The Role Of Necrosis In The Worse Prognosis Of Meningiomas | 105299
Journal of Neurology & Neurophysiology
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Meningiomas are the most frequently reported primary intracranial tumours, accounting for more than 35%.
The 2016 WHO classification of central nervous system tumors stratifies meningiomas in grades I (benign),
II (atypical), and III (malignant), according to histopathological aspects and the risk of progression or recurrence.
In this current edition, the classification and grading of meningiomas did not undergo revisions, except for the
introduction of brain invasion as a criterion for the diagnosis of atypical meningiomas, WHO grade II. The presence
of spontaneous necrosis is an atypical feature only considered a criterion if added to other two atypical features. We
evaluated spontaneous necrosis as a possible isolated factor for progression and recurrence in grade I meningiomas
classified according to the current WHO classification. In our study, necrosis was a consistent factor not only
for recurrence, but also morbidity, mortality and malignant transformation rates. Thus, a significant role of this
histological finding is highlighted in the worst prognosis. The role of necrosis in the higher rate of recurrence and
worse prognosis in intracranial meningiomas presented in this study raises the need to evaluate this criterion alone
for the follow-up of patients with these tumors.
Pedro Góes is a young Neurosurgeon graduated from the Federal University of São Paulo, currently acting as a Member of the Vascular Neurosurgery Group of the Paulo Niemeyer State Brain Institute in Rio de Janeiro. In addition to aneurysms, he is interested in arteriovenous malformations, cavernomas and tumors of the central nervous system, with a recent publication on the role of necrosis in intracranial meningiomas.