Cao Dan, Ou Yibo, Chen Xu, Guo Zhengqian, Chen Yong, Chen Jian
Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.
Department of Neurosurgery Intensive Care Unit, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China.
Neurosurg Rev. 2023 Jan 6;46(1):33. doi: 10.1007/s10143-022-01932-y.
Giant lateral ventricular meningiomas (LVMs), with the largest diameter of at least 5 cm, form a distinct subset. The incidence of giant LVMs is considered to be relatively low. Here, we evaluated clinical characteristics, and clinical outcomes after microsurgical resection, especially functional outcomes and morbidity of giant LVMs. We retrospectively reviewed 49 patients with LVMs, including 18 giant LVMs from 2012 to 2020. And we analyzed clinical, histopathological, surgical, and outcome data at our institution. Giant LVMs were most commonly present in the fourth decade of patients with the male-to-female ratio of 1:2. The most common subtypes were transitional and fibrous. Most lesions were resected via the temporal or parieto-occipital approach in our series. The median volume of blood loss was higher in the giant group (900 vs. 600 ml, p = 0.02). Meanwhile, the median length of hospital stay was prolonged for giant LVMs (20.5 vs. 16.0 days, p < 0.01). The proportion of discharged functional deterioration was higher in giant LVMs (38.9% vs. 6.5%, p = 0.02). However, there was no statistical significance between functional deterioration and tumor size at long-term follow-up (p = 0.28). Giant LVMs patients suffered from neurological and regional complications more commonly, particularly from a postoperative hematoma (4/18 vs. 1/31), and hydrocephalus (2/18 vs. 0/31). Patients with giant LVMs had a high incidence of immediate functional deterioration after microsurgery, and there was no difference in functional deterioration between the giant and non-giant LVMS during long-term follow-up. Microsurgery entails a higher complication rate in giant LVMs. We need to pay special attention to preventing postoperative hematoma and hydrocephalus.
巨大侧脑室脑膜瘤（LVMs）直径至少5厘米，构成一个独特的亚组。巨大LVMs的发病率相对较低。在此，我们评估了巨大LVMs的临床特征以及显微手术切除后的临床结局，尤其是功能结局和发病率。我们回顾性分析了49例LVMs患者，其中包括2012年至2020年期间的18例巨大LVMs患者。我们分析了本机构的临床、组织病理学、手术及结局数据。巨大LVMs最常见于患者的第四个十年，男女比例为1:2。最常见的亚型是过渡型和纤维型。在我们的系列研究中，大多数病变通过颞部或顶枕部入路切除。巨大组的术中失血量中位数更高（900毫升对600毫升，p = 0.02）。同时，巨大LVMs患者的住院时间中位数延长（20.5天对16.0天，p < 0.01）。巨大LVMs患者出院时功能恶化的比例更高（38.9%对6.5%，p = 0.02）。然而，在长期随访中，功能恶化与肿瘤大小之间无统计学意义（p = 0.28）。巨大LVMs患者更常出现神经和局部并发症，尤其是术后血肿（4/18对1/31）和脑积水（2/18对0/31）。巨大LVMs患者显微手术后立即出现功能恶化的发生率较高，在长期随访中，巨大和非巨大LVMs之间的功能恶化无差异。巨大LVMs的显微手术并发症发生率更高。我们需要特别注意预防术后血肿和脑积水。
