Clinical Features And Treatment Of Calcified Meningiomas

Objective:To probe into the clinical features and treatment of the patients with calcified meningiomas (CMs).Methods:We analyzed retrospectively the clinical data of 58 patients with CMs confirmed by CT, operation and pathology from January 1999 to June 2009 in QiLu hospital of Shandong University. The characteristics of epidemiology, clinical manifestations, radiological features, microsurgery, pathological subtypes, prognosis and follow-up are discussed. It's found that the incidence rate of CMs was 6.55%. Evaluation of peritumoral edema grade depended on with the width of the edema and the extent of tumor removal was according to Simpson grade. We used SPSS13.0 software for data analysis.Results:Incidence of calcification rate was 6.55%. There were 16 males and 42 females in this group. Their ages ranged from 19 years to75 years, (mean,53.5 years). The average duration from presenting symptoms to diagnosis was about 27.5 months (ranging between 3 days and 17 years). In this series, the frequencies of symptoms and signs were headache in 31 cases, motor weakness in 10, dizziness in 9, nausea and vomiting in 8, epilepsy in 8, dysopia in 7, hyposmia in 5, superficial sensibility decline in 5, ataxia in 5, asymptomatic in 3, nystagmus and limbs convulsion in 2 respectively, directional force obstacle and cerchnus in 1 respectively. All of the patients were performed CT examination. All tumors were spherical or hemispherical except two cases being nodulous and lobulated in shape. CT value of calcification area in tumor was from 80Hu to 600Hu (CT value over 80Hu for calcification). The calcification forms of CMs were in spots, nodules, flakes, lumps, ring, diffusivity, even completeness.52 cases were totally removed, subtotal removal in 6 cases. Postoperative mortality was 1.7%. CMs compared with the overall data, have the following features:①The average age is 53.5 years, higher than the overall average of 49.7 years in meningiomas (P<0.05).②Male-female ratio is 1:2.6, higher than the overall ratio 1:2.③Calcification is common in convexity meningiomas, cerebral falx meningiomas, tentorial meningiomas and the middle cranial fossa meningiomas.④Pertumoral brain edema is less in CMs.⑤The tumor blood supply is not abundant in most of calcified meningiomas, especially in complete or diffuse CMs.⑥Calcification are most common in the transitional, meningothelial and fibroblastic meningiomas, and most obvious in psammomatous meningiomas. However, there are nearly no calcification in malignant meningiomas, atypical meningiomas and meningeal sarcoma. The CMs have low proliferation and invasiveness.Conclusions:Compared with the general meningioma, CMs have some clinical features:①Calcified tumors have the characteristics of Low-invasive and slow growth rate.②CMs are low invasive and generally not rich in blood supply, which brings convenience to the surgery, and the prognosis is better than that of the overall meningioma after surgery.