Save
Hyperostosis in meningiomas - a retrospective exploration of histological correlates
EANS Academy. Khan D. Sep 27, 2019; 275972; EP04025
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]

Code of conduct/disclaimer available in General Terms & Conditions
Anonymous User Privacy Preferences

Strictly Necessary Cookies (Always Active)

MULTILEARNING platforms and tools hereinafter referred as “MLG SOFTWARE” are provided to you as pure educational platforms/services requiring cookies to operate. In the case of the MLG SOFTWARE, cookies are essential for the Platform to function properly for the provision of education. If these cookies are disabled, a large subset of the functionality provided by the Platform will either be unavailable or cease to work as expected. The MLG SOFTWARE do not capture non-essential activities such as menu items and listings you click on or pages viewed.


Performance Cookies

Performance cookies are used to analyse how visitors use a website in order to provide a better user experience.



Google Analytics is used for user behavior tracking/reporting. Google Analytics works in parallel and independently from MLG’s features. Google Analytics relies on cookies and these cookies can be used by Google to track users across different platforms/services.


Save Settings