Рathomorphological features of recurrent meningiomas

Background. Meningiomas are common tumors of the central nervous system, most of which are benign. Anaplastic and atypical meningiomas, which together account for 25 % of all meningiomas, have a high recurrence rate even after gross total resection and radiotherapy, which determines a significantly worse prognosis. The mechanisms of recurrence remain poorly understood.

Purpose. To assess the significance of arachnoid granulations in the recurrence of meningiomas; to present our own clinical case; to make the review of the literature on this topic.

Materials and methods. We searched for publications in the Pubmed, EMBASE, Cohrane Library, and eLibrary databases published between the beginning of database management to February 2023 on the issue of the role of arachnoid granulation in meningioma reccurence. The materials of the desease history and results of histological examination of 71-year-old with intracranial meningioma who were treated in Almazov National Medical Research Center are used in this work.

Results. The clinical case of intracranial meningioma surgery is described. Histological examination of the tumor revealed papillary meningioma, grade 3. Tumor growth of meningioma was found in the granulations of the arachnoid. According to the review the clinical case shows the importance of the arachnoid granulations in determining the clinical management for this group of patients.

Conclusion. The presented clinical case and analysis of literature data demonstrates the importance of considering the structure of arachnoid granulations in patients with intracranial meningiomas, especially in the recurrent type of the disease. The role of granulations of the arachnoid membrane is currently “forgotten”, but the study of these important structures within the boundaries of the tumor field can provide new information and mechanisms of oncogenesis, malignancy, and recurrence of meningiomas, which may serve as the basis for inclusion in the standards for making a final pathomorphological diagnosis in this groups of patients.

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