Ebook Oxford textbook of neuro-oncology: Part 2
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Ebook Oxford textbook of neuro-oncology: Part 2
CHAPTER 11MeningiomasRakesh Jalali, Patrick Y. Wen, and Takamitsu FujimakiEpidemiologyMeningiomas are the most common type of primary brain tumours in Ebook Oxford textbook of neuro-oncology: Part 2n adults, accounting for 30% of the total (1, 2). The incidence of meningioma increases progressively with age. Meningiomas in children are rare, and usually associated with neurofibromatosis type 2 (NF2) or prior therapeutic radiation therapy (3, 4). Meningiomas are more common in women, with a fem Ebook Oxford textbook of neuro-oncology: Part 2ale-to-male ratio of about 2:1 or 3:1 (3, 5). Spinal meningiomas, which account for 10% of all meningiomas, have an even higher female-to-male ratio oEbook Oxford textbook of neuro-oncology: Part 2
f approximately 9:1. In contrast, the incidence in females is not significantly increased in atypical or anaplastic meningiomas, children, and radiatiCHAPTER 11MeningiomasRakesh Jalali, Patrick Y. Wen, and Takamitsu FujimakiEpidemiologyMeningiomas are the most common type of primary brain tumours in Ebook Oxford textbook of neuro-oncology: Part 2 lists 15 subtypes of meningioma (Box 11.1) (6). Nine of them are purely benign (grade I) tumours, whereas atypical meningioma, clear cell meningioma, and chordoid meningioma are grade II, and papillary meningioma, anaplastic meningioma, and rhabdoid meningioma are grade III. Histologically, atypica Ebook Oxford textbook of neuro-oncology: Part 2l meningiomas are defined as meningiomas with loss of architectural pattern, prominent nucleoli, nuclear pleomorphism, increased mitotic activity, necEbook Oxford textbook of neuro-oncology: Part 2
rosis, and hypercellularity. They may invade the brain or show malignant histology. These tumours have a more aggressive natural history than benign tCHAPTER 11MeningiomasRakesh Jalali, Patrick Y. Wen, and Takamitsu FujimakiEpidemiologyMeningiomas are the most common type of primary brain tumours in Ebook Oxford textbook of neuro-oncology: Part 2not necessarily imply WHO grade III meningioma; in the absence of289frank anaplasia (7), approximately 70-80% are WHO grade 1, 5-35% are WHO grade 11, and 1-3% are WHO grade 111 (8, 9). Al (he lime of recurrence, most tumours retain (he same histological pattern, but some exhibit a more advanced gra Ebook Oxford textbook of neuro-oncology: Part 2de or a higher proliferative index (10).Box 11.1 The grading of meningiomas according to the 2007 WHO classification of tumours of the central nervousEbook Oxford textbook of neuro-oncology: Part 2
systemGrade IMeningothelialFibrous (fibroblastic)Transitional (mixed)PsammomatousAngiomatousMicrocysticSecretoryLymphoplasmocyte-richMetaplastic.GradCHAPTER 11MeningiomasRakesh Jalali, Patrick Y. Wen, and Takamitsu FujimakiEpidemiologyMeningiomas are the most common type of primary brain tumours in Ebook Oxford textbook of neuro-oncology: Part 2i ĨĨ, Wiestler OĐ, Cavenee WK, Ellison DW, Figarella-Branger D, Perry A, Reifenberger G, Von Deimling A (Eds), World Health Organization Classification of Tumours of the Central Nervous System, Fourth Edition Revised, Copyright (2016), 1ARC Publications.Genetic factorsApproximately 50-75% of patient Ebook Oxford textbook of neuro-oncology: Part 2s with NF2 have meningiomas, which are often multiple (11). NF2 is an autosomal dominant disorder caused by290a mutation in the NF2 gene on chromosomeEbook Oxford textbook of neuro-oncology: Part 2
22, a tumour suppressor gene which encodes a membrane cytoskclctal protein called merlin or schwannomin (12). Meningiomas may also occur in schwannomCHAPTER 11MeningiomasRakesh Jalali, Patrick Y. Wen, and Takamitsu FujimakiEpidemiologyMeningiomas are the most common type of primary brain tumours in Ebook Oxford textbook of neuro-oncology: Part 2 are more common in women, especially during their reproductive years (14, 15), as well as the presence of progesterone and androgen receptors in two-thirds of patients (16, 17), there has been longstanding interest hl the possible role of sox hormones in meningioma growth (18, 19, 20). Additionally Ebook Oxford textbook of neuro-oncology: Part 2, meningiomas may be more common among breast cancer patients (21). Epidemiological data (22, 23) and case reports (24) have suggested that exogenousEbook Oxford textbook of neuro-oncology: Part 2
oestrogens and progestins for hormone replacement therapy and contraceptive use may promote meningioma development or growth, but the associations areCHAPTER 11MeningiomasRakesh Jalali, Patrick Y. Wen, and Takamitsu FujimakiEpidemiologyMeningiomas are the most common type of primary brain tumours inCHAPTER 11MeningiomasRakesh Jalali, Patrick Y. Wen, and Takamitsu FujimakiEpidemiologyMeningiomas are the most common type of primary brain tumours inGọi ngay
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