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Peritumoral edema in meningiomas: pathophysiology, predictors, and principles for treatment

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Abstract

Meningiomas is a tumor of the meninges and is among the most common intracranial neoplasms in adults, accounting for over a third of all primary brain tumors in the United States. Meningiomas can be associated with peritumoral brain edema (PTBE) which if not managed appropriately can lead to poor clinical outcomes. In this review, we summarize the relevant pathophysiology, predictors, and principles for treatment of PTBE. The results of various case-reports and case-series have found that meningioma-associated PTBE have patterns in age, tumor size, and hormone receptor positivity. Our study describes how increased age, increased tumor size, tumor location in the middle fossa, and positive expression of hormone receptors, VEGF, and MMP-9 can all be predictors for worse clinical outcomes. We also characterize treatment options for PTBE such as glucocorticoids and VEGF inhibitors along with the ongoing clinical trials attempting to alleviate PTBE in meningioma cases. The trends summarized in this review can be used to better predict the behavior of meningioma-associated PTBE and establish prognosis models to identify at risk patients.

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Authors and Affiliations

  1. Department of Neurosurgery, Weill Cornell Medical Center/NewYork Presbyterian Hospital, 525 East 68th Street, New York, NY, 10065, USA

    Brian Fiani

  2. Department of Neurological Surgery, Mayo Clinic, Rochester, MN, USA

    Ryan Jarrah & Archis R. Bhandarkar

  3. Department of Neurosurgery, University of Kansas Medical Center, Kansas, MO, USA

    Frank De Stefano

  4. Morehouse School of Medicine, Morehouse College, Atlanta, GA, USA

    Abrham Amare

  5. Lincoln Memorial DeBusk College of Osteopathic Medicine, Lincoln Memorial University, Knoxville, TN, USA

    Usama A. Aljameey

  6. Kentucky College of Osteopathic Medicine, University of Pikeville, Pikeville, KY, USA

    Taylor Reardon

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Fiani, B., Jarrah, R., Bhandarkar, A.R. et al. Peritumoral edema in meningiomas: pathophysiology, predictors, and principles for treatment. Clin Transl Oncol 25, 866–872 (2023). https://doi.org/10.1007/s12094-022-03009-0

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