Summary
Nineteen cases of malignant meningiomas-seven haemangiopericytic, two papillary and ten of the anaplastic type-were examined clinicopathologically. These were ten male and nine female patients and eleven of these received reoperation for recurrence.
Tumours of the hemangiopericytic type had similar angiographic and macrooscopic features and malignant characteristics were found microscopically in some tumours. There were intratumoral cysts in both cases of the papillary type and these tumours had a high cellularity, an increased number of mitosis, haemorrhage and partially haemangiopericytic patterns. Six cases of the anaplastic type had changed from a benign type at recurrence and those tumours had variable features radiographically and macroscopically. Lack of typical arrangement, a large number of mitoses, increased cellularity, focal necrosis, brain infiltration, pleomorphism and anaplasia were found histologically. Four cases of the anaplastic type were diagnosed at the first operation and these tumours had apparently similar angiographic and macroscopic features, but with variable organoid structures and malignant forms, microscopically. Electron microscopic features are also described.
In malignant meningiomas, the recurrence rate was high even in cases of total removal. The outcome for these patients was good in the papillary type, relatively good in the haemangiopericytic type and poor in the anaplastic type. From these results therapeutic indications are also suggested.
Similar content being viewed by others
References
Carella, R. J., Ransohoff, J., Newall, J., Role of radiation therapy in the management of meningioma. Neurosurgery10 (1982), 332–339.
Cervós-Navarro, J., Martins, L. F., Lazaro, M. C., Ultrastructure of malignant meningioma and meningosarcoma. In: Advances in Neurosurgery 2 (Klug, W.,et al., eds.), pp. 12–22. Berlin-Heidelberg-New York: Springer. 1975.
Crompton, M. R., Gautier-Smith, P. C., The prediction of recurrence in meningiomas. J. Neurol. Neurosurg. Psychiat.33 (1970), 80–87.
Dietemann, J. L., Heldt, N., Burguet, J. L., Medjek, L., Maitrot, D., Wackenheim, A., CT findings in malignant meningiomas. Neuroradiology23 (1982), 207–209.
Fabiani, A., Trebini, F., Favero, M., Peres, B., Palmucci, L., The significance of atypical mitoses in malignant meningiomas. Acta Neuropath. (Berl.)38 (1977), 229–231.
Fromm, H., Schäfer, M., Vitzthum, H. G., Unusual course of surgically treated intracranial Maningiomas, with special reference to their malignant degeneration. In: Advances in Neurosurgery 2 (Klug, W.,et al., eds.), pp. 23–28. Berlin-Heidelberg-New York: Springer. 1975.
Fukui, M., Kitamura, K., Yonemasu, Y., Takaki, T., Soejima, T., Wakisaka, S., Okudera, T., Mihara, K., Malignant primary meningeal tumors. Neurol. Med. Chir.14 (1974), 35–46.
Fukui, M., Kitamura, K., Ohgami, S., Takaki, T., Kinoshita, K., Watanabe, K., Mihara, K., Radiosensitivity of meningioma-Analysis of five cases of highly vascular meningioma treated by preoperative irradiation. Acta Neurochir. (Wien)36 (1977), 47–60.
Inoue, A., Hirano, A., Kawakami, S., Nakai, O., Metastasizing malignant meningioma: A case report-Histopathological observation. Neurol. Surg. (Tokyo)11 (1983), 187–192.
Kyoi, K., Utsumi, S., Yokoyama, K., Tanikake, T., Konishi, Y., Matsuo, N., Malignant meningioma with multiple extracranial metastases, Case report. Neurol. Med. Chir. (Tokyo)22 (1982), 1022–1028.
Ludwin, S. K., Conley, F. K., Malignant meningioma metastasizing through the cerebrospinal pathways. J. Neurol. Neurosurg. Psychiat.38 (1975), 136–142.
New, P. F. J., Hesselink, J. R., O'Carroll, C. P., Kleinman, G. M., Malignant meningiomas: CT and histologic criteria, including a new CT sign. AJNR3 (1982), 267–276.
Peña, C. E., Meningioma and intracranial hemangiopericytoma: A comparative electron microscopic study. Acta Neuropath. (Berl.)39 (1977), 69–74.
Pietruszka, M., Salazar, H., Peña, C., Malignant meningioma: Ultrastructure and observations on histogenesis. Pathology10 (1978). 169–173.
Popoff, N. A., Malinin, T. I., Rosomoff, H. L., Fine structure of intracranial hemangiopericytoma and angiomatous meningioma. Cancer34 (1974), 1187–1197.
Simpson, D., The recurrence of intracranial meningiomas after surgical treatment. J. Neurol. Neurosurg. Psychiat.20 (1957), 22–39.
Tamura, M., Kawafuchi, J., Inoue, H., Takeda, F., Prognosis in meningioma after surgical treatment-with special reference to malignant transformation and recurrence. Neurol. Med. Chir.19 (1979), 411–419.
Thomas, H. G., Dolman, C. L., Berry, K., Malignant meningioma: clinical and pathological features. J. Neurosurg.55 (1981), 929–934.
Turner, O. A., Craig, W. M., Kernohan, J. W., Malignant meningiomas: A clinical and pathologic study. Surgery11 (1942), 81–100.
Tyths, J. S., Lasersohn, J. T., Reifel, E., The problem of malignancy in meningiomas. J. Neurosurg.27 (1967), 551–557.
Wara, W. M., Sheline, G. E., Newman, H., Townsed, J. J., Boldrey, E. B., Radiation therapy of meningiomas. Amer. J. Roentgenol. Radium Ther. Nucl. Med.123 (1975), 453–458.
Yamakawa, Y., Kinoshita, K., Fukui, M., Mihara, K., Koga, K., Kitamura, K., Radiosensitive meningioma. Surg. Neurol.13 (1980), 471–475.
Zülch, K. J., Mennel, H. D., Malignant meningiomas. In: Advances in Neurosurgery 2 (Klug, W.,et al., eds.), pp. 3–11. Berlin-Heidelberg-New York: Springer. 1975.
Zülch, K. J., Histological typing of tumours of the central nervous system. International histological classification of tumours, No. 21. Geneva: World Health Organization. 1979.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Inoue, H., Tamura, M., Koizumi, H. et al. Clinical pathology of malignant meningiomas. Acta neurochir 73, 179–191 (1984). https://doi.org/10.1007/BF01400851
Issue Date:
DOI: https://doi.org/10.1007/BF01400851