title: Cystic meningioma: radiological, histological, and surgical particularities in 43 patients.
abstract: The presence of cysts is a rare occurrence for intracranial meningiomas in adults. We report our experience in a large consecutive series of cystic meningiomas.
  
  
  
  We prospectively collected data for a dedicated database of cystic meningioma cases between January 2004 and December 2011 in two tertiary neurosurgical centers. Studied data included preoperative imaging, surgical records, and pathology reports.
  
  
  
  Among 1214 surgeries for intracranial meningioma, we identified 43 cases of cystic meningioma, corresponding to an incidence of 3.5 %. The most common localization was the hemispheric convexity (17/43 cases). Twenty-eight patients had intratumoral cysts, nine peritumoral, and five mixed intra and extratumoral. In 29 patients with available diffusion imaging, ADC coefficients were significantly lower in grade II-III tumors compared to grade I (p = 0.01). Complete resection of the cystic components was possible in 27/43 patients (63 %); partial resection in 4/43 (9 %); in 6/43 (14 %) cyst resection was not possible but multiple biopsies were performed from the cystic walls; in another 6/43 (14 %) the cystic wall was not identified during surgery. Cells with neoplastic features were identified within the cyst walls at pathology in 26/43 cases (60 %). All patients were followed-up for 24 months; long-term follow-up was available only in 32 patients for an average period of 49 months (range, 36-96 months). No recurrence requiring surgery was observed.
  
  
  
  Cystic meningiomas are rare. Cells with neoplastic features are often identified within the cyst walls. Complete cyst resection is recommendable when considered technically feasible and safe.
authors: Department of Neuroradiology, Lariboisière University Hospital, Paris, France.
authors: Monique
authors: M
authors: Boukobza
authors: Department of Neurosurgery, Hautepierre University Hospital, Strasbourg, France.
authors: Helene
authors: H
authors: Cebula
authors: Department of Interventional Neuroradiology UF6954, Hautepierre University Hospital, 1 Avenue Moliere, 67098, Strasbourg, France. pop.raoul@gmail.com.
authors: Raoul
authors: R
authors: Pop
authors: Department of Neurosurgery, Hautepierre University Hospital, Strasbourg, France.
authors: Fulbert
authors: F
authors: Kouakou
authors: Department of Neurosurgery, Hautepierre University Hospital, Strasbourg, France.
authors: Amirouche
authors: A
authors: Sadoun
authors: Department of Neurosurgery, Hautepierre University Hospital, Strasbourg, France.
authors: Hugo Andres
authors: HA
authors: Coca
authors: Department of Histopathology, Lariboisière University Hospital, Paris, France.
authors: Marc
authors: M
authors: Polivka
authors: Department of Neurosurgery, Hautepierre University Hospital, Strasbourg, France.
authors: Paolo
authors: P
authors: Diemidio
authors: Department of Neurosurgery, Hautepierre University Hospital, Strasbourg, France.
authors: Mario
authors: M
authors: Ganau
authors: Department of Neurosurgery, Lariboisière University Hospital, Paris, France.
authors: Bernard
authors: B
authors: George
authors: Department of Neurosurgery, Lariboisière University Hospital, Paris, France.
authors: Sebastien
authors: S
authors: Froelich
authors: Department of Neurosurgery, Hautepierre University Hospital, Strasbourg, France.
authors: Francois
authors: F
authors: Proust
authors: Department of Neurosurgery, Hautepierre University Hospital, Strasbourg, France.|Department of Neurosurgery, Lariboisière University Hospital, Paris, France.
authors: Salvatore
authors: S
authors: Chibbaro
mesh_terms: D000328:Adult; D000368:Aged; D003560:Cysts / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008579:Meningioma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology; D011859:Radiography; D014057:Tomography, X-Ray Computed
keywords: Cystic; Histopathology; MRI; Meningioma; Surgery