• Journal of Korean Neurosurgical Society
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• v.47 no.1
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• pp.11-16
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• 2010

Objective: Abnormalities of the bone are frequently encountered in patients with meningioma, and hyperostosis and endostosis are common bone alterations in these tumors. Extensive bony destruction is very unusual in patients with meningioma. We report six cases of intracranial meningioma associated with an osteolytic lesion of the skull and discuss the underlying mechanisms that may be responsible for bone destruction in patients with meningioma. Methods: Six patients were classified into three groups, severe, moderate and mild, according to the degree of osteolytic bony destruction. The tumor was classified as intracranial or extracranial, depending on its location. We investigated the potential role of matrix metalloproteinase (MMP) in meningioma-associated osteolysis. The levels of MMP expression were determined by gelatin zymography, reverse transcription-quantitative PCR analysis (RT-PCR) and immunohistochemical analysis. Results: Complete surgical removal of the lesion was performed in each patient. Histological examination revealed benign meningioma in four cases, and two cases of atypical meningioma. Patients did not have a poor prognosis except one case of recurred atypical meningioma. Gelatin zymography and RT-PCR detected high levels of MMP-2 in almost all extracranial masses in comparison with the intracranial masses and MMP9 in two. There was no difference in the severity of bone destruction. Immunohistochemical analysis revealed MMP-2 expression in the vicinity of the bone destruction, and a few MMP-9-positive stainings were observed. Conclusion: Osteolysis of the skull in patients with meningiomas might not be indicative of malignant pathological features and poor prognosis. Invasion to the extracranial portion and osteolysis might be associated with MMP-2 expression in meningioma.

• Journal of Korean Neurosurgical Society
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• v.61 no.1
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• pp.120-126
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• 2018

Intraparenchymal meningiomas without dural attachment are extremely rare, especially when they occur in basal ganglia region in child. An 8-year-old boy was admitted at our hospital, complaining of recurrent headache and vomiting for 3 months. Neurological examination showed impaired vision and mild paresis of the left extremities. Magnetic resonance imaging demonstrated a lesion located in the right basal ganglia region extending to superasellar cistern with solid, multiple cystic and necrotic components. Computed tomography revealed calcification within the mass. Due to the anterior cerebral artery involvement, a subtotal resection was achieved and postoperative radiotherapy was recommended. Histopathological examination indicated that the lesion was an atypical meningioma. The postoperative rehabilitation was uneventful. Mildly impaired vision and motor weakness of left extremities improved significantly and the patient returned to normal life after surgery. To our knowledge, intraparenchymal atypical meningioma in basal ganglia extending to superasellar cistern was never reported. The significance in differential diagnosis of lesions in basal ganglia should be emphasized.

• Journal of Korean Neurosurgical Society
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• v.55 no.1
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• pp.40-42
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• 2014

A correlation between radiation therapy and cavernoma has been suspected since 1994. Since then, only a few cases of radio-induced cavernomas have been reported in the literature (85 patients). Most of them were children, and the most frequent original tumour had been medulloblastoma. The authors report a case of two cystic cavernous angiomas after radiation therapy for atypical meningioma in adult woman. This is the first case of cavernous angioma after radiotherapy for low grade meningioma. A 39-year-old, Latin american woman was operated on for a frontal atypical meningioma with intradiploic component and adjuvant radiotherapy was delivered (6000 cGy local brain irradiation, fractionated over 6 weeks). Follow-up MR imaging showed no recurrences of the tumour and no other lesions. Ten years later, at the age of 49, she consulted for progressive drug-resistant headache. MR imaging revealed two new well defined areas of different signal intensity at the surface of each frontal pole. Both lesions were surgically removed; the histopathological diagnosis was cavernous angioma. This is the first case of cavernous angioma after radiation therapy for atypical meningioma : it confirms the development of these lesions after standard radiation therapy also in patients previously affected by non-malignant tumours.

• THE JOURNAL OF KOREAN ORIENTAL ONCOLOGY
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• v.9 no.1
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• pp.47-52
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• 2003

Acupuncture is a complementary medical treatment whose use in cancer patients has been recommended by the American Cancer Society (ACS) for the treatment of cancer and treatment-related symptoms. Pain, nausea, breathlessness, vasomotor symptoms and limb edema have all been found to respond to this treatment modality. This has become quite familiar to many Koreans not only for pain, but also for many other health problems, both in acute and chronic conditions. Actually, acupuncture is a therapeutic technique that is part of a larger system of traditional oriental medicine. There are several styles of acupuncture. We treated one 72-year-old female patient with Dongshiqixue Acupuncture Technique who had refused surgical operation for brain meningioma showing right hemiparesis, dysarthria, headache and dizziness. During the acupuncture treatment, there were no other adverse effects. After six day's treatment, she could ambulate and make usual life all by herself. On her brain magnetic resonence image follow-up, there was no interval change in meningioma. After discharged from our hospital, she has kept up her independent daily life as before. So it is suggested that some acupuncture treatment should be effect on brain meningioma clinically.

• Journal of Korean Neurosurgical Society
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• v.39 no.2
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• pp.144-147
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• 2006

Rhabdoid meningioma is an uncommon meningioma variant, which was initially described in 1998 by Perry et al. It is classified as a variant corresponding to grade III in the recent World Health Organization[WHO] classification of tumors of the nervous system, because of its unique histopathological features and its highly aggressive clinical course. To date there were still a lot of arguments about their developmental patterns and the treatment strategy especially for rhabdoid meningiomas lacking other histological features of malignancy. Although the exact causes of rhabdoid transformation of a benign meningioma are unknown, malignant transformation long duration after surgical resection under an underlying predilection for malignancy is suggested in our case. And we suggest that any histological rhabdoid features in recurrent meningiomas or even in primary cases seem to indicate the malignant clinical course and the need for aggressive treatments, because transformation from a benign or atypical one to a malignant one seems to occur at last.

• Journal of Korean Neurosurgical Society
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• v.39 no.2
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• pp.109-113
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• 2006

Objective : Meningioma is a benign tumor which has a high occurrence rate of postoperative hematomas. The purpose of this study is to analyze risk factors for postoperative hemorrhages after meningioma surgery. Methods : One hundred and fifty three patients with intracranial meningiomas, operated at the Department of Neurosurgery, National Medical Center, between January 1995 and December 2003 were included in this retrospective study. Risk factors considered to be related with postoperative hematomas were age, sex, preoperative pharmacological anticoagulants for medical co-morbidity, tumor location, histological type of the meningioma, infiltration of dural sinus and arachnoid, removal range of tumors, and the perioperative coagulation status including prothrombin time, partial thromboplastin time, and platelet count. Results : Patients' aged more than 70 years with a platelet count of less than $150{\times}10^9{\ell}^{-1}$ after surgery had statistically significant relations to the occurrence rate of postoperative hematomas. The other factors had no statistical significance. Conclusion : Various and intensive preoperative examinations for coagulation factors of patients, especially of older age, and proper transfusion before meningioma surgery are necessary for preventing postoperative hematoma.

• Journal of Korean Neurosurgical Society
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• v.54 no.5
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• pp.373-378
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• 2013

Objective : We present our experience of conventional posterior approach without fat lateral approach for ventral foramen magnum (FM) meningioma (FM meningioma) and tried to evaluate the approach is applicable to ventral FM meningioma. Methods : From January 1999 to March 2011, 11 patients with a ventral FM meningioma underwent a conventional posterior approach without further extension of lateral bony window. The tumor was removed through a working space between the dura and arachnoid membrane at the cervicomedullary junction with minimal retraction of medulla, spinal cord or cerebellum. Care should be taken not to violate arachnoid membrane. Results : Preoperatively, six patients were of Nurick grade 1, three were of grade 2, and two were of grade 3. Median follow-up period was 55 months (range, 20-163 months). The extent of resection was Simpson grade I in one case and Simpson grade II in remaining 10 cases. Clinical symptoms improved in eight patients and stable in three patients. There were no recurrences during the follow-up period. Postoperative morbidities included one pseudomeningocele and one transient dysphagia with dysarthria. Conclusion : Ventral FM meningiomas can be removed gross totally using a posterior approach without fat lateral approach. The arachnoid membrane can then be exploited as an anatomical barrier. However, this approach should be taken with a thorough understanding of its anatomical limitation.

• Journal of the Korean Society of Radiology
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• v.83 no.4
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• pp.924-930
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• 2022

Most spinal meningiomas have an intradural or partly extradural location. The meningothelial origin is the most common pathologic type of spinal meningioma. Pure extradural spinal meningiomas are not common, and lymphoplasmacyte-rich meningioma (LPRM) is very rare. We report a case of isolated extradural spinal meningioma in the thoracic spine that was pathologically confirmed as LPRM.

• Journal of Korean Neurosurgical Society
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• v.43 no.1
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• pp.34-36
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• 2008

Meningioma en plaque (MEP) is a rare tumor characterized more by its clinical and biological behavior than its histological appearance. Hyperostosis of the skull is one of the characteristic signs of MEP. This bony change can produce clinical symptoms and signs in MEP by pressing against adjacent structures. The authors report a rare case of an osteolytic MEP extending from the sphenoid wing into the orbital wall, middle fossa, and temporalis muscle.

• Journal of Korean Neurosurgical Society
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• v.46 no.1
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• pp.71-73
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• 2009

In surgical planning of the parasagittal meningioma, invasion and occlusion of the superior sagittal sinus are important factors. When tumor is located within anterior 1/3, or when angiographic finding shows total occlusion of superior sagittal sinus, it is regarded that the ligation of superior sagittal sinus is safe. We report a case of parasagittal meningioma in 59-year-old male patient with complete occlusion of superior sagittal sinus which was confirmed by preoperative angiography, who developed temporary neurologic deterioration after superior sagittal sinus ligation and resection.