Publication:

The role of peritumoural brain edema in ascertaining the high risk meningiomas

Background Meningiomas are benign tumours which possess a potential to recur. Peritumoural brain edema (PTBE) has been associated with several complications and future recurrence. This study aims to establish the relation of PTBE in different histopathological grades and subtypes of meningiomas and in addition determines the significance of PTBE in ascertaining tumour recurrence.

Methods Complete surgical resection samples from 50 meningioma patients were obtained from the neurosurgical department and histopathologically processed. CT (computerised tomography) scans were used for ascertaining the tumour site and PTBE. Patients were followed up yearly for 4years. Recurrent cases were surgically resected and histologically typed.

Results Meningiomas were more common in the females (70%) than males (30%). PTBE was found in 56% of the cases. 62% were <50 years of age. No significant association was found between gender or age and PTBE. Cerebral convexity was the most common site (56%). 48.8% of grade I meningiomas (p<0.05) and 100% of grade II and grade III meningiomas showed PTBE. Yearly follow up for 4 years showed 10 cases to recur. 90% of these had evidence of PTBE on their pre-operative CT scans. These results were statistically significant (Z=11.31, p<0.001).

Conclusions Meningiomas are mostly benign entities. However, some histological subtypes possess a potential to recur and invade. It has been found that cases showing radiological evidence of PTBE are at a high risk. Hence, follow up of such cases is essential to improve patient survival.