Retrospective analysis of meningomal cases in Neurosurgery Clinic of Dokuz Eylul University

Objective: Menegiomas are the most commonly seen intracranial benign tumors, as one thirds of the central nervou system tumors. Menengiomas make up 30% of the primary brain tumors in adults. These tumors has characteristic clinical, histopathological and radiological features. When the current studies about menengiomas are analyzed, we can conclude that most of the studies having higher number of cases and being references to reference books are studies with limited information about the cases themselves. We analyzed intracranial menengioma cases with detailed information about the cases retrospectively. Material and Methods: 144 cases were included to the staudy among the total of 206 cases which were operated between 01/01/2008 and 31/12/2016 in Dokuz Eylül University Hospital Neurosurgery Clinic and the pathology reported as menengioma. Demographic, clinical, radological, pathological, treatment and follow-up information of these patients were assesed and then statistically analyzed. Results: 102(70,8%) of the cases were woman, 42(29,2%) of the cases were man among 144 cases included in the study and the mean age of diagnosis was 54,4± 12,64 (range of age was 27-78). 42,4%(61 case) of the cases had a chronic disease, 30,6%(44 case) had history of smoking, 27,8%(40 case) had previous history of other surgery, 12,5%(18 case) had additional malignant disease, 2,8%(4 case) had preoperative history of radiotherapy due to a non-menengiomal disease, 2,8%(4 case) had history of head trauma. Histopathological assesment of the cases in our study were done according to 2007 World Health Organization Classification. According to this classification 107(74,3%) of the cases were Grade I typical meningioma, 35(24,3%) were Grade II atypical meningioma, 2(1,4%) were Grade III anaplastic-malignant meningioma. When the cases evaluated according to the localization, 63(43,8%) of the cases were located in the skullbase. The distrubution of localization was 49 (34%) of the cases were cerebral convexity, 22 (15,3%) were falcine, 20 (13,7%) were parasagittal, 14 (9,7%) were sphenoidal wing, 7 (4,9%) were olfactory groove, 7 (4,9%) were sphenoorbital, 6(4,2%) were cerebellar, , 6 (4,2%) were sellar/parasellar, 5 (3,5%) were cerebellopontine angle, 5 (3,5%) were tentorial, 3 (2,1%) were intraorbital. Regarding radiological finding 45 (31,3%) cases had calsification, 85 (59%) had surrounding edema, 36 (25%) had dural tail, 5 (3,5%) had multiple meningioma, 4 (2,8%) had end plate. Among 50 (34,7%) of the cases which have bony changes, 47 (32,6%) cases with hypertrophic changes in the bone and 3 (2,1%) cases with lytic changes were observed. MRI sequnces in grey matter distribution was: in T1 sequence 49(34%) of the cases with hypointensity, 79 (54,9%) with isointensity, 16 (11,1%) with hyperintensity and in T2 sequence 32 (22,2%) of the cases with hypointensity, 43 (29,9%) with isointensity, 69 (47,9%) with hyperintensity was determined. When analyzed according to postoperative prognosis in 49 (34%) of the cases the complaints remain the same, in 79 (54,9%) the complaints got better, in 16 (11,1%) the complaint got worse. Patients' postoperative and preoperative results compared, increament in postoperative mean value was seen. Excision degree of the menegiomas was evaluated with Simpson grading system: 47(32,6%) cases were simpson grade 1, 65(45,1%) were simpson grade 2, 20 (13,9%) were simpson grade 3, 12(8,4%) were simpson grade 4.The postoperative complications were compared: in 7(4,9%) of the cases wound site infection, in 1(0,7%) menengitis, in 4(2,8%) CSF leak, in 2(1,4%) epidural hematoma, in 3(2,1%) intracerebellar hematoma, in 3 (2,1%) abscess, in 1 (0,7%) hydrocephalus and in 2 (1,4%) deaths were seen in the postoperative inpatient follow-up. The mean duration of hospitalization was 12,31± 34,17 days and mean duration of postoperative follow-up was 26,17± 27,52 months. During postoperative follow-up in 5(3,5%) cases recurrence was seen. Postoperatively 16 (11,2%) cases were given radiotherapy. Conclusion: This study will contribute to the literature as composes detailed information on the case basis however prospective studies with genetic and molecular parameters about menegiomas will be required.