====== Meningioma ====== ===== Latest Meningioma PubMed News ===== {{rss>https://pubmed.ncbi.nlm.nih.gov/rss/search/1zQzz5Ri6T93YIIeRh3V_ROi2_rvQ635PTNC5dB8mrUD---Q6M/?limit=15&utm_campaign=pubmed-2&fc=20230630024958}} {{ ::meningioma.png?300|}} Meningiomas are [[leptomeninge]]al [[neoplasm]]s thought to originate from [[arachnoid membrane]]s that form the [[cranial]] and spinal [[meninge]]s ((Smith MJ, O'Sullivan J, Bhaskar SS, Hadfield KD, Poke G, Caird J, Sharif S, Eccles D, Fitzpatrick D, Rawluk D, du Plessis D, Newman WG, Evans DG. Loss-of-function mutations in SMARCE1 cause an inherited disorder of multiple spinal meningiomas. Nat Genet. 2013 Mar;45(3):295-8. doi: 10.1038/ng.2552. Epub 2013 Feb 3. PubMed PMID: 23377182. )). ===== History ===== ====== History of Meningioma ====== ===== Ancient and Pre-Modern Descriptions ===== * **Prehistoric evidence**: Trepanned skulls from ancient Egypt and Peru show bone changes suggestive of slowly growing intracranial tumors. * **7th century – Paul of Aegina**: Described cranial masses possibly corresponding to meningiomas, noting their local expansion and compressive effects. ===== 19th Century Developments ===== * **1833 – Jean Cruveilhier**: * Provided early pathological illustrations of dural-based tumors. * Identified their expansive but typically non-invasive nature. * **1887 – Sir William Macewen**: * Performed one of the first successful surgical removals of an intracranial tumor compatible with meningioma. * **1891 – Francesco Durante**: * Reported resection of a parasagittal meningioma. * Pioneered surgical techniques for cranial tumors. ===== Coining the Term “Meningioma” ===== * **1922 – Harvey Cushing**: * Introduced the term *meningioma*. * Distinguished these tumors from gliomas and other intracranial neoplasms. * Developed surgical approaches and a preliminary classification based on clinical and pathological features. ===== Mid-20th Century: Diagnostic Progress ===== * **1930s–1950s**: * Use of pneumoencephalography and cerebral angiography to localize tumors. * **1970s**: * Introduction of **Computed Tomography (CT)**. * **1980s–1990s**: * Magnetic Resonance Imaging (MRI) improved non-invasive diagnosis and preoperative planning. ===== Histopathology and Grading ===== * **1993 – WHO Classification**: * Meningiomas classified into Grade I (benign), Grade II (atypical), and Grade III (anaplastic/malignant). * **Updated classifications**: * Revisions in 2000, 2007, 2016, and 2021 incorporate molecular markers. ===== Molecular and Genetic Insights ===== * **NF2 gene mutations**: * Found in ~50% of sporadic meningiomas. * **Other genetic alterations**: * TRAF7, KLF4, AKT1, SMO, and PIK3CA mutations identified. * **2020s**: * Molecular profiling influences prognosis and guides emerging targeted therapies. ===== Current Management and Future Directions ===== * Multimodal approach: * Observation, microsurgery, stereotactic radiosurgery, conventional radiotherapy. * Clinical trials investigating immunotherapy and targeted therapies. * Personalized medicine: * Tumor genetics and radiogenomics support individualized treatment plans. ---- **Note**: This page summarizes the key historical milestones in the understanding, diagnosis, and treatment of meningiomas. ---- Written with [[Louise Eisenhardt]] and published in [[1938]], [[Meningioma]]s is a monograph of incredible description and detail. The meticulous categorization of meningiomas, their presentation, clinical [[outcome]], and surgical therapies are even further supplemented by [[Cushing]]'s personal commentary, questions, and recollections. Cushing's genius was evident in his ability not only to make insightful clinical observations, but also to synthesize these ideas within the neurosurgical context of his era. As he says in Meningiomas, "Thus the pathological curiosity of one day becomes in its proper time a commonplace... most of which are one and the same disorder--had, for their interpretation, to await the advent of the Neurosurgeon ((Shrivastava RK, Segal S, Camins MB, Sen C, Post KD. Harvey Cushing's Meningiomas text and the historical origin of resectability criteria for the anterior one-third of the superior sagittal sinus. J Neurosurg. 2003 Oct;99(4):787-91. PubMed PMID: 14567620. )). ===== Epidemiology ===== [[Meningioma epidemiology]]. ===== Classification ===== [[Meningioma classification]]. ===== Cell lines ===== see [[Meningioma cell line]]s. ===== Meningioma immune response ===== [[Meningioma immune response]] ===== Etiology ===== see [[Meningioma etiology]]. ===== Pathogenesis ===== see [[Meningioma Pathogenesis]]. ===== Clinical features ===== [[Meningioma clinical features]]. ===== Diagnosis ===== see [[Meningioma Diagnosis]]. ===== Differential diagnosis ===== see [[Meningioma differential diagnosis]]. ===== Treatment ===== see [[Meningioma treatment]]. ===== Outcome ===== see [[Meningioma outcome]]. ===== Meningioma metastases ===== see [[Meningioma metastases]]. ===== Recurrence ===== see [[Meningioma recurrence]]. ====Simpson grading system==== see [[Simpson grading system]]. ===== Systematic reviews ===== [[Meningioma Systematic reviews]]. ====The Top 100 Most Cited Articles==== In November 2016, Almutairi et al. performed a title-specific search of the Scopus database using "Meningioma" as the search query term without publication date restrictions. The top 100 most cited articles were obtained and reviewed. The top 100 most cited articles received a mean 198 citations per paper. Publication dates ranged from 1953 to 2013; most articles were published between 1994 and 2003, with 50 articles published during that period. NEUROSURGERY published the greatest number of top cited articles (22 of 100). The most frequent study categories were laboratorial studies (31 of 100) and natural history studies (28 of 100). Non-operative management studies were twice as common as operative management studies in the top cited articles. Neurosurgery as a specialty contributed to 50% of the top 100 list. The most contributing institute was the Mayo Clinic (11%); the majority of the top cited articles originated in the United States (53%). They identified the top 100 most-cited articles on meningioma that may be considered significant and impactful works, as well as the most noteworthy. Additionally, they recognized the historical development and advances in meningioma research, and the important contributions of various authors, specialty fields, and countries. A large proportion of the most cited articles were written by authors other than neurosurgeons, and many of these articles were published in non-neurosurgery journals ((Almutairi O, Albakr A, Al-Habib A, Ajlan A. The Top 100 Most Cited Articles on Meningioma. World Neurosurg. 2017 Aug 10. pii: S1878-8750(17)31318-9. doi: 10.1016/j.wneu.2017.08.021. [Epub ahead of print] Review. PubMed PMID: 28804043. )). ===== Case series ===== [[Meningioma case series]].