Basic principles and features of surgical treatment for relapse and continued growth of giant intracranial meningiomas
https://doi.org/10.56618/2071-2693_2024_16_3_62
EDN: JHWQLK
Abstract
INTRODUCTION. Currently, significant progress has been made in the surgery of intracranial meningiomas. However, surgery for recurrent meningiomas has its own peculiarities; compared to the removal of initially detected meningiomas, it is more difficult and leads to significantly worse results.
AIMS. Analysis of the factors affecting the radicality of tumor removal, determination of the basic principles and features of surgical treatment of patients with relapse and continued growth of giant intracranial meningiomas, presentation of a clinical case of microsurgical removal of a giant recurrent sphenoid wing meningioma.
MATERIALS AND METHODS. The study was based on patients (n=32) with relapse and continued growth of histologically confirmed intracranial meningiomas of gigantic size (more than 50 cm3 in volume) operated on in the Department of Neurosurgery No. 4 of the Polenov Neurosurgery Institute – the branch of Almazov National Medical Research Centre in the period from 2014 to 2024. The degree of radicality was assessed by the operating surgeon intraoperatively and using contrastenhanced computed tomography and (or) contrast-enhanced brain magnetic resonance imaging in the period 24 to 72 hours after surgery.
RESULTS. The basic surgical techniques are described and the principles of surgery for recurrent giant meningiomas are formulated. A description of a clinical case of surgical treatment of a patient with a giant recurrent sphenoid wing meningioma is presented.
About the Authors
K. K. Kukanov
Polenov Neurosurgery Institute – the branch of Almazov National Medical Research Centre
Russian Federation
Russian Federation
Konstantin K. Kukanov – Cand. of Sci. (Med.), Neurosurgeon of the Highest Qualification Category of the Neurosurgical Department No. 4, Senior Researcher at the Institute of Neuro-Oncology
12 Mayakovskogo street, St. Petersburg, 191025
N. E. Voinov
Polenov Neurosurgery Institute – the branch of Almazov National Medical Research Centre
Russian Federation
Russian Federation
Nikita E. Voinov – Neurosurgeon; Specialist in Scientific and Analytical Work, World-Class Research Centre for Personalizet Medicine
12 Mayakovskogo street, St. Petersburg, 191025
A. S. Nechaeva
Polenov Neurosurgery Institute – the branch of Almazov National Medical Research Centre
Russian Federation
Russian Federation
Anastasiia S. Nechaeva – Neurosurgeon; Junior Researcher, World-Class Research Centre for Personalizet Medicine
12 Mayakovskogo street, St. Petersburg, 191025
V. E. Olyushin
Polenov Neurosurgery Institute – the branch of Almazov National Medical Research Centre
Russian Federation
Russian Federation
Victor E. Olyushin – Dr. of Sci. (Med.), Full Professor, Honored Doctor of Russia, Neurosurgeon of the Highest Qualification Category, Chief Researcher at the Institute of Neuro-Oncology
12 Mayakovskogo street, St. Petersburg, 191025
K. A. Samochernykh
Polenov Neurosurgery Institute – the branch of Almazov National Medical Research Centre
Russian Federation
Russian Federation
Konstantin A. Samochernykh – Dr. of Sci. (Med.), Professor of the Russian Academy of Sciences, Neurosurgeon of the Highest Category at the Department of Neurosurgery for Children No. 7, Director
12 Mayakovskogo street, St. Petersburg, 191025
References
1. Tigliev G. S., Oljushin V. E., Kondrat’ev A. N. Vnutricherepnye meningiomy. SPb.: Rossijskij nejrohirurgicheskij institut im. prof. A. L. Polenova; 2001. (In Russ.).
2. Pospelova M. L., Ternovy`kh I. K., Rudneva V. A., Alekseeva T. M., Olyushin V. E., Efimczev A. Yu., Kukanov K. K., Lepekhina A. S., Ivanova N. E., Ulitin A.Y u. Diagnostika opukholi golovnogo mozga v praktike nevrologa i nejrokhirurga: klinicheskij sluchaj. Russian neurosurgical journal named after professor A. L. Polenov. 2020;12(3):74–78. (In Russ.). EDN: https://elibrary.ru/YJHINN.
3. Kukanov K. K., Vorobyova O. M., Zabrodskaya Yu. M., Potemkina E. G., Ushanov V. V., Tastanbekov M. M., Ivanova N. E. Intracranial meningiomas: clinical, intrascopic and pathomorphological causes of recurrence (literature review). Siberian journal of oncology. 2022;21(4):110–123. (In Russ.). Doi: https://doi.org/10.21294/1814-4861-2022-21-4-110-123. EDN: https://elibrary.ru/dbarsi.
4. Zabolotny R. A., Fedyanin A. V., Yulchiev U. A., Galkin M. V., Kozlov A. V. Comprehensive treatment of patients with parasagittal meningiomas. Voprosy Neirokhirurgii: Zhurnal Imeni N. N. Burdenko. 2019;83(4):121–125. (In Russ.). Doi: https://doi.org/10.17116/neiro201983041121.
5. Kukanov K. K., Ushanov V. V., Zabrodskaya Yu. M., Tastanbekov M. M., Vorobyova O. M., Sitovskaya D. A., Dikonenko M. V. Ways to personalize the treatment of patients with relapse and continued growth of intracranial meningiomas. Russian Journal for Personalized Medicine. 2023;3(3):48–63. (In Russ.). Doi: https://doi.org/10.18705/2782-38062023-3-3-48-63.
6. Certificate of state registration of the database No. RU 2023621571/02.05.2023. Register of patients with relapse and continued growth of intracranialmeningiomas; Kukanov K. K., Ushanov V. V., Voinov N. E. 2023. (In Russ.). EDN: https://elibrary.ru/vbrsbm.
7. Gogorjan S. F., Bersnev V. P., Kim A. V., Samochernykh K. A., Malkhosyan Zh. G. Opuholi golovnogo mozga, sochetajushhiesja s gidrocefaliej. Voprosy Neirokhirurgii: Zhurnal Imeni N. N. Burdenko. 2008;4(72):39–42. (In Russ.). EDN: https://elibrary.ru/JXFQID.
8. Necmettin Pamir M., Peter M.Black, Rudolf Fahlbusch. Meningiomas: a comprehensive text. Acta Neurochirurgica. 2010;(152):1445–1445. Doi: https://doi.org/10.1007/s00701-010-0622-9 .
9. Konovalov A. N., Kozlov A. V., Cherekaev V. A., Shimanskiĭ V. N., Taniashin S. V., Kornienko V. N., Pronin I. N., Golanov A. V., Kobiakov G. L., Shishkina L. V., Ryzhova M. V., Gol’bin D. A., Galkin M. V., Bocharov A. A., Lasunin N. V. Meningioma challenge: analysis of 80- year experience of Burdenko Neurosurgical Institute and future. Voprosy Neirokhirurgii: Zhurnal Imeni N. N. Burdenko. 2013;77(1):12–23. (In Russ.). EDN: https://elibrary.ru/pyatkb.
10. Kukanov K. K., Tastanbekov M. M., Zabrodskaya Yu. M., Ushanov V. V., Kukanova O. M., Kiyashko S. S., Ivanova N. E., Olyushin V. E. Clinical features in recurrence and progression of intracranial meningiomas. Russian neurosurgical journal named after professor A. L. Polenov. 2022;15(3):55–62. (In Russ.). Doi: https://doi.org/10.56618/20712693_2023_15_3_55. EDN: TCGYNW.
11. UshanovV.V., Tastanbekov M. M., Kukanov K. K., Dikonenko M. V., Paltsev A. A., Fris N. I., Zabrodskaya Yu. M. Аrachnoid granulation in the recurrence of meningiomas. Russian neurosurgical journal named after professor A. L. Polenov. 2023;15(2):161–165. (In Russ.). Doi: 10.56618/2071–2693_2023_15_2_161.
12. Kondratiev S. A., Kondratieva E. A., Kondratiev A. N., Lesteva N. A., Kukanov K. K., Ivanova N. E. Muscle weakness in the early postoperative period after removal of a brain tumor. Russian neurosurgical journal named after professor A. L. Polenov. 2021;13(4):51–58. (In Russ.). EDN: ERBXEE.
13. Kiiashko S. S., Olushin V. E., Zrelov A. A., Kukanov K. K., Sklyar S. S., Maslova L. N., Ivanova N. E. Static-dynamic disorders in patients after microsurgical resection of the cerebellopontine angle tumors: long-term results. Medical News of North Caucasus. 2022;17(1):10–14. (In Russ.). Doi: https://doi.org/10.14300/mnnc.2022.17003.
14. Kukanov K. K., Tastanbekov M. M., Olyushin V. E., Pustovoy S. V. Surgical treatment of patients with meningiomas of the foramen magnum: immediate and long-term results. Russian neurosurgical journal named after professor A. L. Polenov. 2017;9(1):36– 42. (In Russ.). EDN: https://elibrary.ru/REBCQI .
15. Kukanov K. K., Tastanbekov M. M., Olyushin V. E. Meningiomas of the foramen magnum: results of surgical and radiosurgical treatment. Russian neurosurgical journal named after professor A. L. Polenov. 2016;8(4):26–35. (In Russ.). EDN: https://elibrary.ru/LJHXLU.
16. Khachatryan V. A., Kim A. V., Samochernykh K. A., Gogoryan S. F., Malkhasyan J. G., Rabandiyarov M. R., Golubova O. V., Sakhno L. V., Nesterova L. P., Lebedev K. E., Simonyan D. A. Malignant tumors of the cerebral hemisphere, coexisting with hydrocephalus. Neurosurgery and Neurology of Kazakhstan. 2009;4(17):3–20. (In Russ.).
17. Schipmann S., Schwake M., Sporns P. B. et al. Is the Simpson Grading System Applicable to Estimate the Risk of Tumor Progression After Microsurgery for Recurrent Intracranial Meningioma? // World Neurosurg. 2018;(119):e589–e597. Doi: https://doi:10.1016/j.wneu.2018.07.215.
18. Olyushin V. E., Kukanov K. K., Nechaeva A. S., Sklyar S. S., Vershinin A. E., Dikonenko M. V., Golikova A. S., Mansurov A. S., Safarov B. I., Rynda A. Y., Papayan G. V. Photodynamic therapy in neurooncology. Biomedical Photonics. 2023;12(3):25–35. Doi: https://doi.org/10.24931/2413-9432-2023-12-3-25-35.
19. Kukanov K. K., Nechaeva A. S., Sitovskaya D. A., Dikonenko M. V., Sukhoparov P. D., Ishchenko I. O., Zabrodskaya Yu. M., Samochernykh N. K., Papayan G. V., Olyushin V. E., Samochernykh K. A. Intraoperative photodynamic therapy in the structure of complex treatment of patients suffering from recurrence and continued growth of intracranial meningioma. Bulletin of the Russian Military Medical Academy. 2024;26(2):243–258. (In Russ.). Doi: https://doi.org/10.17816/brmma624272.
20. Kukanov K. K., Nechaeva A. S., Ulitin A. Yu., Sklyar S. S., Vershinin A. E., Dikonenko M. V., Politova A. O., Papayan G. V., Olyushin V. E. Achievements and prospects for further development of photodynamic therapy technology in the treatment of cerebral tumors. Russian Journal for Personalized Medicine. 2024;4(1):44– 57. (In Russ.). Doi: https://doi.org/10.18705/2782-3806-2024-4-1-44-57. EDN: ZPQYNN.
21. Schipmann S., Schwake M., Sporns P. B. et al. Is the Simpson Grading System Applicable to Estimatethe Risk of Tumor Progression After Microsurgery for Recurrent Intracranial Meningioma?. World Neurosurg. 2018;(119):589–597. Doi: https://doi.org/10.1016/j.wneu.2018.07.215.
22. Cao X., Hao S., Wu Z. et al. Treatment Response and Prognosis After Recurrence of Atypical Meningiomas. World Neurosurg. 2015;84(4):1014–1019. Doi: https://doi:10.1016/j
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For citations:
Kukanov K.K., Voinov N.E., Nechaeva A.S., Olyushin V.E., Samochernykh K.A. Basic principles and features of surgical treatment for relapse and continued growth of giant intracranial meningiomas. Russian Neurosurgical Journal named after Professor A. L. Polenov. 2024;16(3):62-74. (In Russ.) https://doi.org/10.56618/2071-2693_2024_16_3_62. EDN: JHWQLK
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