China
Africa
Explore chapters and articles related to this topic
Central Nervous System
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
WHO Grade 1 tumors comprise nine histological variants, all with similar behavior. Atypical meningioma (WHO Grade 2) is identified when tumors show increased cellularity, a sheet-like growth pattern, increased mitosis, high nuclear: cytoplasmic ratio, geographic necrosis, and brain invasion. WHO 2016 specifically allocates any case with brain invasion to this category. Malignant meningioma (WHO Grade 3) is said to be present when these features become increasingly prominent (very high mitotic rates). The rare chordoid subtype represents <1% of meningiomas and is always regarded as WHO Grade 2, since there is a high risk of recurrence. It is clear that these definitions are not precise, and they are subject to variation between pathologists. The combination of histology with genomic and epigenomic data promises a new approach to diagnosis and management in these patients.
Choroid Plexus Tumors and Meningiomas
Published in David A. Walker, Giorgio Perilongo, Roger E. Taylor, Ian F. Pollack, Brain and Spinal Tumors of Childhood, 2020
Kenneth K. Wong, Elwira Szychot, Jennifer A. Cotter, Mark Krieger
Differentiating an atypical or malignant meningioma from a benign meningioma purely on the basis of neuroimaging is difficult. Features that may suggest the presence of a high-grade meningioma rather than a benign meningioma include intratumor cystic change, hyperostosis of the adjacent skull or bone destruction, extension of tumor through the skull base, peritumoral brain edema, elevated cerebral blood volume, and low apparent diffusion coefficient.108,124–126 None of these neuroimaging findings is sufficiently specific to be clinically useful.
Meningioma
Published in Dongyou Liu, Tumors and Cancers, 2017
Benign, atypical, and malignant meningiomas have 5-year overall survival rates of 95%, 80%, and 20%, respectively, and 5-year recurrence rates of 3%, 40%, and 78%, respectively. The median overall survival for malignant meningioma is about 2–3 years [5].
Pharmacotherapeutic options for atypical meningiomas
Published in Expert Opinion on Pharmacotherapy, 2019
Syed Ali Ahsan, Kassem Chendeb, Christos Profyris, Charles Teo, Michael E. Sughrue
Benign meningiomas have a good prognosis with a 5-year survival rate of 97.5%. Contrastingly, atypical meningiomas have a 5-year survival rate of 75% and malignant meningiomas have a rate of 32% with median survival being around 142.5 months and 138.5 months, respectively, [2,6]. Surgery when possible is the primary method to treat meningiomas of all grades; surgery can be followed up with radiation therapy, radiosurgery a potential chemotherapy [7]. Whilst largely unsuccessful there are some chemotherapeutic agents that have shown potential [8]. The main problems encountered when addressing this issue include the heterogeneity of atypical meningiomas, the changing definitions of the grades, lack of large randomized trials/phase III trials for chemotherapeutic drugs and general lack of understanding of the pathways that regulate meningioma growth. Many of the studies report on mixed cohorts with benign, atypical and malignant meningioma patients all treated with a particular pharmaceutical agent, we have included these in our review. Furthermore, studies that have looked at recurrent benign meningiomas have also been included as they may also be beneficial in treating atypical meningiomas.
Serum neopterin as well as ferritin, soluble interleukin-2 receptor, KL-6 and anti-MDA5 antibody titer provide markers of the response to therapy in patients with interstitial lung disease complicating anti-MDA5 antibody-positive dermatomyositis
Published in Modern Rheumatology, 2019
Aki Nishioka, Shinichiro Tsunoda, Takeo Abe, Takahiro Yoshikawa, Miki Takata, Masayasu Kitano, Kiyoshi Matsui, Ran Nakashima, Yuji Hosono, Koichiro Ohmura, Tsuneyo Mimori, Hajime Sano
Table 1 describes the patients and their clinical characteristics. All 15 anti-MDA5-positive patients had dermatomyositis and were women. The mean age was 58 (49–63.5) years. The time from the onset of clinical symptoms (including skin lesions) to the initiation of treatment was 2 (1–5.5) months. Raynaud’s phenomenon was present in four patients: Gottron’s sign in 14 and skin ulceration in 9. While 13 patients had CADM, chest CT revealed characteristic signs of interstitial lung disease in all 15 patients. One patient had a concomitant malignant meningioma tumor. Five patients developed mediastinal emphysema during follow-up and four died during treatment. Fourteen patients were treated with IVCY with a median of 6 (4–8.5) times. Concomitantly administered drugs included calcineurin inhibitors in 14 patients, tacrolimus in 11, and cyclosporine in 3. While serum creatine kinase (CK) levels were slightly above the normal range, a majority of patients had normal serum CK levels. Average lactate dehydrogenase (LDH) levels exceeded the normal values. Although the average sialylated carbohydrate antigen KL-6 level was high at 649 (432–905.5) U/mL, almost all surfactant protein D levels were within the normal range. Serum IgG levels were slightly above normal, whereas serum ferritin and sIL-2R levels were high. As shown in Table 2, anti-MDA5 Ab, neopterin, IL-18, ferritin, sIL-2R, and KL-6 levels did not differ significantly in those who survived than in those who succumbed to the disease. For the line of anti-MDA5 Ab titer, cases with Ab titers exceeding 150 and those with 150 or less were separately shown. Among the remeasured cases, there were six survival cases and three nonsurvival cases because the anti-MDA5 Ab titer exceeded 150.
Clinical factors and outcomes of malignant meningioma: a population-based study
Published in Neurological Research, 2022
Gui-Jun Zhang, Xiao-Yin Liu, Wei Wang, Chao You
In our analysis of 806 patients with malignant meningioma, the effect of surgery, radiotherapy, and stage of tumor on survival was analyzed. Additionally, the significant distributions, among age-stratified cohorts, in clinical variables and survival outcomes were defined. This current study provided the first nomograms for estimation of 3-, 5-, and 8-year survival in patients with malignant meningioma, emphasizing the relative contribution of easily accessible clinical factors to survival prediction.