Skip to main content

Advertisement

SpringerLink
Log in

Comparative analysis of intracranial meningiomas in patients younger than 40 years

  • Clinical Study
  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

Abstract

Purpose

Intracranial meningiomas are relatively rare in young adults, and their specific clinical features remain unclear. The authors analyzed the clinical characteristics of intracranial meningioma in patients younger than 40 years.

Methods

Consecutive patients younger than 40 years with meningioma (n = 223) who underwent surgical treatment at our hospital from 2010 to 2018 were retrospectively reviewed. The study cases was further divided into a younger group (≤ 30 years old; n = 63) and an older group (31–40 years old; n = 160). The clinical information, radiological characteristics, intraoperative findings, and pathological outcomes were extracted from the patients’ records and statistically analyzed.

Results

Intracranial meningioma is uncommon in patients younger than 40 years (8.6%). The study group’s most common symptoms at presentation were headaches (46.7%), visual impairment (27.8%), limb weakness (20.6%), and epilepsy (13.5%). The mean tumor size was larger (51.47 ± 50.36 cm3) in the younger group than in the older group (22.94 ± 27.20 cm3). According to multivariate analyses, young age was an independent predictor of large tumor size, and large tumor size was significantly associated with peritumoral brain edema and intraoperative blood loss.

Conclusion

Intracranial meningiomas in younger adult patients may have special complexity and perioperative risk due to large tumor sizes. Therefore, individualized treatment strategy is recommended, and the appropriate caution should be taken during surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Cushing H, Eisenhardt L (1938) Meningiomas: their classification, regional behavior, life history, and surgical end results. Charles C Thomas, Springfield

    Google Scholar 

  2. Claus EB, Bondy ML, Schildkraut JM, Wiemels JL, Wrensch M, Black PM (2005) Epidemiology of intracranial meningioma. Neurosurgery 57:1088–1095. https://doi.org/10.1227/01.Neu.0000188281.91351.B9

    Article  PubMed  Google Scholar 

  3. Baldi I, Engelhardt J, Bonnet C, Bauchet L, Berteaud E, Gruber A, Loiseau H (2018) Epidemiology of meningiomas. Neurochirurgie 64:5–14. https://doi.org/10.1016/j.neuchi.2014.05.006

    Article  CAS  PubMed  Google Scholar 

  4. Ravindranath K, Vasudevan MC, Pande A, Symss N (2013) Management of pediatric intracranial meningiomas: an analysis of 31 cases and review of literature. Child’s Nerv Syst 29:573–582. https://doi.org/10.1007/s00381-012-2010-7

    Article  Google Scholar 

  5. Santos MV, Furlanetti L, Valera ET, Brassesco MS, Tone LG, de Oliveira RS (2012) Pediatric meningiomas: a single-center experience with 15 consecutive cases and review of the literature. Child’s Nerv Syst 28:1887–1896. https://doi.org/10.1007/s00381-012-1823-8

    Article  Google Scholar 

  6. Gao X, Zhang R, Mao Y, Wang Y (2009) Childhood and juvenile meningiomas. Child’s Nerv Syst 25:1571–1580. https://doi.org/10.1007/s00381-009-0964-x

    Article  Google Scholar 

  7. Menon G, Nair S, Sudhir J, Rao BRM, Mathew A, Bahuleyan B (2009) Childhood and adolescent meningiomas: a report of 38 cases and review of literature. Acta Neurochir 151:239–244. https://doi.org/10.1007/s00701-009-0206-8

    Article  CAS  PubMed  Google Scholar 

  8. Arivazhagan A, Devi BI, Kolluri SV, Abraham RG, Sampath S, Chandramouli BA (2008) Pediatric intracranial meningiomas–do they differ from their counterparts in adults? Pediatr Neurosurg 44:43–48. https://doi.org/10.1159/000110661

    Article  CAS  PubMed  Google Scholar 

  9. Liu Y, Li F, Zhu S, Liu M, Wu C (2008) Clinical features and treatment of meningiomas in children: report of 12 cases and literature review. Pediatr Neurosurg 44:112–117. https://doi.org/10.1159/000113112

    Article  PubMed  Google Scholar 

  10. Caroli E, Russillo M, Ferrante L (2006) Intracranial meningiomas in children: report of 27 new cases and critical analysis of 440 cases reported in the literature. J Child Neurol 21:31–36. https://doi.org/10.2310/7010.2006.00009

    Article  PubMed  Google Scholar 

  11. Erdinçler P, Lena G, Sarioğlu AÇ, Kuday C, Choux M (1998) Intracranial meningiomas in children: review of 29 cases. Surg Neurol 49:136–140. https://doi.org/10.1016/s0090-3019(97)00343-1

    Article  PubMed  Google Scholar 

  12. Bitzer M, Wöckel L, Luft AR, Wakhloo AK, Petersen D, Opitz H, Sievert T, Ernemann U, Voigt K (1997) The importance of pial blood supply to the development of peritumoral brain edema in meningiomas. J Neurosurg 87:368–373. https://doi.org/10.3171/jns.1997.87.3.0368

    Article  CAS  PubMed  Google Scholar 

  13. Osawa T, Tosaka M, Nagaishi M, Yoshimoto Y (2013) Factors affecting peritumoral brain edema in meningioma: special histological subtypes with prominently extensive edema. J Neurooncol 111:49–57. https://doi.org/10.1007/s11060-012-0989-y

    Article  PubMed  Google Scholar 

  14. Simpson D (1957) The recurrence of intracranial meningiomas after surgical treatment. J Neurol Neurosurg Psychiatry 20:22–39

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Ferrante L, Acqui M, Artico M, Mastronardi L, Rocchi G, Fortuna A (1989) Cerebral meningiomas in children. Child’s Nerv Syst 5:83–86. https://doi.org/10.1007/bf00571115

    Article  CAS  Google Scholar 

  16. Germano IM, Edwards MSB, Davis RL, Schiffer D (1994) Intracranial meningiomas of the first two decades of life. J Neurosurg 80:447–453. https://doi.org/10.3171/jns.1994.80.3.0447

    Article  CAS  PubMed  Google Scholar 

  17. Kotecha RS, Junckerstorff RC, Lee S, Cole CH, Gottardo NG (2011) Pediatric meningioma: current approaches and future direction. J Neuro-Oncol 104:1–10. https://doi.org/10.1007/s11060-010-0503-3

    Article  Google Scholar 

  18. Kotecha RS, Pascoe EM, Rushing EJ, Rorke-Adams LB, Zwerdling T, Gao X, Li X, Greene S, Amirjamshidi A, Kim S-K, Lima MA, Hung P-C, Lakhdar F, Mehta N, Liu Y, Devi BI, Sudhir BJ, Lund-Johansen M, Gjerris F, Cole CH, Gottardo NG (2011) Meningiomas in children and adolescents: a meta-analysis of individual patient data. Lancet Oncol 12:1229–1239. https://doi.org/10.1016/s1470-2045(11)70275-3

    Article  PubMed  Google Scholar 

  19. Rushing EJ, Olsen C, Mena H, Rueda M-E, Lee Y-S, Keating RF, Santi M (2005) Central nervous system meningiomas in the first two decades of life: a clinicopathological analysis of 87 patients. J Neurosurg Pediatr 103:489–495. https://doi.org/10.3171/ped.2005.103.6.0489

    Article  Google Scholar 

  20. Wiedmann MKH, Brunborg C, Di Ieva A, Lindemann K, Johannesen TB, Vatten L, Helseth E, Zwart JA (2017) Overweight, obesity and height as risk factors for meningioma, glioma, pituitary adenoma and nerve sheath tumor: a large population-based prospective cohort study. Acta Oncol 56:1302–1309. https://doi.org/10.1080/0284186X.2017.1330554

    Article  PubMed  Google Scholar 

  21. Niedermaier T, Behrens G, Schmid D, Schlecht I, Fischer B, Leitzmann MF (2015) Body mass index, physical activity, and risk of adult meningioma and glioma. Neurology 85:1342–1350. https://doi.org/10.1212/wnl.0000000000002020

    Article  PubMed  Google Scholar 

  22. Zhang D, Chen J, Wang J, Gong S, Jin H, Sheng P, Qi X, Lv L, Dong Y, Hou L (2016) Body mass index and risk of brain tumors: a systematic review and dose-response meta-analysis. Eur J Clin Nutr 70:757–765. https://doi.org/10.1038/ejcn.2016.4

    Article  CAS  PubMed  Google Scholar 

  23. Wiedmann M, Brunborg C, Lindemann K, Johannesen TB, Vatten L, Helseth E, Zwart JA (2013) Body mass index and the risk of meningioma, glioma and schwannoma in a large prospective cohort study (The HUNT Study). Br J Cancer 109:289–294. https://doi.org/10.1038/bjc.2013.304

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Li X, Wang C, Lin Z, Zhao M, Ren X, Zhang X, Jiang Z (2019) Risk factors and control of seizures in 778 Chinese patients undergoing initial resection of supratentorial meningiomas. Neurosurg Rev. https://doi.org/10.1007/s10143-019-01085-5

    Article  PubMed  PubMed Central  Google Scholar 

  25. Seyedi JF, Pedersen CB, Poulsen FR (2018) Risk of seizures before and after neurosurgical treatment of intracranial meningiomas. Clin Neurol Neurosurg 165:60–66. https://doi.org/10.1016/j.clineuro.2018.01.002

    Article  PubMed  Google Scholar 

  26. Whittle IR, Smith C, Navoo P, Collie D (2004) Meningiomas. Lancet 363:1535–1543. https://doi.org/10.1016/s0140-6736(04)16153-9

    Article  PubMed  Google Scholar 

  27. Riemenschneider MJ, Perry A, Reifenberger G (2006) Histological classification and molecular genetics of meningiomas. Lancet Neurol 5:1045–1054. https://doi.org/10.1016/s1474-4422(06)70625-1

    Article  CAS  PubMed  Google Scholar 

  28. Guenther F, Swozil F, Heber S, Buchfelder M, Messlinger K, Fischer MJ (2018) Pre- and postoperative headache in patients with meningioma. Cephalalgia. https://doi.org/10.1177/0333102418793636

    Article  PubMed  Google Scholar 

  29. Hou J, Kshettry VR, Selman WR, Bambakidis NC (2013) Peritumoral brain edema in intracranial meningiomas: the emergence of vascular endothelial growth factor-directed therapy. Neurosurg Focus 35:E2. https://doi.org/10.3171/2013.8.FOCUS13301

    Article  PubMed  Google Scholar 

  30. Park KJ, Kang SH, Chae YS, Yu MO, Cho TH, Suh JK, Lee HK, Chung YG (2010) Influence of interleukin-6 on the development of peritumoral brain edema in meningiomas. J Neurosurg 112:73–80. https://doi.org/10.3171/2009.4.JNS09158

    Article  CAS  PubMed  Google Scholar 

  31. Bitzer M, Wockel L, Morgalla M, Keller C, Friese S, Heiss E, Meyermann R, Grote E, Voigt K (1997) Peritumoural brain oedema in intracranial meningiomas: influence of tumour size, location and histology. Acta Neurochir 139:1136–1142. https://doi.org/10.1007/bf01410973

    Article  CAS  PubMed  Google Scholar 

  32. Bitzer M, Opitz H, Popp J, Morgalla M, Gruber A, Heiss E, Voigt K (1998) Angiogenesis and brain oedema in intracranial meningiomas: influence of vascular endothelial growth factor. Acta Neurochir 140:333–340. https://doi.org/10.1007/s007010050106

    Article  CAS  PubMed  Google Scholar 

  33. Inamura T, Nishio S, Takeshita I, Fujiwara S, Fukui M (1992) Peritumoral brain edema in meningiomas–influence of vascular supply on its development. Neurosurgery 31:179–185. https://doi.org/10.1227/00006123-199208000-00002

    Article  CAS  PubMed  Google Scholar 

  34. Maiuri F, Gangemi M, Cirillo S, Delehaye L, Gallicchio B, Carandente M, Giamundo A (1987) Cerebral edema associated with meningiomas. Surg Neurol 27:64–68. https://doi.org/10.1016/0090-3019(87)90109-1

    Article  CAS  PubMed  Google Scholar 

  35. Schmid S, Aboul-Enein F, Pfisterer W, Birkner T, Stadek C, Knosp E (2010) Vascular endothelial growth factor: the major factor for tumor neovascularization and edema formation in meningioma patients. Neurosurgery 67:1703–1708. https://doi.org/10.1227/NEU.0b013e3181fb801b

    Article  PubMed  Google Scholar 

  36. Gawlitza M, Fiedler E, Schob S, Hoffmann KT, Surov A (2017) Peritumoral brain edema in meningiomas depends on aquaporin-4 expression and not on tumor grade, tumor volume, cell count, or Ki-67 labeling index. Mol Imaging Biol 19:298–304. https://doi.org/10.1007/s11307-016-1000-7

    Article  CAS  PubMed  Google Scholar 

  37. Lieu A-S, Howng S-L (1999) Intracranial meningiomas and epilepsy: incidence, prognosis and influencing factors. Epilepsy Res 38:45–52. https://doi.org/10.1016/s0920-1211(99)00066-2

    Article  Google Scholar 

  38. Vignes JR, Sesay M, Rezajooi K, Gimbert E, Liguoro D (2008) Peritumoral edema and prognosis in intracranial meningioma surgery. J Clin Neurosci 15:764–768. https://doi.org/10.1016/j.jocn.2007.06.001

    Article  CAS  PubMed  Google Scholar 

  39. Alaywan M, Sindou M (1993) Prognostic factors in the surgery for intracranial meningioma. Role of the tumoral size and arterial vascularization originating from the pia mater. Study of 150 cases. Neurochirurgie 39:337–347

    CAS  PubMed  Google Scholar 

  40. Chun JY, McDermott MW, Lamborn KR, Wilson CB, Higashida R, Berger MS (2002) delayed surgical resection reduces intraoperative blood loss for embolized meningiomas. Neurosurgery 50:1231–1237. https://doi.org/10.1097/00006123-200206000-00010

    Article  PubMed  Google Scholar 

  41. Lü J (2013) Correlation between preoperative imaging features and intraoperative blood loss of meningioma: a new scoring system for predicting intraoperative blood loss. J Neurosurg Sci 57:153–161

    PubMed  Google Scholar 

  42. Karsy M, Burnett B, Di Ieva A, Cusimano MD, Jensen RL (2018) Microvascularization of Grade I meningiomas: effect on tumor volume, blood loss, and patient outcome. J Neurosurg 128:657–666. https://doi.org/10.3171/2016.10.JNS161825

    Article  PubMed  Google Scholar 

  43. Goldbrunner R, Minniti G, Preusser M, Jenkinson MD, Sallabanda K, Houdart E, von Deimling A, Stavrinou P, Lefranc F, Lund-Johansen M, Moyal EC-J, Brandsma D, Henriksson R, Soffietti R, Weller M (2016) EANO guidelines for the diagnosis and treatment of meningiomas. Lancet Oncol 17:e383–e391. https://doi.org/10.1016/s1470-2045(16)30321-7

    Article  PubMed  Google Scholar 

  44. Berhouma M, Jacquesson T, Jouanneau E, Cotton F (2019) Pathogenesis of peri-tumoral edema in intracranial meningiomas. Neurosurg Rev. https://doi.org/10.1007/s10143-017-0897-x

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurosurgery, The First Hospital of China Medical University, Nanjing Street 155, Heping District, Shenyang, 110001, China

    Tianhao Hu, Run Wang, Haiyun Wang, Yifu Song, Yang Jiang, Yuzhou Duan & Sheng Han

  2. Department of Pathology, China Medical University, Shenyang, 110001, China

    Juanhan Yu & Di Zhang

  3. Department of Neurosurgery, Shanghai First People’s Hospital of Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, China

    Yang Jiang

Authors
  1. Tianhao Hu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Run Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Haiyun Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yifu Song
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Juanhan Yu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Di Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Yang Jiang
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Yuzhou Duan
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Sheng Han
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sheng Han.

Ethics declarations

Conflict of interest

The authors declare no potential conflicts of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hu, T., Wang, R., Wang, H. et al. Comparative analysis of intracranial meningiomas in patients younger than 40 years. J Neurooncol 143, 563–571 (2019). https://doi.org/10.1007/s11060-019-03191-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11060-019-03191-2

Keywords

Search

Navigation