Intracranial papillary meningioma: a clinicopathologic study of 30 cases at a single institution.
BACKGROUND
Papillary meningioma (PM) is an uncommon meningioma subtype, and the clinical characteristics remain unclear.


OBJECTIVE
To determine the clinical characteristics and prognosis of PM.


METHODS
The clinical data of 30 PM patients were collected, the samples were reexamined, and the patients' prognoses were based on clinical observations and calculated according to the Kaplan-Meier method.


RESULTS
The 30 patients included 16 males and 14 females (median: 34.0 years upon initial diagnosis). Of the 48 intracranial operations in the 30 patients, total removal was attained in 34 surgeries, and subtotal removal in 14 surgeries. Radiotherapy was provided in 20 patients. In 40 specimens with follow-up, 29 attained the positive aggressive factors. Six tumors showed positive progestogen receptor (PR) combined with negative Bcl-2. The median follow-up period was 39.0 months. Tumor recurrence occurred in 18 patients (median: 17.0 months); the recurrence rates following total removal and subtotal removal were 57.1% and 100%, respectively. Fourteen patients died of the recurrence. In the univariate analyses, positive aggressive factors (P = .021), positive PR combined with negative Bcl-2 immunoreactivity (P = .011), the extent of resection (P = .001), and radiotherapy (P = .002) were significantly related to progression-free survival. The MIB-1 labeling index was not significantly related to progression-free survival (P = .88).


CONCLUSIONS
PM is a rare subtype of meningioma with a tendency of recurrence. The extent of resection is an important prognosis factor. The presence of positive histopathological index increases the recurrence risk. Positive PR combined with negative Bcl-2 immunoreaction might predict a good prognosis. Postoperative radiotherapy may play a vital role in prolonging the time to tumor recurrence.
‡Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China; §Department of Neuropathology, Huashan Hospital, Fudan University, Shanghai, China; ¶Department of Neurosurgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Xiao-Qiang
XQ
Wang
Hong
H
Chen
Lin
L
Zhao
Shi-Ting
ST
Li
Jie
J
Hu
Guang-Hai
GH
Mei
Cheng-Chuan
CC
Jiang
D000293:Adolescent; D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000378:metabolism; D002540:Cerebral Cortex / Q000378:metabolism / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D019938:Cyclin D1 / Q000378:metabolism; D066246:ErbB Receptors / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008577:Meningeal Neoplasms / Q000378:metabolism / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D008579:Meningioma / Q000378:metabolism / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D008875:Middle Aged; D018396:Mucin-1 / Q000378:metabolism; D009419:Nerve Tissue Proteins / Q000378:metabolism; D011987:Receptors, Steroid / Q000378:metabolism; D012189:Retrospective Studies; D055815:Young Adult
D015703:Antigens, CD; D018396:Mucin-1; D009419:Nerve Tissue Proteins; D011987:Receptors, Steroid; D019938:Cyclin D1; D066246:ErbB Receptors