referensi meningioma

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A role for the p53 pathway in the pathology of meningiomas withNF2lossZeNan Chang

Introduction

Arising from the arachnoid coverings of the brain and spinal cord, meningiomas account for1520% of primary neoplasms of the central nervous system, and have an estimated annual

incidence of about 6 per 100,000 individuals [1].

Meningiomas have long been known to exhibit receptors to sexual steroids [44], suggesting

that hormonal influences may explain the sexually dimorphic characteristics of this disease.

However, discrepancies on the proliferative effects of sexual hormones on meningiomas and

failure of variations in sexual receptor expression to explain the increased prevalence of

meningiomas in women suggests that more complex factors are at play [45].


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Sukri Rahman

Meningioma merupakan tumor jinak yang biasanya ditemukan pada meningen otak dan medula spinalis, sangat

jarang ditemukan di ekstrakranial.

Meningioma adalah tumor jinak, dengan pertumbuhan tumor yang lambat dan biasanya terjadi di daerah

intrakranial.1,3,5

Menurut Longstreth Jr dkk2 angka kejadian meningioma 6 per 1000 populasi atau sekitar 13-26% dari keseluruhan

tumor intrakranial. Meningioma yang terjadi di ekstrakranial merupakan kasus yang sangat jarang, diperkirakan

antara 1-2% dari keseluruhan kejadian meningioma.


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Meningiomas: causes and risk factorsJILL S. BARNHOLTZ-SLOAN, PH.D.,1 AND CAROL KRUCHKO, B.A.2

MENINGIOMAS account for 30% of all primary brain

tumor diagnoses in adults in the United States.9

The overall age-adjusted incidence rate is 4.52 per

100,000.9 Although age-adjusted incidence rates are reportedly

similar across racial groups, the incidence in women is

approximately twice that in men (Table 1).9 The incidence

increases with increasing age, peaking in the seventh and

eighth decades of life; these tumors are very rare in children(Fig. 1).9 It is currently estimated that 83% of all meningiomas

are microscopically confirmed.36 The incidence

of both diagnostically and nondiagnostically confirmed

meningiomas increased between 1985 and 1999;36 on average

the incidence of nondiagnostically confirmed meningiomasincreased significantly at 4.1% per year (95% CI

2.55.6) potentially reflecting both the increased use of

improved imaging techniques such as MR imaging and increasednumbers of meningiomas treated with observation

or primary radiotherapy rather than through surgical intervention.

The vast majority of meningiomas are considered histologically

benign (92.8%); only 2.2% are defined as uncertain

or atypical, and 5% as malignant.9 Five-year survival

rates are high for this tumor type (reported to be anywherefrom 70 to 95%)60,77,94 and therefore the estimated population

prevalence (number of individuals living with this

tumor) is relatively high, 50.4 per 100,000.15 Long survival

times coupled with potentially significant neurocognitive

and physical deficits could lead to significant medical costs

over time. The estimated average years of potential life lost in persons with meningiomas is 13 years,providing further

evidence of the long-term burden of this disease.110

In addition to increasing age, the most consistent factorassociated with risk of meningioma is exposure to ionizing

radiation; many other environmental, lifestyle and genetic

risk factors have been studied with inconclusive results.12Some of the factors that have been studied are endogenous

and exogenous hormone use,11,13,33,41,49,51,97,113 cell phone use,10,28,

30,31,40,42,46,55,65,100 and genetic variants or polymorphisms.


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DIAGNOSIS AND TREATMENT OF ATYPICAL ANDANAPLASTIC MENINGIOMAS: A REVIEWAshok Modha, M.D.

Between 13 and 26% of all intracranial

tumors are meningiomas (9, 12, 24, 29, 48).Meningiomas occur mostly in middle-aged

or elderly patients, but they can also occurin younger patients with dysgenetic syndromessuch as neurofibromatosis Type 2

(NF2). The annual incidence rate is approximately6 per 100,000 (19) but some tumorsare only discovered during autopsy. Often,

they are diagnosed incidentally on brain imagingfor unrelated complaints. A minorityof these tumors demonstrate histopathologicaland clinical features suggesting an aggressive

potential. These are the atypicaland anaplastic meningiomas. The formerconstitute between 4.7 and 7.2% of meningiomas,

whereas the latter account for 1.0 to2.8% (9, 12, 24, 48). Some series have shownthat up to 2% of all benign meningiomastransform into malignant forms (2, 51),whereas up to 28.5% of all recurrent benign

meningiomas will be found to be atypical oranaplastic (2, 18, 19). Hug et al. (17) reportedthat the annual incidence of these tumors inthe United States is approximately 150 to

225. There is a wide range in the prevalence

data for these malignant forms because variable

pathological criteria exist for their classification.Benign meningiomas are more

prevalent in women, but atypical and anaplasticforms seem to be more common in men (29). The atypicaland anaplastic forms are also more

common in the cerebral convexities (29).Atypical meningiomas have been reported to occur aftercranial irradiation for other tumors or conditions. These are

usually found in younger patients (3). This complicationwasfirst reported in 1953, in a child receiving radiation therapyfor

an optic glioma (17). Subsequently, children undergoingcranialradiation for medulloblastomas, astrocytomas, leukemia,

and lymphoma have all been reported to developmeningiomas(17). These tumors have also been noted in patients whoreceived low doses of irradiation fortinea capitis or afterexperimental

radiation treatments during World War II (17).Dental x-rays have also been implicated (17). Often,multiplemeningiomas are found in patients with these risk factors

(3).


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Risk of meningioma amongusers of high doses of cyproterone acetate as comparedwith the general population: evidence from a population-based cohortstudyMiguel Gil,1

Meningiomas are mostly benign, slow growing tumoursoriginating from the arachnoid cap cells. Meningiomas

have an annual incidence ranging from 3 to 8 per 100 000person-years in the different series, occur more frequentlyin women and its incidence increases with age [1, 2].

referensi meningioma

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