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Int J Clin Exp Pathol 2013;6(3):358-374

Original Article
Secretory meningiomas: clinical, radiological and pathological find-ings in 70
consecutive cases at one institution

Dai-Jun Wang, Qing Xie, Ye Gong, Yin Wang, Hai-Xia Cheng, Ying Mao, Ping Zhong, Feng-Ping Huang, Kang Zheng, Yong-Fei Wang, Wei-Min
Bao, Bo-Jie Yang, Hong Chen, Li-Qian Xie, Ming-Zhe Zheng, Hai-Liang Tang, Hong-Da Zhu, Xian-Cheng Chen, Liang-Fu Zhou

Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, China; Department of Neu-
ropathology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, China

Received November 28, 2012; Accepted January 17, 2013; Epub February 15, 2013; Published March 1, 2013

Abstract: Secretory meningioma (SM) is a rare, benign subtype of meningioma. Between January 2005 and December 2010, 70 SMs were
operated on at the Department of Neurosurgery, Huashan Hospital, Fudan University. We retrospectively analyzed the clinical data, radiological
and immunohistochemical findings, and patient outcome to discuss the specific features of SMs. Cranial base preference, hyper-signal in T2
weighted MR image, “xenon light” gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA) enhancement were frequently observed in the 70
cases. Non-skull base SMs, which received more complete resection (p<0.01) and had better short-term and long-term outcome, were
observed with more severe peritumoral brain edema (PTBE) (p<0.001). In follow-up, only 1 cranial base SM case showed tumor progression. 3
cases died after operation, all with cranial base SMs. As for the 10 cases given Simpson grade 3 or 4 resection who were available at follow-
up, 3 died, 5 received gamma-knife therapy, and the other 2 cases received no treatment at all. Only one of the 2 residual SMs without
postoperative radiation presented minor progression at a median of 48 months follow-up. In conclusion, cranial base preference, hyper-signal
T2 weighted MR image and “xenon light” GD-DTPA enhancement are specific for SMs. Prognosis of SMs is related with operation
completeness and surgical risks, rather than the extent of PTBE. Residual SM grows slowly and reacts well to gamma-knife therapy.
(IJCEP1211040).

Keywords: Location, prognosis, radiology, secretory meningiomas

Address correspondence to: Dr. Gong Ye, Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, No.
12 Middle Wulumuqi Road, Shanghai 200040, China. Tel: (+86) 021-52888682; Fax: (+86) 021-62490665; E-mail: meningioma@yahoo.cn