Hyperostosis in meningiomas - a retrospective exploration of histological correlates
EANS Academy. Khan D. 09/27/19; 275972; EP04025
Mr. Danyal Zaman Khan
Mr. Danyal Zaman Khan

Access to this content is reserved for EANS members and attendees of this event. Click here to become an EANS member and gain your access to the full content of the EANS Academy


Abstract
Discussion Forum (0)
Rate & Comment (0)
Background: Cranial meningiomas are the most common type of primary brain tumour, with incidence estimated between 1.3-7.8/100,000. ~25% of meningiomas display hyperostosis, however its aetiology and implications remain controversial. This study aims to further illuminate the relationships between tumour variables and hyperostosis.
Methods: A mono-institutional retrospective analysis performed at Cambridge University Hospital. 275 histologically-confirmed meningioma cases, managed operatively between 2014-2017, were reviewed. Univariate analysis of relationships between variables and hyperostosis was performed.
Results: Summarised in Figure 1. The WHO 2016 Grading (G) distribution was; G1 =210 (76.36%), G2 =55 (20%), G3 =10 (3.64%). The most common subtypes were G1 Indeterminate =83 (30.18%), G2 Atypical =47 (17.09%) and G1 Meningothelial =45 (16.36%). 102 (37.09%) had evidence of radiological hyperostosis on CT/MRI. 23 (8.36%) had confirmed bony invasion, whilst 1 (0.36%) was an intraosseous tumour variant. No statistically significant relationship was found between WHO subtype and hyperostosis.
A statistically significant (p= 0.0003) association was found between tumour location and hyperostosis.
Hyperostosis was found at 55 (45.83%) of the 120 skull base tumours, versus 41 (28.67%) of the 143 convexity tumours.
Moreover, MIB-1 index (available in n=267) was lower in tumours with radiological hyperostosis (n=100, mean=4.45%) when compared to cases without hyperostosis (n=167, mean=6.06%; p=0.011).
Discussion: Many authors accept hyperostosis as a manifestation of bony infiltration by meningiomas, necessitating bony drilling or bone flap removal to achieve complete macroscopic resection. This is reflected in Simpson surgical resection grading. Higher MIB-1 scores have been associated with higher tumour grade and recurrence rates. However, our study describes a previously unknown negative association between MIB scores and hyperostosis. Further research is needed into the pathophysiology of the meningioma:bone interface, how it differs between subtypes and its implications for surgical management.


[Figure 1: Histological and Radiological Characteristics of Meningioma Cases]

Background: Cranial meningiomas are the most common type of primary brain tumour, with incidence estimated between 1.3-7.8/100,000. ~25% of meningiomas display hyperostosis, however its aetiology and implications remain controversial. This study aims to further illuminate the relationships between tumour variables and hyperostosis.
Methods: A mono-institutional retrospective analysis performed at Cambridge University Hospital. 275 histologically-confirmed meningioma cases, managed operatively between 2014-2017, were reviewed. Univariate analysis of relationships between variables and hyperostosis was performed.
Results: Summarised in Figure 1. The WHO 2016 Grading (G) distribution was; G1 =210 (76.36%), G2 =55 (20%), G3 =10 (3.64%). The most common subtypes were G1 Indeterminate =83 (30.18%), G2 Atypical =47 (17.09%) and G1 Meningothelial =45 (16.36%). 102 (37.09%) had evidence of radiological hyperostosis on CT/MRI. 23 (8.36%) had confirmed bony invasion, whilst 1 (0.36%) was an intraosseous tumour variant. No statistically significant relationship was found between WHO subtype and hyperostosis.
A statistically significant (p= 0.0003) association was found between tumour location and hyperostosis.
Hyperostosis was found at 55 (45.83%) of the 120 skull base tumours, versus 41 (28.67%) of the 143 convexity tumours.
Moreover, MIB-1 index (available in n=267) was lower in tumours with radiological hyperostosis (n=100, mean=4.45%) when compared to cases without hyperostosis (n=167, mean=6.06%; p=0.011).
Discussion: Many authors accept hyperostosis as a manifestation of bony infiltration by meningiomas, necessitating bony drilling or bone flap removal to achieve complete macroscopic resection. This is reflected in Simpson surgical resection grading. Higher MIB-1 scores have been associated with higher tumour grade and recurrence rates. However, our study describes a previously unknown negative association between MIB scores and hyperostosis. Further research is needed into the pathophysiology of the meningioma:bone interface, how it differs between subtypes and its implications for surgical management.


[Figure 1: Histological and Radiological Characteristics of Meningioma Cases]

Code of conduct/disclaimer available in General Terms & Conditions

By clicking “Accept Terms & all Cookies” or by continuing to browse, you agree to the storing of third-party cookies on your device to enhance your user experience and agree to the user terms and conditions of this learning management system (LMS).

Cookie Settings
Accept Terms & all Cookies