Treatment Outcomes of Intraventricular Meningiomas

Abstract

Introduction: Intraventricular meningioma is a rare disease among all meningiomas. Although microsurgery for intraventricular meningiomas remains a standard treatment, it is challenging procedure because of relatively high incidence of post-operative neurologic deficit. As result, stereotactic radiosurgery has been introduced as alternative. We summarized treatment outcomes of two modalities.

Methods: A total 55 patients were enrolled

36 and 19 patients underwent microsurgery and stereotactic radiosurgery for primary treatment, respectively. Under approval of review board, demographic and clinical data was obtained using electronic medical records. Radiologic studies were reviewed for measuring volumes of tumors as well as identifying recurrence. Risk factor analysis for tumor recurrence and post-operative neurologic deficit was performed.

Results: The mean age of patients was 46.0±14.8. There were 40 (72.7%) female patients. The most common symptom was headache. The mean tumor diameter was measured as 4.2cm. In microsurgery group, gross total resection was achieved in 32 (88.9%) cases. Benign pathology was confirmed in 29 (80.6%) cases. In 4 cases with remained choroid plexus during microsurgery, 2 experienced tumor recurrence. Remained choroid plexus was a single risk factor related with tumor recurrence. Nineteen (52.8%) experienced newly developed neurologic deficit and it was remained permanently in 14 (38.9%) patients. Left-sided tumor was identified as risk factor. In stereotactic radiosurgery group, there was no progression case during 43 months follow-up. However temporary tumor expansion was observed in 6 (31.6%) cases. There was no patient presenting neurological change.

Conclusions: For preventing tumor recurrence, resection of choroid plexus seems to be important during microsurgery. The incidence of post-operative neurologic deficit is relatively high, especially in the case of left-sided tumors. In limited cases, stereotactic radiosurgery seems to be effective and safe.