Peritumoral brain edema in benign meningiomas: correlation with clinical, radiologic, and surgical factors and possible role on recurrence.
BACKGROUND
Approximately 60% of meningiomas are associated with peritumoral edema. Various causative factors have been discussed in the literature. The objective of this study was to investigate the correlation of PTBE with clinical, radiologic, and surgical aspects and recurrence of meningiomas.


METHODS
Sixty-one patients with benign meningiomas were chosen for surgical treatment by the Group of Brain Tumors and Metastasis of the Department of Neurosurgery. All patients underwent complete surgical resection (Simpson grades 1 and 2), and those with atypical and malignant histopathologic grades were excluded. Tumors located in the cavernous sinus, tuberculum sellae, foramen magnum, ventricles, and petroclival region were excluded.


RESULTS
Edema extension had a positive correlation with the higher recurrence rates (P = .042) and with the presence of irregular margins (P < .011) on bivariate analysis. Meningiomas with larger edema sizes also showed correlation with large meningiomas (P = .035), and the ones with smaller edema sizes correlated with the tentorial location (P = .032). Multivariate analysis showed an association between PTBE and the presence of seizures (odds ratio, 3.469), large meningiomas (odds ratio, 15.977), and for each cubic centimeter added to its size, the risk of edema increased 1.082 times (odds ratio).


CONCLUSIONS
Peritumoral brain edema may be related to the invading potential of meningiomas and may play a role in the recurrence potential of the tumor. As a consequence, it is reasonable to consider the presence of edema as an additional factor to be taken into account when mapping out strategies for the treatment of meningiomas.
Simis
Andre
A
Division of Neurosurgery, Hospital das Clínicas-São Paulo Medical School, University of São Paulo, 05403-000 São Paulo, Brazil. asimis@uol.com.br
Pires de Aguiar
Paulo Henrique
PH
Leite
Claudia C
CC
Santana
Pedro Augustto
PA
Rosemberg
Sergio
S
Teixeira
Manoel Jacobsen
MJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001929:Brain Edema / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery*; D008579:Meningioma / Q000150:complications / Q000473:pathology* / Q000601:surgery*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology*; D012307:Risk Factors; D016896:Treatment Outcome