Turkish Neurosurgery
Radiation-Induced Meningiomas: A Series of Consecutive Four Patients and Review of the Literature
Anas Abdallah1, Hasan Burak Gündüz2, Murad Asiltürk2, Özden Erhan Sofuoğlu2, Bilge Bilgiç3, Erhan Emel2, Betül Güler Abdallah4
1Bezmialem Vakif University, Vatan Street, 34093 Fatih, Istanbul, Turkey, Department of Neurosurgery, Fatih/Istanbul,
2Bakırköy Research and Training Hospital for Neurology Neurosurgery, and Psychiatry, Department of Neurosurgery, Bakirkoy/Istanbul,
3Istanbul University Faculty of Medicine, Department of Pathology, Fatih/Istanbul,
4Bakırköy Research and Training Hospital for Neurology Neurosurgery, and Psychiatry, Department of Neurology-Intensive Care Unit, Bakirkoy/Istanbul,
DOI: 10.5137/1019-5149.JTN.21197-17.2
Aim:To assess the clinical outcomes of treatment for radiation-induced meningiomas.Material and Methods:Medical records of all cranial meningioma cases which diagnosed or/and underwent surgery in our hospital, during a 7-year period from 2009 to 2016 were retrospectively reviewed. All radiation-associated meningiomas were selected as the core sample used for this study. Results:This series included one female and three male patients with mean age 47.3±16.3 years on average. The mean preoperative course was less than three months. The most common presenting symptom was headache (100%). Three patients had alopecia and thin scalp skin. The mean age when received radiotherapy was 18.5±13.7. The mean latency period was 19.2±7.4 years. The first malignancies were two desmoplastic medulloblastomas (13-year-old female, 65Gy), (11-year-old male, 54Gy) and one oligodendroglioma-gradeII (39-year-old male, 30Gy). One patient received radiotherapy for chronic otitis (10-year-old male, Low-dose). The histopathological examinations were revealed (fibroblastic-gradeI, Ki-67 was 2-3%, 25.5years, cerebellopontine angle), (atypical meningioma-gradeII, ki-67 was 8%, 21years, frontal) and (transitional-gradeI, ki-67 was 3-4%, 11years, frontal), respectively. Fourth patient had three radiation-induced meningiomas and 27 radiation-induced cavernomas. This patient had treated using gamma knife. The mean follow-up period was 34.8±39.4 months. One patient had rhinorrhea, another one was experienced CSF fistula. Both of them were re-operated. The former was lost after involved with meningitis on postoperative 31st day.Conclusion:Most radiation-induced meningiomas are low-grade, but they have high trend to recurrence. Close follow-up and yearly MRI would minimize their morbidity rate. To reduce fatal complications, surgery has to plan with plastic surgeons.
Corresponding author : Anas Abdallah