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DOI: 10.1055/s-0045-1811604
Clinico-Histomorphological and Mib-1 Analysis of Recurrent Meningiomas: A Retrospective Study

Abstract
Introduction
Meningiomas are the most common primary brain tumors in adults, comprising 37.6% of central nervous system neoplasms. Though gross total resection is the treatment of choice, meningiomas recur even after complete resection. Additionally, meningiomas with a high Ki67/MIB-1 labeling index (LI) have a higher recurrence rate.
Aim
This article analyzes the clinico-histomorphological features of recurrent meningiomas and compares the expression of MIB-1 LI of primary and recurrent tumors.
Materials and Methods
This was a retrospective observational study of 50 recurrent meningiomas diagnosed between 2019 and 2023. Tumors were analyzed for site, radiological/histopathological features, and expression of MIB-1 LI in both primary and recurrent tumors.
Results
Thirty-four percent of the recurrent cases were between 41 and 50 years of age, 58% of the recurrent cases were males. Recurrence was most commonly seen in the frontal region (26%; n = 13) and 52% cases recurred between 1 and 10 years after primary resection. Of the primary tumors, 30 cases (60%) were grade 1, 16 cases (32%) were grade 2, and 4 cases (8%) were grade 3. Mean MIB-1 of primary meningiomas was 4.25% overall and 1.8% for grade 1. Progression in grade was noted in 15 cases with 5 cases showing brain invasion on recurrence while 17/30 grade 1, 14/16 grade 2, and 4/4 grade 3 tumors recurred with no change in grade. Overall mean MIB-1 LI of recurrent tumors was 5.4%.
Conclusion
Although MIB-1 LI is not an independent criterion for tumor grading, it can be used as an additional tool to identify at-risk patients and recommend close follow-up.
Publication History
Article published online:
08 September 2025
© 2025. Asian Congress of Neurological Surgeons. 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 commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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