title: Papillary meningioma: an aggressive variant meningioma with clinical features and treatment: a retrospective study of 10 cases.
abstract: BACKGROUND
  Papillary meningioma is a rare subtype of malignant meningiomas. The aim of this retrospective study was to investigate the clinical, radiological, histopathological features and prognosis for papillary meningioma at our institutions.
  
  
  METHODS
  Ten patients with clinically, radiologically and histopathologically confirmed papillary meningiomas were treated at our hospitals. The clinical data, imaging characteristics, histopathological features, surgical treatment and postoperative follow-up, were analyzed retrospectively.
  
  
  RESULTS
  The patients with a mean age of 36.9 years at the time of their initial operations. The papillary meningiomas were predominantly located in the convexity (n = 6). At their initial operation, six patients underwent gross total resection and four patients underwent subtotal resection. The mean post-operative follow-up period was 42.6 months (range: 12-90 months). Six patients underwent multiple surgical resections. The mean time to first recurrence was 21.5 months. On magnetic resonance imaging scan, marked enhancements and dural tail signs were displayed in all lesions. All lesions showed peritumoral edema. Cysts were seen in four lesions. Bone hyperostosis or destruction was seen in six lesions. Cerebrospinal fluid dissemination was seen in three lesions. Incomplete surgical resection was associated with recurrence. MIB-1 labeling index was associated with progression-free survival for patients (p = 0.0442).
  
  
  CONCLUSIONS
  Papillary meningioma has a tendency to present in middle-aged patients, and it has specific clinical and histopathological characteristics. MIB-1 labeling index and the extent of resection might predict the recurrence. Cystic formation, peritumoral edema, osseous change and CSF dissemination might be neuroimaging characteristics of papillary meningioma, especially in recurrence papillary meningioma.
authors: a 1 Department of Neurosurgery Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine , Shanghai , China.
authors: Bin
authors: B
authors: Li
authors: a 1 Department of Neurosurgery Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine , Shanghai , China.
authors: Bangbao
authors: B
authors: Tao
authors: b 2 Department of Neurosurgery, Liuhua Bridge Hospital , Guangzhou , China.
authors: Hongmin
authors: H
authors: Bai
authors: a 1 Department of Neurosurgery Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine , Shanghai , China.
authors: Jun
authors: J
authors: Zhong
authors: c 3 Department of Pathology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine , Shanghai , China.
authors: Xiangru
authors: X
authors: Wu
authors: c 3 Department of Pathology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine , Shanghai , China.
authors: Juanhong
authors: J
authors: Shi
authors: c 3 Department of Pathology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine , Shanghai , China.
authors: Hui
authors: H
authors: Sun
authors: a 1 Department of Neurosurgery Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine , Shanghai , China.
authors: Shiting
authors: S
authors: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D000974:Antibodies, Antinuclear; D000911:Antibodies, Monoclonal; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D008579:Meningioma / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000974:Antibodies, Antinuclear; D000911:Antibodies, Monoclonal; C440408:MIB-1 antibody
keywords: histopathology; papillary meningioma; prognosis; treatment