor e o diagnóstico definitivo de MA só se dá por meio do anatomopatológico. Ademais, estudos importantes têm apontado para a relação da presença do marcador anticorpo monoclonal/mindbomb (Ki-67/MIB1) como auxiliador na definição de MA e um dos determinantes de agressividade tumoral. Os estudos de imagem também avançam no sentido de buscar critérios na ressonância magnética que possam sugerir a malignidade de uma lesão. Em relação ao tratamento, a cirurgia de ressecção total se mantém como principal terapêutica, com relação direta na sobrevida e no tempo livre de progressão de doença. Por fim, o prognóstico em MA é multifatorial.

Conclusão MA continuam como um desafio, necessitando de mais estudos específicos para compreendê-los melhor.

Keywords

meningioma - malign meningioma - immunohistochemistry - prognosis

Palavras-chave

meningioma - meningioma maligno - imuno-histoquímica - prognóstico

* Authors with the same contribution to the article.




Publication History

Received: 03 February 2021

Accepted: 17 November 2021

Article published online:
03 March 2022

© 2022. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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