Skip to main content
SpringerLink
Log in

Atypical and ischemic features of embolized meningiomas

  • Original Article
  • Published:
Brain Tumor Pathology Aims and scope Submit manuscript

Abstract

Preoperative embolization (POE) of meningiomas is widely used to facilitate surgical removal and to reduce intraoperative blood loss. The resulting necrosis and enhanced proliferation have been reported to affect subsequent histologic grading. However, there was little concern about ischemic features, for example small cells resembling atypical meningiomas, cytoplasmic vacuoles resembling clear cell meningioma, intercellular discohesion resembling rhabdoid meningioma, and perivascular cuffs resembling papillary meningioma. Therefore, the extent of these ischemic features was scored and Ki-67 staining indices were investigated in a POE group composed of 29 specimens of meningiomas treated with POE and compared with equivalent results for a non-POE group composed of 29 meningiomas that were not treated with POE. Small cells with high N/C ratios, cytoplasmic vacuoles, intercellular discohesion, and perivascular cuffs were significantly increased in the POE group (versus the non-POE group, p < 0.05). There were no significant differences of the Ki-67 index between the POE group (2.2%) and the non-POE group (1.9%) (p = 0.49). Our results suggest that small cell change resulting in necrosis may be followed by POE, and that clear cell-like, rhabdoid cell-like, or pseudopapillary pattern identified in meningiomas may also be induced by POE. Therefore, histological findings and determination of grading should be evaluated cautiously in cases of embolized meningiomas.

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

Fig. 1

Similar content being viewed by others

References

  1. Dean BL, Flom RA, Wallace RC et al (1994) Efficacy of endovascular treatment of meningiomas: evaluation with matched samples. Am J Neuroradiol 15:1675–1680

    PubMed  CAS  Google Scholar 

  2. Grand C, Bank WO, Balériaux D et al (1993) Gadolinium-enhanced MR in the evaluation of preoperative meningioma embolization. Am J Neuroradiol 14:563–569

    PubMed  CAS  Google Scholar 

  3. Manelfe C, Lasjaunias P, Ruscalleda J (1986) Preoperative embolization of intracranial meningiomas. Am J Neuroradiol 7:963–972

    PubMed  CAS  Google Scholar 

  4. Nelson PK, Setton A, Choi IS, Ransohoff J, Berenstein A (1994) Current status of interventional neuroradiology in the management of meningiomas. Neurosurg Clin N Am 5:235–259

    PubMed  CAS  Google Scholar 

  5. Richter HP, Schachenmayr W (1983) Preoperative embolization of intracranial meningiomas. Neurosurgery 13:261–268

    Article  PubMed  CAS  Google Scholar 

  6. Wakhloo AK, Juengling FD, Van Velthoven V, Schumacher M, Hennig J, Schwechheimer K (1993) Extended preoperative poly(vinyl alcohol) microembolization of intracranial meningiomas: assessment of two embolization techniques. Am J Neuroradiol 14:571–582

    PubMed  CAS  Google Scholar 

  7. Nakasu S, Nakajima M, Nakazawa T, Nakasu Y, Handa J (1997) P53 accumulation and apoptosis in embolized meningiomas. Acta Neuropathol 93:599–605

    Article  PubMed  CAS  Google Scholar 

  8. Ng H-K, Poon W-S, Goh K, Chan MSY (1996) Histopathology of post-embolized meningiomas. Am J Surg Pathol 20:1224–1230

    Article  PubMed  CAS  Google Scholar 

  9. Patsouris E, Laas R, Hagel C, Stavrou D (1998) Increased proliferative activity due to necroses induced by pre-operative embolization in benign meningiomas. J Neurooncol 40:257–264

    Article  PubMed  CAS  Google Scholar 

  10. Paulus W, Meixensberger J, Hofmann E, Roggendorf W (1993) Effect of embolization of meningioma on Ki-67 proliferation index. J Clin Pathol 46:876–877

    Article  PubMed  CAS  Google Scholar 

  11. Perry A, Chicoine MR, Filiput E, Miller JP (2001) Clinicopathologic assessment and grading of embolized meningiomas: a correlative study of 64 patients. Cancer 92:701–711

    Article  PubMed  CAS  Google Scholar 

  12. Perry A, Louis DN, Scheithauer BW, Budka H, Von Deimling A (2007) Meningiomas. In: Louis DN, Ohgaki H, Wiestler OD, Cavenee WK (eds) WHO classification of tumours of the central nervous system. IARC press, Lyon, pp 164–172

    Google Scholar 

  13. Takeuchi H, Kubota T, Kabuto M, Kitai R, Nozaki J, Yamashita J (1997) Prediction of recurrence in histologically benign meningiomas, proliferating cell nuclear antigen and Ki-67 immunohistochemical study. Surg Neurol 48:501–506

    Article  PubMed  CAS  Google Scholar 

  14. Bendszus M, Rao G, Burger R et al (2000) Is there a benefit of preoperative meningioma embolization? Neurosurgery 47:1306–1312

    Article  PubMed  CAS  Google Scholar 

  15. Carli DF, Sluzewski M, Beute GN, van Rooij WJ (2010) Complications of particle embolization of meningiomas: frequency, risk factors, and outcome. Am J Neuroradiol 31:152–154

    Article  PubMed  CAS  Google Scholar 

  16. Kallmes DF, Evans AJ, Kaptain GJ et al (1997) Hemorrhagic complications in embolization of a meningioma: case report and review of the literature. Neuroradiology 39:877–880

    Article  PubMed  CAS  Google Scholar 

  17. Mawrin C, Perry A (2010) Pathological classification and molecular genetics of meningiomas. J Neurooncol 99:379–391

    Article  PubMed  CAS  Google Scholar 

  18. Latchaw RE (1993) Preoperative intracranial meningioma embolization: technical considerations affecting the risk-to-benefit ratio. Am J Neuroradiol 14:583–586

    PubMed  CAS  Google Scholar 

  19. Perry A, Stafford SL, Scheithauer BW, Suman VJ, Lohse CM (1997) Meningioma grading: an analysis of histologic parameters. Am J Surg Pathol 21:1455–1465

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji, Fukui, 910-1193, Japan

    Ken Matsuda, Hiroaki Takeuchi, Yoshikazu Arai, Ryuhei Kitai, Tetsuya Hosoda, Kenzo Tsunetoshi, Hidetaka Arishima, Kazufumi Sato & Ken-ichiro Kikuta

Authors
  1. Ken Matsuda
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hiroaki Takeuchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yoshikazu Arai
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ryuhei Kitai
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Tetsuya Hosoda
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kenzo Tsunetoshi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hidetaka Arishima
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Kazufumi Sato
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Ken-ichiro Kikuta
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hiroaki Takeuchi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Matsuda, K., Takeuchi, H., Arai, Y. et al. Atypical and ischemic features of embolized meningiomas. Brain Tumor Pathol 29, 17–24 (2012). https://doi.org/10.1007/s10014-011-0058-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10014-011-0058-9

Keywords

Search

Navigation