Dev meningiomlar: 40 olgunun detaylı analizi

Amaç: Çapı 6 santimetreden (cm) büyük meningiomlar dev meningiomlar olarak isimlendirilir. Bu çalışmada cerrahi uyguladığımız 40 dev meningiom olgusunun klinik, patolojik ve radyolojik özellikleri ile tedavi yaklaşımlarını tartıştık.Gereç ve yöntem: 2015-2019 yılları arasında çapı 6 cm’den büyük olan ve patolojik tanısı meningiom olarak rapor edilen hastalar yaş, cinsiyet, lokalizasyon, semptom ve bulgular, tedavi, takip süresi, nüks, morbidite ve mortalite açısından incelenmiştir.Bulgular: Çalışmada toplam 40 vaka olup, vakaların 30 tanesi (%75) kadın, 10 tanesi ise (%25) erkek cinsiyette idi. Ortalama yaş 55,77,33 (ortalama  Standart Sapma-SS) (min:39, maks:72) olarak saptandı. En sık konveksite yerleşimliydi (13 hasta, %32). En sık semptom %42,5 ile baş ağrısıydı. Hastaların 7’sinde (%17,5) Simpson Evre I, 16 hastada (%40) Evre II, 2 hastada (%5) Evre III ve 15 hastada ise (%37,5) Evre IV cerrahi rezeksiyon uygulandı. Patolojik tanı 32 olguda (%80) Evre I, 6 olguda (%15) Evre II ve 2 olguda ise (%5) Evre III meningiom olarak raporlandı. Hastaların ortalama takip süresi 225,24 (min:12, maks:44), nüks oranı %7,5 oranında görüldü. Serimizde morbidite %30, mortalite %0 olarak saptandı.Sonuç: Tümörün mevcut lokalizasyonu ve boyutu total rezeksiyon oranını, mortalite ve morbiditeyi önemli oranda etkilemektedir. Dev meningiomların yönetiminde cerrahi tedavi esas olup, dikkat ve deneyim gerektiren özellikli bir tedavi şeklidir.

Anahtar Kelimeler:

meninjioma, dev, gama knife, cerrahi

Giant meningiomas: a detailed analysis of 40 cases

Purpose: Meningiomas greater than 6 centimetres (cm) are called giant meningiomas. This report discussed the surgical, pathological and radiological features of 40 cases with giant meningiomas. Materials and methods: Patients radiologically and pathologically diagnosed with giant meningiomas between 2015-2019 were retrospectively evaluated in terms of the age, gender, localization of the lesion, symptoms and signs, treatment, follow-up, recurrence, morbidity and mortality. Results: A total of 40 cases were enrolled in the study. Thirty cases (75%) were female, and 10 (25%) were male gender. The mean age of patients was 55.77.33 (mean  Standard deviation-SD) (min:39, max:72). The most common localization of lesions was convexity, with a rate of 32% (13 patients). The most common symptom was headache, with a rate of 42.5%. In 7 patients (17.5%) Simpson Grade I, in 16 patients (40%) Simpson Grade II, in 2 patients (5%) Simpson Grade III and 15 patients (37.5%), Simpson Grade IV surgical resection were performed. Pathological diagnoses were reported as Grade I meningioma in 32 patients (80%), Grade II in 6 patients (15%) and Grade III in 2 patients (5%). The mean follow-up period was 22 months (min:12, max:44), the recurrence rate was 7.5%. In our series, the rates of morbidity and mortality were 30% and 0%, respectively.Conclusion: This study demonstrated that the localization and the size of the tumour significantly influence the total resection rate, mortality and morbidity. Surgical treatment of giant meningiomas requires attention and experience and is essential in the management.

Keywords:

Meningioma, giant, gamma knife, surgery,

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