Abstract
In retrospective review of our malignant meningioma patients, we discussed about clinical analysis and treatment methods. Among 124 cases of surgically treated meningiomas, 11 cases were of malignant meningiomas, which includes 5 cases of atypical meningiomas, 4 cases of anaplastic meningiomas and 2 cases of papillary meningiomas. Duration of median follow-up was 73 months. The malignant meningiomas patients presented in more than 60 years of age and had poor outcome. Three of surgical treatment with Simpson's grade I had no recurrence. But the other 8 patients, with Simpson's grade II to IV surgical removal had recurrence (sizable regrowth of tumor) and the time elapsed to recurrence from surgical treatment had no statistically significant difference. Conventional radiotherapy was given to 8 cases postoperatively, but could not prevent the enlargement of such tumors. It was known that recurrence of tumor was unavoidable if the tumor could not be removed with Simpson's grade I. However, when the tumor, surgically treated with Simpson's grade II to IV, enlarged following the treatment, if removal of the tumor was performed as soon as possible, performance status of the patient sustained in good condition. The cause of death was not cerebral herniation but gradual deterioration of general condition caused by radiation necrosis following conventional radiotherapy, radical surgical treatment and deterioration of performance status by enlargement of the recurred tumor. We would like to propose as follows: 1. Surgery should be performed with Simpson's grade I , if possible. 2. Tumor progression must be found out by - study in symptom free period. 3. Cyto-reduction surgery should be performed to preserve the performance status. 4. Stereotaxic radiosurgery may be a suitable choice as a radiation therapy, instead of conventional radiotherapy.
