Neurosurgery Department, Centro Hospitalar Universitário São João, Porto, Portugal.
Faculty of Medicine, University of Porto, Porto, Portugal.
Br J Neurosurg. 2024 Aug;38(4):1027-1030. doi: 10.1080/02688697.2021.1995592. Epub 2021 Nov 2.
Cranioplasty with titanium mesh provides a stable and cosmetically sound option for the correction of extensive skull bone defects following trauma or tumour surgery with osseous involvement. Meningiomas are for the most part benign lesions that are amenable to surgical cure, however lesions with extradural extension pose additional challenges not only due to increased technical difficulty in achieving gross total resection but also because of distinct biological behaviour. We describe the case of a 43-years-old woman that had been submitted to gross total resection of a WHO grade I falcine and superior sagittal sinus secretory meningioma with extradural and bone extension and cranioplasty with a titanium mesh who had a recurrence 4 years later as two tumour masses on top of the titanium mesh with no adjacent soft tissue invasion, and without dural involvement. To our knowledge, this is the first reported case of meningioma growth on top of titanium cranioplasty material. Seeded or incompletely removed tumoral cells might have exploited the biocompatibility of titanium to promote tumour regrowth.
颅骨修复钛网为创伤或肿瘤手术后广泛颅骨骨缺损的矫正提供了一种稳定且美容效果良好的选择，这些颅骨骨缺损与骨受累有关。脑膜瘤大多是良性病变，可通过手术治愈，然而，具有硬膜外延伸的病变不仅由于在实现大体全切除方面增加了技术难度，而且由于其独特的生物学行为，带来了额外的挑战。我们描述了一例 43 岁女性的病例，该女性曾接受过 WHO 分级 I 矢状窦镰旁和上矢状窦分泌型脑膜瘤的大体全切除，脑膜瘤具有硬膜外和骨延伸，并进行了钛网颅骨修复，4 年后在钛网顶部出现了两个肿瘤肿块，没有相邻的软组织侵犯，也没有硬膜受累。据我们所知，这是首例报告的脑膜瘤在钛颅骨修复材料上生长的病例。种植或未完全切除的肿瘤细胞可能利用钛的生物相容性促进肿瘤复发。
