145
Views
44
CrossRef citations to date
0
Altmetric
Original Article

Atypical meningiomas: WHO moved the goalposts?

, &
Pages 588-592 | Received 10 Jun 2007, Accepted 13 Sep 2007, Published online: 06 Jul 2009
 

Abstract

The histological grading of meningiomas underwent substantial revision and standardization in a WHO review of 2000. Prior to this the histological definition of atypical and malignant meningiomas was less tightly defined. We conducted a retrospective analysis of all meningiomas operated on between 1993 and 2003 in our unit (n = 565), to assess whether the WHO changes had altered the proportion of tumours diagnosed as atypical. The percentage of tumours graded WHO II (atypical meningiomas) has increased significantly since these changes were adopted (18.3 – 23.1%, p = 0.0408). We also examined the epidemiology of meningioma, finding that previous irradiation is associated with atypical meningiomas (p = 0.038) and surgeons find that complete excision is also more difficult with atypical tumours (p = 0.010), reporting poorer Simpson grades intraoperatively before the tumour grade is known. The increase in atypical lesions caused by the grading changes may lead to a corresponding increase in the numbers of patients referred for radiotherapy/radiosurgery, and we examine the evidence base for this strategy and whether our experience is replicated in other units.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.