More Related Content
Similar to Overview of Meningioma (Short review of types,symptoms and treatment)
Similar to Overview of Meningioma (Short review of types,symptoms and treatment) (20)
Recently uploaded
Recently uploaded (20)
Overview of Meningioma (Short review of types,symptoms and treatment)
- 1. Overview of Meningioma Dr. Khan Md. Nazmus Sakib Sr. Rmo, Department of Neurosurgery Asgar Ali Hospital
- 2. Defination • Meningiomas are the most common primary central nervous system (CNS) tumors. • They are usually benign, slow growing neoplasms. • They originate from arachnoid cap cells. • Arachnoid cap cells make up the outer layer of the arachnoid mater and arachnoid villi.
- 4. 54 24 12.6 6.2 2.1 1.1 1 0 10 20 30 40 50 60 Meningioma Pituitary tumor Nerve sheet tumur All other tumor of CNS Haemangioma Craniopharangioma Ependymal Tumor Percntages Types of tumor Distribution of non-malignant CNS tumor
- 5. Risk Factors • Ionizing Radiation • Obesity • Occupational (Pesticide/Herbicide)/Diet/Allergies • Hormone • Cytogenetics • Familial Syndrome • Neurofibromatosis Type 2 (NF2) • Gorlin syndrome • Cowden syndrome • Werner syndrome • BAP1 Tumor Predisposition Syndrome • Familial Syndromes Associated with SMARCB1 and SMARCE1 • Other familial syndrome (Li-Fraumeni, Turcot, Gardener, von Hippel-Lindau, Rubinstein–Taybi syndromeand MEN1)
- 6. Locational classification of meningioma with associated mutations & frequency Location & associated mutations Frequency Convexity 20-37% Parasagittal (NF2) 13-22% Spine (AKT1) 7-12% Skull Base • Frontobasal (TRAF7, AKT1, POLR2A, PIK3CA, SMO) • Sphenoid and Middle Cranial Fossa (TRAF7, AKT1, PIK3CA) • Posterior Fossa (NF2) 43-51% Inraventricular(NF2) 1-5% Orbital <1-2% Ectopic Location <1%
- 7. Skull base and non-skull base meningioma
- 8. WHO classification of meningioma Grade I (Benign) Grade II (Atypical) Grade III (Malignant or Anaplastic) Histological Subtypes • Meningothelial • Fibrous • Transitional • Psammomatous • Angiomatous • Microcystic • Secretory • Lymphoplasmacyte-rich • Metaplastic • Atypical • Clear cell • Choroid • Anaplastic • Rhabdoid • Papillary Diagnostic criteria Presence of <4 mitoses per 10 HPF 1.Presence of 4–19 mitoses per 10 HPF or 2.Brain invasion or 3.At least 3/5 of the following: -Patternless sheeting architecture -Small cell formation with high N/C ratio -Prominent nucleoli -Hypercellularity -Spontaneous intratumoral micronecrosis 1. Presence of ≥20 mitoses per 10 HPF or 2. Overtly malignant morphology (carcinomatous, sarcomatous, and melanomatous cytology)
- 9. Symptoms • Headache • Seizures • Changes in personality or behavior • Progressive focal neurological deficit • Confusion • Drowsiness • Hearing loss on ringing in the ears • Muscle weakness • Nausea or voimting • Visual disorders
- 10. Convexity meningioma: May cause seizures, headaches and neurological deficits.
- 11. Suprasellar meningioma: Vision problems due to compression of the optic nerves.
- 12. Falx and Parasagittal meningoma: Impaired levels of brain functioning, such as in reasoning and memory. If located in the middle section, it would likely cause leg weakness/numbness or seizures
- 13. Olfactory Groove meningioma: Loss of smell due to compression of the nerves that run between the brain and the nose. If the tumor grows large enough, vision problems may occur due to compression of the optic nerve.
- 14. Posterior Fossa meningioma: Facial symptoms or loss of hearing due to compression of cranial nerves, unsteady gait and problems with coordination.
- 15. Sphenoid meningioma: Vision problems, loss of sensation in the face or facial numbness and seizures.
- 16. Intraventricular meningioma: May block the flow of cerebrospinal fluid, resulting in obstructive hydrocephalus, potentially leading to headaches, lightheadedness and changes in mental function.
- 17. Spinal meningioma: Back pain or pain in the limbs caused by compression of the nerves that run into the spinal cord.
- 18. Diagnosis • CT scan • MRI
- 19. Treatment Small (Diameter <3cm), Asymptomatic Wait & See Contrast enhanced MRI after 6 months, then Annually for 5 years, Then every 2 years Short life expectancy (old age or severe complications)> Paliative care
- 20. Treatment Symptomatic meningioma Surgery WHO Grade I GTR Follow up STR Diameter <3cm or Volume <10cm3 Yes SRS No FRT WHO Grade II GTR Follow up STR FRT WHO Grade III All simpson grade FRT Chemotherapy RT and or chemotherapay
- 21. Thank you all