title: Treatment recommendations for primary extradural meningiomas.
abstract: Primary extradural meningiomas (PEMs) represent about 2% of all meningiomas and are often encountered by non-neurosurgeons. These lesions typically present as enlarging, painless, benign masses that can be surgically cured. Imaging is critical for defining involvement of adjacent structures; however, diagnosis depends on classic histologic patterns. Treatment for benign PEMs (WHO I) consists of resection with wide margins, whereas adjuvant therapy after resection of atypical (WHO II) or malignant (WHO III) PEMs should be considered. By using the collective experience from our comprehensive cancer center, including neuro-oncologists, neuroradiologists, and neurosurgeons, in addition to a complete literature review, the authors have established treatment guidelines not previously reported. This manuscript describes key features of these challenging tumors to aid in diagnosis, presents the largest published review of all reported PEMs (n = 163), and provides salient treatment guidelines to surgeons unfamiliar with these challenging tumors.
authors.affiliation: Department of Surgery (Division of Neurosurgery), Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: Austin
authors.initials: A
authors.lastname: Mattox
authors.forename: Betsy
authors.initials: B
authors.lastname: Hughes
authors.forename: James
authors.initials: J
authors.lastname: Oleson
authors.forename: David
authors.initials: D
authors.lastname: Reardon
authors.forename: Roger
authors.initials: R
authors.lastname: McLendon
authors.forename: Cory
authors.initials: C
authors.lastname: Adamson
mesh_terms: D000008:Abdominal Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000628:therapy; D000465:Algorithms; D001859:Bone Neoplasms / Q000175:diagnosis / Q000628:therapy; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D008577:Meningeal Neoplasms; D008579:Meningioma / Q000628:therapy*; D017410:Practice Guidelines as Topic