Meningiomas: estudo epidemiologic e anátomo-patológico de 304 casos

Torres, Luiz Fernando Bleggi; Madalozzo, Luiz Ernani; Werner, Betina; Noronha, Lúcia de; Jacob, Graciela V. Vicelli; Medeiros, Bruno C.; Vialle, Emiliano N.

doi:10.1590/S0004-282X1996000400001

Resumos

No presente estudo, foram pesquisados os tumores do sistema nervoso central (SNC) diagnosticados na cidade de Curitiba entre 1990 e 1994. Realizaram-se 2371 biópsias de SNC das quais 1340 casos eram neoplasias primárias. Dentre as neoplasias primárias de SNC 304 (22,6%) eram meningiomas. Duzentos e nove meningiomas ocorreram em mulheres (68,7%) e 95 ocorreram em homens (31,3%). As idades variaram de 3 a 90 anos, com média de 45,8 anos. Duzentos e oitenta meningiomas localizavam-se no cérebro, 10 na medula espinhal, 9 no cerebelo e 5 na emergência de nervos cranianos. Na classificação histológica verificou-se que 294 (96,7%) eram do tipo clássico, 6 malignos (ou anaplásicos), 3 atípicos e 1 papilar. No grupo dos meningiomas clássicos 267 eram meningoteliais, 10 psamomatosos, 5 fibroblásticos, 5 microcísticos, 5 transicionais e 2 angiomatoses. Os autores concluem que as neoplasias meníngeas representaram o grupo mais freqüente de tumores primários do SNC e apresentaram características epidemiológicas e anátomo-patológicas similares às da literatura mundial, na qual é dada ênfase à dificuldade de estabelecer critérios biológicos e histológicos de malignidade neste grupo de tumores.

tumor cerebral; meningioma; epidemiologia; histopatologia

The authors have retrospectively reviewed all tumors of central nervous system (CNS) operated at the most important neurosurgery hospitals of Curitiba in a 5-year period (1990-1994) and found 304 (22.4%) cases of meningioma. Age mean of the patients was 48.5 years, with a range of 3 to 90 years. A marked female preponderance (68.7%) was noted. The most common tumor location was brain (n=280) and the remaining cases occurred in spinal cord (n=10), cerebellum (n=9) and cranial nerves (n=5). Histologically, there were 294 (96.7%) meningiomas of the classical type, six malignant or anaplastic, three atypical and one papillary. Two hundred and sixty seven classical meningiomas were from the meningotelial subtype, ten psamomatousos, five fibroblastic, five microcystic, five transicional and two angiomatous. The authors conclude that meningiomas are one of the most common group of primary neoplasias of CNS and the definition of malignancy in those tumors is beset by frequent discordance between histologic and biologic features.

brain tumor; meningioma; epidemiology; histopathology

Meningiomas: estudo epidemiologic e anátomo-patológico de 304 casos

Meningiomas: epidemiological and pathological studies of 304 cases

Luiz Fernando Bleggi Torres^I; Luiz Ernani Madalozzo^II; Betina Werner^I; Lúcia de Noronha^I; Graciela V. Vicelli Jacob^I; Bruno C. Medeiros^I; Emiliano N. Vialle^I

^ISeção de Neuropatologia e Microscopia Eletrônica do Serviço de Anatomia Patológica

^IIServiço de Neurocirurgia do Hospital de Clínicas de Curitiba, Universidade Federal do Paraná. (UFPR)

RESUMO

No presente estudo, foram pesquisados os tumores do sistema nervoso central (SNC) diagnosticados na cidade de Curitiba entre 1990 e 1994. Realizaram-se 2371 biópsias de SNC das quais 1340 casos eram neoplasias primárias. Dentre as neoplasias primárias de SNC 304 (22,6%) eram meningiomas. Duzentos e nove meningiomas ocorreram em mulheres (68,7%) e 95 ocorreram em homens (31,3%). As idades variaram de 3 a 90 anos, com média de 45,8 anos. Duzentos e oitenta meningiomas localizavam-se no cérebro, 10 na medula espinhal, 9 no cerebelo e 5 na emergência de nervos cranianos. Na classificação histológica verificou-se que 294 (96,7%) eram do tipo clássico, 6 malignos (ou anaplásicos), 3 atípicos e 1 papilar. No grupo dos meningiomas clássicos 267 eram meningoteliais, 10 psamomatosos, 5 fibroblásticos, 5 microcísticos, 5 transicionais e 2 angiomatoses. Os autores concluem que as neoplasias meníngeas representaram o grupo mais freqüente de tumores primários do SNC e apresentaram características epidemiológicas e anátomo-patológicas similares às da literatura mundial, na qual é dada ênfase à dificuldade de estabelecer critérios biológicos e histológicos de malignidade neste grupo de tumores.

Palavras-chave: tumor cerebral, meningioma, epidemiologia, histopatologia.

ABSTRACT

The authors have retrospectively reviewed all tumors of central nervous system (CNS) operated at the most important neurosurgery hospitals of Curitiba in a 5-year period (1990-1994) and found 304 (22.4%) cases of meningioma. Age mean of the patients was 48.5 years, with a range of 3 to 90 years. A marked female preponderance (68.7%) was noted. The most common tumor location was brain (n=280) and the remaining cases occurred in spinal cord (n=10), cerebellum (n=9) and cranial nerves (n=5). Histologically, there were 294 (96.7%) meningiomas of the classical type, six malignant or anaplastic, three atypical and one papillary. Two hundred and sixty seven classical meningiomas were from the meningotelial subtype, ten psamomatousos, five fibroblastic, five microcystic, five transicional and two angiomatous. The authors conclude that meningiomas are one of the most common group of primary neoplasias of CNS and the definition of malignancy in those tumors is beset by frequent discordance between histologic and biologic features.

Key words: brain tumor, meningioma, epidemiology, histopathology.

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Full text available only in PDF format.

Agradecimentos - Agradecemos aos Drs. Acir Mulinari, José Ederaldo Q. Telles, Elizabete S. Gugelmin e Lysandro A. Sampaio pela permissão para pesquisar os arquivos dos Serviços de Anatomia Patológica; à bióloga Daniele Martins da Costa e ao Centro de Patologia de Curitiba pelas preparações imuno-histoquímicas, e às biólogas Fádua de Queiroz e Maria Iolanda Sanches pelas preparações de microscopia eletrônica. Este estudo foi realizado com apoio do Centro de Microscopia Eletrônica da UFPR e do CNPq. Registro no Banpesq n° 94003830.

Aceite: 20-maio-1996.

Dr. Luiz Fernando Bleggi Torres - Seção de Neuropatologia e Microscopia Eletrônica do Serviço de Anatomia Patológica, Hospital de Clínicas - Rua General Carneiro 181 - 80060-900 Curitiba PR - Brasil. FAX: 041 2642513.

1. Adegbite AB, Khan MI, Paine KWE, Tan LK. The recurrence of intracranial meningiomas after surgical treatment. J Neurosurg 1983;58:51-56.
2. Bancroft JD, Stevens A, Dawson IMP. Theory and practice of histological techniques. Ed2. London: Churchill Livingston, 1982.
3. Berho M, Suster S. Mucinous meningioma: report of an unusual variant of meningioma that may mimic metastatic mucin-producing carcinoma. Am J Surg Pathol 1994;18:100-106.
4. Burger PC, Scheithauer BW. Atlas of tumor pathology. Chapter 9: Tumors of the central nervous system.Washington D.C: Armed Forces Institute of Pathology, 1993:259-286.
5. Carroll RS, Zhang J, Dashner K, Sar M, Wilson EM, Black PM. Androgen receptor expression in meningiomas. J Neurosurg 1995;82:453-460.
6. Chan RC, Thopson GB. Morbidity, mortality and quality of life following surgery for intracranial meningiomas: a retrospective study in 257 cases. J Neurosurg 1984;60:52-60.
7. Dietemann JL, Heldt N, Burquet JL, Medjek L, Maitrot D, Wackenhein A. CT findings in malignant meningioma. Neuroradiology 1982;23:207-209.
8. Jaaskelainen J, Haltia M, Servo A. Atypical and anaplastic meningiomas: radiology, surgery, radiotherapy and outcome. Surg Neurol 1986;25:233-242.
9. Jesus O, Rifkinson N, Negrón B. Cystic meningiomas: a review. Neurosurgery 1995;36:489-492.
10. Kepes J J, Chen W YK, Pang LC, Kepes M. Tumours of the central nervous system in Taiwan, Republic of China. Surg Neurol 1984;22:149.
11. Kinjo T, Al-Mefty O, Ciric I. Diaphragma sellae meningiomas. Neurosurgery 1995;36:1082-1092.
12. Kleihues P, Burger PC, Scheithauer BW. The new WHO classification of brain tumours. Brain Pathol 1993;3:255-268.
13. Kuratsu J, Seto H, Kochi M, Ushio Y. Expression of PDGF, PDGF-receptor, EGF-receptor and sex hormone receptors on meningioma. Acta Neurochir (Wien) 1994;31:289-293.
14. Mack EE, Wilson CB. Meningiomas induced by high-dose cranial irradiation. J Neurosurg 1993;79:28-31.
15. Maier H, Ofher D, Hittmair A, Kitz Klaus, Budka H. Classic, atypical, and anaplastic meningioma: three histopathological subtypes of clinical relevance. J Neurosurg 1992;77:616-623.
16. Marks SM, Whitwell HL, Lye RM: Recurrence of meningioma after operation. Surg Neurol 1986;25:436-440.
17. Mirimanoff RO, Dosoretz DE, Linggood RM, Ojemann RG, Martuza RL. Meningioma: analysis of recurrence and progression following neurosurgical resection. J Neurosurg 1985;62:18-24.
18. Motta LACR, Motta LDC. Tratamento endócrino dos meningiomas, uma revisão. Arq Neuropsiquiatr 1995;53:324-332.
19. Nakasu S, Hirano A, ShimuaT, Llena JF. Incidental meningiomas in autopsy study. Surg Neurol 1987;27:319-322.
20. New PF, Araonow S, Hesselink JR. National Cancer Institute study: Evaluation of computed tomography on the diagnosis of intracranial neoplasms. Radiology 1980;136:665-675.
21. Olivero WC, Lister R, Elwood PW. The natural history and growth rate of asymptomatic meningiomas: a review of 60 patients. J Neurosurg 1995;83:222-224.
22. Pasquier B, Gasnier F, Pasquier D. Papillary meningioma: clinicopathologic study of seven cases and review of the literature. Cancer 1986;58:299-305.
23. Perrot- Applanat M, Groyer-Picard MTh, Kujas M. Immunocytochemical study of progesterone receptor in human meningioma. ActaNeurochir(Wien) 1992,115:20-30.
24. Rhee BA, Kim TS, Kim GK, Leem W. Hemifacial spasm caused by contralateral cerebellopontine angle meningioma: case report. Neurosurgery 1995;36:393-395.
25. Russel EI, George AE, Kricheff IL, Budzilovich G. Atypical computed tomographic features of intracranial meningiomas: radiological pathological correlation in a series of 131 consecutive cases. Radiology 1980;135:673-682.
26. Schwechheimer K, Kartenbeck J, Moll R, Franke WW. Vimentin filament-desmosome cytoskeleton of diverse types of human meningiomas. Lab Invest 1984,51:584-591.
27. Sheehy JP, Crockard HA. Multiple meningiomas: a long-term review. J Neurosurg 1983;59:1-5.
28. Shuangshoti S, Boonjunwetwat D, Kaoroptham S. Association of primary intraspinal meningiomas and subcutaneous meningioma of the cervical region: case report and review of literature. Surg Neurol 1992;38:129-134.
29. Soffer D, Pitaluga S, Feiner M, Beller AJ. Intracranial meningiomas following low-dose irradiation to the head. J Neurosurg 1983;59:1048-1053.
30. Torres LFB, Almeida R, Avila S, Alessi S, Freitas R. Brain tumours in south Brazil. Arq Neuropsiquiatr 1990;48:279-285.
31. Torres LFB, Noronha L, Telles JEQ. A importância da imunohistoqufmica no diagnóstico anátomo-patológico em hospital geral: análise de 885 casos. J Bras Patol 1995;31:65-71.
32. Younis GA, Sawaya R, DeMonte F, Hess KR, Albrecht S, Bruner JM. Agressive meningeal tumors: review of a series. J Neurosurg 1995;82:17-27.
33. Zee CS, Chen T, Hinton DR, Tan M, Segall HD, Apuzzo MLJ. Magnetic resonance imaging of cystic meningiomas and its surgical implications. Neurosurgery 1995;36:482-488.

Datas de Publicação

Publicação nesta coleção
12 Nov 2010
Data do Fascículo
Dez 1996

Histórico

Recebido
20 Maio 1996

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Adegbite AB, Khan MI, Paine KWE, Tan LK. The recurrence of intracranial meningiomas after surgical treatment. J Neurosurg 1983;58:51-56.

[2] 2. Bancroft JD, Stevens A, Dawson IMP. Theory and practice of histological techniques. Ed2. London: Churchill Livingston, 1982.

[3] 3. Berho M, Suster S. Mucinous meningioma: report of an unusual variant of meningioma that may mimic metastatic mucin-producing carcinoma. Am J Surg Pathol 1994;18:100-106.

[4] 4. Burger PC, Scheithauer BW. Atlas of tumor pathology. Chapter 9: Tumors of the central nervous system.Washington D.C: Armed Forces Institute of Pathology, 1993:259-286.

[5] 5. Carroll RS, Zhang J, Dashner K, Sar M, Wilson EM, Black PM. Androgen receptor expression in meningiomas. J Neurosurg 1995;82:453-460.

[6] 6. Chan RC, Thopson GB. Morbidity, mortality and quality of life following surgery for intracranial meningiomas: a retrospective study in 257 cases. J Neurosurg 1984;60:52-60.

[7] 7. Dietemann JL, Heldt N, Burquet JL, Medjek L, Maitrot D, Wackenhein A. CT findings in malignant meningioma. Neuroradiology 1982;23:207-209.

[8] 8. Jaaskelainen J, Haltia M, Servo A. Atypical and anaplastic meningiomas: radiology, surgery, radiotherapy and outcome. Surg Neurol 1986;25:233-242.

[9] 9. Jesus O, Rifkinson N, Negrón B. Cystic meningiomas: a review. Neurosurgery 1995;36:489-492.

[10] 10. Kepes J J, Chen W YK, Pang LC, Kepes M. Tumours of the central nervous system in Taiwan, Republic of China. Surg Neurol 1984;22:149.

[11] 11. Kinjo T, Al-Mefty O, Ciric I. Diaphragma sellae meningiomas. Neurosurgery 1995;36:1082-1092.

[12] 12. Kleihues P, Burger PC, Scheithauer BW. The new WHO classification of brain tumours. Brain Pathol 1993;3:255-268.

[13] 13. Kuratsu J, Seto H, Kochi M, Ushio Y. Expression of PDGF, PDGF-receptor, EGF-receptor and sex hormone receptors on meningioma. Acta Neurochir (Wien) 1994;31:289-293.

[14] 14. Mack EE, Wilson CB. Meningiomas induced by high-dose cranial irradiation. J Neurosurg 1993;79:28-31.

[15] 15. Maier H, Ofher D, Hittmair A, Kitz Klaus, Budka H. Classic, atypical, and anaplastic meningioma: three histopathological subtypes of clinical relevance. J Neurosurg 1992;77:616-623.

[16] 16. Marks SM, Whitwell HL, Lye RM: Recurrence of meningioma after operation. Surg Neurol 1986;25:436-440.

[17] 17. Mirimanoff RO, Dosoretz DE, Linggood RM, Ojemann RG, Martuza RL. Meningioma: analysis of recurrence and progression following neurosurgical resection. J Neurosurg 1985;62:18-24.

[18] 18. Motta LACR, Motta LDC. Tratamento endócrino dos meningiomas, uma revisão. Arq Neuropsiquiatr 1995;53:324-332.

[19] 19. Nakasu S, Hirano A, ShimuaT, Llena JF. Incidental meningiomas in autopsy study. Surg Neurol 1987;27:319-322.

[20] 20. New PF, Araonow S, Hesselink JR. National Cancer Institute study: Evaluation of computed tomography on the diagnosis of intracranial neoplasms. Radiology 1980;136:665-675.

[21] 21. Olivero WC, Lister R, Elwood PW. The natural history and growth rate of asymptomatic meningiomas: a review of 60 patients. J Neurosurg 1995;83:222-224.

[22] 22. Pasquier B, Gasnier F, Pasquier D. Papillary meningioma: clinicopathologic study of seven cases and review of the literature. Cancer 1986;58:299-305.

[23] 23. Perrot- Applanat M, Groyer-Picard MTh, Kujas M. Immunocytochemical study of progesterone receptor in human meningioma. ActaNeurochir(Wien) 1992,115:20-30.

[24] 24. Rhee BA, Kim TS, Kim GK, Leem W. Hemifacial spasm caused by contralateral cerebellopontine angle meningioma: case report. Neurosurgery 1995;36:393-395.

[25] 25. Russel EI, George AE, Kricheff IL, Budzilovich G. Atypical computed tomographic features of intracranial meningiomas: radiological pathological correlation in a series of 131 consecutive cases. Radiology 1980;135:673-682.

[26] 26. Schwechheimer K, Kartenbeck J, Moll R, Franke WW. Vimentin filament-desmosome cytoskeleton of diverse types of human meningiomas. Lab Invest 1984,51:584-591.

[27] 27. Sheehy JP, Crockard HA. Multiple meningiomas: a long-term review. J Neurosurg 1983;59:1-5.

[28] 28. Shuangshoti S, Boonjunwetwat D, Kaoroptham S. Association of primary intraspinal meningiomas and subcutaneous meningioma of the cervical region: case report and review of literature. Surg Neurol 1992;38:129-134.

[29] 29. Soffer D, Pitaluga S, Feiner M, Beller AJ. Intracranial meningiomas following low-dose irradiation to the head. J Neurosurg 1983;59:1048-1053.

[30] 30. Torres LFB, Almeida R, Avila S, Alessi S, Freitas R. Brain tumours in south Brazil. Arq Neuropsiquiatr 1990;48:279-285.

[31] 31. Torres LFB, Noronha L, Telles JEQ. A importância da imunohistoqufmica no diagnóstico anátomo-patológico em hospital geral: análise de 885 casos. J Bras Patol 1995;31:65-71.

[32] 32. Younis GA, Sawaya R, DeMonte F, Hess KR, Albrecht S, Bruner JM. Agressive meningeal tumors: review of a series. J Neurosurg 1995;82:17-27.

[33] 33. Zee CS, Chen T, Hinton DR, Tan M, Segall HD, Apuzzo MLJ. Magnetic resonance imaging of cystic meningiomas and its surgical implications. Neurosurgery 1995;36:482-488.