Retrospective study of peritumoral cerebral edema correlation with tumor size, its location and histological structure of sphenoid wing meningiomas

Abstract

Meningiomas are one of the most common intracranial primary tumors. They are more common in women, their number increases with age. Sphenoid wing meningiomas make up 15–20 % of intracranial meningiomas. The aim of the study – to evaluate the relationship between preoperative peritumoral cerebral edema (PTCE) and tumor size, histological structure and location. Materials and Methods. Data from 67 patients with removed sphenoid wing meningioma in the period from January 2007 to January 2021 were retrospectively examined. One-factor and two-dimensional statistical analysis of factors that may affect PTCE was performed. Results. The average age of the patients examined was 47 years (ranging from 20 to 74), men – 16 (23.9 %), women – 51 (76.1 %). The mean tumor volume was 32.8 cm3, ranging from 4.2 cm3 to 143.7 cm3. The edema index (EI) is 1 in 27 (40.3 %) was absent, EI > 1 in 40 (59.7 %) was present. Small tumor volume was in 21 cases, PTCE – 57.2 %, medium – 32 cases, PTCE – 59.2 %, large tumor volume was in 9 cases, PTCE – 66.7 % and giant – in 5 cases, PTCE – 60.0 %. According to the WHO classification, there were 54 cases of central nervous system malignant tumors grade I (80.6 %), which were classified into endothelial type – 37 (68.5 %), fibrous – 7 (12.9 %), transient – 5 (9.2 %), angiomatous – 6 (11.1 %) ) and psammomatous type, which was found in one patient. Tumors grade II – atypical type, found in 11 cases (16.4 %), and III – anaplastic type, were in 2 cases (3.0 %). In a one-way analysis, we found a significant relationship between PTCE and the degree of malignancy (χ2 = 8.59, p = 0.0034), while no relationship was found between PTCE and tumor volume (W = 627, p = 0.27). PTCE was more pronounced in the lateral, middle and medial variants of location and less pronounced in the case of spheno-orbital location of the tumor (p = 0.10) and the overall edema index (χ2 = 4.48, p = 0.034). Conclusions. The relationship between PTCE and tumor volume is statistically insignificant. We found that high-grade (grade II and III) and low-grade subtypes (grade I, angiomatous type) are strongly associated with PTCE, although there is no relationship between the degree of malignancy and tumor location, χ2 = 0.37, p = 0.83. The results of a two-dimensional analysis of the simultaneous effect of tumor volume and PTCE on the pathological stage confirmed the higher risk of PTCE in tumors of grade II and III (p = 0.0027). There was also a small association between tumor volume and pathology (p = 0.74). A higher frequency of PTCE was found in the lateral variant in sphenoid wing meningioma, while a lower in spheno-orbital meningioma (p = 0.10), and a lower overall edema index (χ2 = 4.48, p = 0.034)

Keywords

• peritumoral edema of the brain
• sphenoid wing meningioma
• tumor volume
• grade of malignancy