Toader Corneliu, Bratu Bogdan-Gabriel, Covache-Busuioc Razvan-Adrian, Dumitrascu David-Ioan, Glavan Luca-Andrei, Ciurea Alexandru Vladimir
Department of Neurosurgery, "Carol Davila" University of Medicine and Pharmacy, Bucharest, ROU.
Department of Vascular Neurosurgery, National Institute of Neurology and Neurovascular Diseases, Bucharest, ROU.
Cureus. 2023 Dec 31;15(12):e51376. doi: 10.7759/cureus.51376. eCollection 2023 Dec.
Meningiomas represent a prevalent class of primary brain tumors, with malignancies such as World Health Organization grade III meningiomas posing significant clinical challenges due to their aggressive nature and potential for recurrence. This case report showcases the clinical journey of a 67-year-old female patient presenting with a giant malignant meningioma post-thyroidectomy, who unfortunately succumbed to postoperative complications. The report offers a comprehensive analysis of the tumor's clinical presentation, including its substantial size, which qualifies it as a 'giant' meningioma, and explores the patient's endocrine dysfunction as a possible contributing factor to her neurological pathology. In the broader context of meningioma management, the report synthesizes data from multiple studies, underscoring the higher incidence of such malignancies in post-pubertal women and the complexity of treatment modalities. Surgical resection remains the cornerstone of treatment, especially when combined with adjuvant therapies. The report concludes with a discussion on the persistent gaps in knowledge regarding the pathogenesis of giant malignant meningiomas and the need for further research, particularly concerning the role of endocrine dysregulation in their development. This case underscores the imperative for multidisciplinary approaches and individualized treatment strategies in the management of malignant meningiomas, with an emphasis on the intricate interplay between endocrine factors and tumor progression.
脑膜瘤是一类常见的原发性脑肿瘤,诸如世界卫生组织III级脑膜瘤这类恶性肿瘤,因其侵袭性和复发可能性而带来重大临床挑战。本病例报告展示了一名67岁女性患者的临床历程,该患者在甲状腺切除术后出现巨大恶性脑膜瘤,不幸因术后并发症死亡。报告对肿瘤的临床表现进行了全面分析,包括其巨大尺寸(符合“巨大”脑膜瘤的标准),并探讨了患者的内分泌功能障碍作为其神经病理学可能的促成因素。在脑膜瘤治疗的更广泛背景下,报告综合了多项研究的数据,强调此类恶性肿瘤在青春期后女性中发病率较高以及治疗方式的复杂性。手术切除仍然是治疗的基石,尤其是与辅助治疗相结合时。报告最后讨论了关于巨大恶性脑膜瘤发病机制的知识持续存在的空白以及进一步研究的必要性,特别是关于内分泌失调在其发展中的作用。本病例强调了在恶性脑膜瘤管理中采取多学科方法和个体化治疗策略的紧迫性,重点在于内分泌因素与肿瘤进展之间的复杂相互作用。