Meningiomas: Update on the Diagnosis and Management

A special issue of Cancers (ISSN 2072-6694).

Deadline for manuscript submissions: closed (20 June 2022) | Viewed by 12241

Special Issue Editors


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Guest Editor
Department of Neuroscience and Reproductive and Odontostomatological Sciences, University of Naples Federico II, 80131 Naples, Italy
Interests: neurosurgery; neuro-oncology; neuropathology
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
Interests: neuropathology; neuro-oncology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The aim of this Special Issue is to discuss the most actual aspect on the diagnosis and management of meningiomas with the contribution of several experts on this field.

We are pleased to invite you to contribute an article relating to the following topics:

  • Pathological and biomolecular diagnosis;
  • Radiomics and image-correlated features with tumor pathology;
  • Management options of meningiomas.

The aim of this Special Issue is to discuss the most recent innovations of the epidemiological, pathological and neuroradiological diagnosis and management of the meningiomas.

In this Special Issue, original research articles and reviews are welcome. Research areas may include (but are not limited to) the following:

  • Population-based aspects
  • Diagnosis
  • Management
  • Recurrences

I look forward to receiving your contributions.

Prof. Dr. Francesco Maiuri
Prof. Dr. Marialaura Del Basso De Caro
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • meningioma
  • molecular biology
  • radiomics
  • transbasal endoscopy
  • imaging-guided surgery
  • radiation therapy
  • stereotactic radiosurgery
  • proton beam therapy
  • meningioma recurrence

Published Papers (6 papers)

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Editorial

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4 pages, 207 KiB  
Editorial
Update on the Diagnosis and Management of Meningiomas
by Francesco Maiuri and Marialaura Del Basso de Caro
Cancers 2023, 15(14), 3575; https://doi.org/10.3390/cancers15143575 - 12 Jul 2023
Cited by 1 | Viewed by 699
Abstract
This series of five articles (one original article and four reviews) focuses on the most recent and interesting research studies on the biomolecular and radiological diagnosis and the surgical and medical management of meningiomas [...] Full article
(This article belongs to the Special Issue Meningiomas: Update on the Diagnosis and Management)

Research

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18 pages, 1347 KiB  
Article
Matched Paired Primary and Recurrent Meningiomas Points to Cell-Death Program Contributions to Genomic and Epigenomic Instability along Tumor Progression
by Teresa San-Miguel, Javier Megías, Daniel Monleón, Lara Navarro, Lisandra Muñoz-Hidalgo, Carmina Montoliu, Marina Meri, Pedro Roldán, Miguel Cerdá-Nicolás and Concha López-Ginés
Cancers 2022, 14(16), 4008; https://doi.org/10.3390/cancers14164008 - 19 Aug 2022
Viewed by 1404
Abstract
Meningioma (MN) is an important cause of disability, and predictive tools for estimating the risk of recurrence are still scarce. The need for objective and cost-effective techniques addressed to this purpose is well known. In this study, we present methylation-specific multiplex ligation-dependent probe [...] Read more.
Meningioma (MN) is an important cause of disability, and predictive tools for estimating the risk of recurrence are still scarce. The need for objective and cost-effective techniques addressed to this purpose is well known. In this study, we present methylation-specific multiplex ligation-dependent probe amplification (MS-MLPA) as a friendly method for deepening the understanding of the mechanisms underlying meningioma progression. A large follow-up allowed us to obtain 50 samples, which included the primary tumor of 20 patients in which half of them are suffering one recurrence and the other half are suffering more than one. We histologically characterized the samples and performed MS-MLPA assays validated by FISH to assess their copy number alterations (CNA) and epigenetic status. Interestingly, we determined the increase in tumor instability with higher values of CNA during the progression accompanied by an increase in epigenetic damage. We also found a loss of HIC1 and the hypermethylation of CDKN2B and PTEN as independent prognostic markers. Comparison between grade 1 and higher primary MN’s self-evolution pointed to a central role of GSTP1 in the first stages of the disease. Finally, a high rate of alterations in genes that are related to apoptosis and autophagy, such as DAPK1, PARK2, BCL2, FHIT, or VHL, underlines an important influence on cell-death programs through different pathways. Full article
(This article belongs to the Special Issue Meningiomas: Update on the Diagnosis and Management)
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Review

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33 pages, 6732 KiB  
Review
Midline Skull Base Meningiomas: Transcranial and Endonasal Perspectives
by Ciro Mastantuoni, Luigi Maria Cavallo, Felice Esposito, Elena d’Avella, Oreste de Divitiis, Teresa Somma, Andrea Bocchino, Gianluca Lorenzo Fabozzi, Paolo Cappabianca and Domenico Solari
Cancers 2022, 14(12), 2878; https://doi.org/10.3390/cancers14122878 - 10 Jun 2022
Cited by 7 | Viewed by 2157
Abstract
Skull base meningiomas have always represented a challenge for neurosurgeons. Despite their histological nature, they may be associated with unfavorable outcomes due to their deep-seated location and the surrounding neurovascular structures. The state of the art of skull base meningiomas accounts for both [...] Read more.
Skull base meningiomas have always represented a challenge for neurosurgeons. Despite their histological nature, they may be associated with unfavorable outcomes due to their deep-seated location and the surrounding neurovascular structures. The state of the art of skull base meningiomas accounts for both transcranial, or high, and endonasal, or low, routes. A comprehensive review of the pertinent literature was performed to address the surgical strategies and outcomes of skull base meningioma patients treated through a transcranial approach, an endoscopic endonasal approach (EEA), or both. Three databases (PubMed, Ovid Medline, and Ovid Embase) have been searched. The review of the literature provided 328 papers reporting the surgical, oncological, and clinical results of different approaches for the treatment of skull base meningiomas. The most suitable surgical corridors for olfactory groove, tuberculum sellae, clival and petroclival and cavernous sinus meningiomas have been analyzed. The EEA was proven to be associated with a lower extent of resection rates and better clinical outcomes compared with transcranial corridors, offering the possibility of achieving the so-called maximal safe resection. Full article
(This article belongs to the Special Issue Meningiomas: Update on the Diagnosis and Management)
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13 pages, 2081 KiB  
Review
Meningioma Radiomics: At the Nexus of Imaging, Pathology and Biomolecular Characterization
by Lorenzo Ugga, Gaia Spadarella, Lorenzo Pinto, Renato Cuocolo and Arturo Brunetti
Cancers 2022, 14(11), 2605; https://doi.org/10.3390/cancers14112605 - 25 May 2022
Cited by 10 | Viewed by 2396
Abstract
Meningiomas are the most common extra-axial tumors of the central nervous system (CNS). Even though recurrence is uncommon after surgery and most meningiomas are benign, an aggressive behavior may still be exhibited in some cases. Although the diagnosis can be made by radiologists, [...] Read more.
Meningiomas are the most common extra-axial tumors of the central nervous system (CNS). Even though recurrence is uncommon after surgery and most meningiomas are benign, an aggressive behavior may still be exhibited in some cases. Although the diagnosis can be made by radiologists, typically with magnetic resonance imaging, qualitative analysis has some limitations in regard to outcome prediction and risk stratification. The acquisition of this information could help the referring clinician in the decision-making process and selection of the appropriate treatment. Following the increased attention and potential of radiomics and artificial intelligence in the healthcare domain, including oncological imaging, researchers have investigated their use over the years to overcome the current limitations of imaging. The aim of these new tools is the replacement of subjective and, therefore, potentially variable medical image analysis by more objective quantitative data, using computational algorithms. Although radiomics has not yet fully entered clinical practice, its potential for the detection, diagnostic, and prognostic characterization of tumors is evident. In this review, we present a wide-ranging overview of radiomics and artificial intelligence applications in meningioma imaging. Full article
(This article belongs to the Special Issue Meningiomas: Update on the Diagnosis and Management)
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14 pages, 330 KiB  
Review
Clinical Significance of Molecular Alterations and Systemic Therapy for Meningiomas: Where Do We Stand?
by Alessia Pellerino, Francesco Bruno, Rosa Palmiero, Edoardo Pronello, Luca Bertero, Riccardo Soffietti and Roberta Rudà
Cancers 2022, 14(9), 2256; https://doi.org/10.3390/cancers14092256 - 30 Apr 2022
Cited by 8 | Viewed by 2136
Abstract
Meningiomas are common intracranial tumors that can be treated successfully in most cases with surgical resection and/or adjuvant radiotherapy. However, approximately 20% of patients show an aggressive clinical course with tumor recurrence or progressive disease, resulting in significant morbidity and increased mortality. Despite [...] Read more.
Meningiomas are common intracranial tumors that can be treated successfully in most cases with surgical resection and/or adjuvant radiotherapy. However, approximately 20% of patients show an aggressive clinical course with tumor recurrence or progressive disease, resulting in significant morbidity and increased mortality. Despite several studies that have investigated different cytotoxic agents in aggressive meningiomas in the past several years, limited evidence of efficacy and clinical benefit has been reported thus far. Novel molecular alterations have been linked to a particular clinicopathological phenotype and have been correlated with grading, location, and prognosis of meningiomas. In this regard, SMO, AKT, and PIK3CA mutations are typical of anterior skull base meningiomas, whereas KLF4 mutations are specific for secretory histology, and BAP1 alterations are common in progressive rhabdoid meningiomas. Alterations in TERT, DMD, and BAP1 correlate with poor outcomes. Moreover, some actionable mutations, including SMO, AKT1, and PIK3CA, regulate meningioma growth and are under investigation in clinical trials. PD-L1 and/or M2 macrophage expression in the microenvironment provides evidence for the investigation of immunotherapy in progressive meningiomas. Full article
(This article belongs to the Special Issue Meningiomas: Update on the Diagnosis and Management)
14 pages, 489 KiB  
Review
The Simpson Grading: Is It Still Valid?
by Silky Chotai and Theodore H. Schwartz
Cancers 2022, 14(8), 2007; https://doi.org/10.3390/cancers14082007 - 15 Apr 2022
Cited by 20 | Viewed by 2529
Abstract
The Simpson Grade was introduced in the era of limited resources, outdated techniques, and rudimentary surgical and imaging technologies. With the advent of modern techniques including pre- and post-operative imaging, microsurgical and endoscopic techniques, advanced histopathology and molecular analysis and adjuvant radiotherapy, the [...] Read more.
The Simpson Grade was introduced in the era of limited resources, outdated techniques, and rudimentary surgical and imaging technologies. With the advent of modern techniques including pre- and post-operative imaging, microsurgical and endoscopic techniques, advanced histopathology and molecular analysis and adjuvant radiotherapy, the utility of the Simpson Grade scale for prognostication of recurrence after meningioma resection has become less useful. While the extent of resection remains an important factor in reducing recurrence, a subjective naked-eye criteria to Grade extent of resection cannot be generalized to all meningiomas regardless of their location or biology. Achieving the highest Simpson Grade resection should not always be the goal of surgery. It is prudent to take advantage of all the tools in the neurosurgeons’ armamentarium to aim for maximal safe resection of meningiomas. The primary goal of this study was to review the literature highlighting the Simpson Grade and its association with recurrence in modern meningioma practice. A PubMed search was conducted using terms “Simpson”, “Grade”, “meningioma”, “recurrence”, “gross total resection”, “extent of resection” “human”. A separate search using the terms “intraoperative imaging”, “intraoperative MRI” and “meningioma” were conducted. All studies reporting prognostic value of Simpson Grades were retrospective in nature. Simpson Grade I, II and III can be defined as gross total resection and were associated with lower recurrence compared to Simpson Grade IV or subtotal resection. The volume of residual tumor, a factor not considered in the Simpson Grade, is also a useful predictor of recurrence. Subtotal resection followed by stereotactic radiosurgery has similar recurrence-free survival as gross total resection. In current modern meningioma surgery, the Simpson Grade is no longer relevant and should be replaced with a grading scale that relies on post-operative MRI imaging that assess GTR versus STR and then divides STR into > or <4–5 cm3, in combination with modern molecular-based techniques for recurrence risk stratification. Full article
(This article belongs to the Special Issue Meningiomas: Update on the Diagnosis and Management)
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