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J Neurol Surg B Skull Base 2023; 84(02): 113-118
DOI: 10.1055/a-1757-3212
Original Article

De Novo Skull Base Atypical Meningioma: Incidence and Outcome

Z. James 
1   Department of Neurosurgery, University Hospital of Wales, Cardiff, United Kingdom
,
M. Makwana
1   Department of Neurosurgery, University Hospital of Wales, Cardiff, United Kingdom
,
C. Hayhurst
1   Department of Neurosurgery, University Hospital of Wales, Cardiff, United Kingdom
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Abstract

Objective Atypical meningiomas are uncommon in skull base practice and present a management challenge. We aimed to review all de novo atypical skull base meningioma cases within a single unit to analyze presentation and outcome.

Methods A retrospective review of all patients undergoing surgery for intracranial meningioma identified consecutive cases of de novo atypical skull base meningioma. Electronic case records were analyzed for patient demographics, tumor location and size, extent of resection, and outcome. Tumor grading is based on the 2016 WHO criteria.

Results Eighteen patients with de novo atypical skull base meningiomas were identified. The most common tumor location was the sphenoid wing in 10 patients (56%). Gross total resection (GTR) was achieved in 13 patients (72%) and subtotal resection (STR) in 5 patients (28%). There was no tumor recurrence recorded in patients who had undergone GTR. Patients with tumors >6 cm were more likely to undergo a STR as opposed to a GTR (p < 0.01). Patients who had undergone a STR were more likely to have postoperative tumor progression and be referred for radiotherapy (p = 0.02 and <0.01, respectively). On multiple regression analysis, tumor size is the only significant factor correlating with overall survival (p = 0.048).

Conclusion The incidence of de novo atypical skull base meningioma is higher in our series than currently published data. Tumor size was a significant indicator for patient outcome and extent of resection. Those undergoing a STR were more likely to have tumor recurrence. Multicenter studies of skull base meningiomas with associated molecular genetics are needed to guide management.

Keywords

meningioma - atypical - grade 2 - skull base

Author Contributions

All persons who meet authorship criteria are listed as authors and contributed equally. Data collection, analysis, and writing were done by Z.J. and M.M. under the guidance of C.H. who made regular editions and editing. All authors approved the final copy of the manuscript.




Publication History

Received: 06 November 2021

Accepted: 30 January 2022

Accepted Manuscript online:
01 February 2022

Article published online:
08 March 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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