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Int J Clin Exp Pathol 2013;6(4):695-702

Original Article
Clinical characteristics and treatment of angiomatous meningiomas: a report of 27 cases

Zhiguo Liu, Chuanwei Wang, Hongwei Wang, Yunyan Wang, Jian Yi Li, Yuguang Liu

Department of Neurosurgery, Qilu Hospital of Shandong University, Brain Science Research Institute of Shandong University, Jinan, Shan-dong
Province, P.R. China; Department of Pathology and Laboratory Medicine, North Shore-Long Island Jewish Health System, Lake Success,
Hofstra North Shore-LIJ School of Medicine, NY, USA

Received February 3, 2013; Accepted February 25, 2013; Epub March 15, 2013; Published April 1, 2013

Abstract: Angiomatous meningioma (AM) is a rare histological variant of meningioma. Twenty seven patients (14 male and 13 female) with
angiomatous meningioma were treated in our institution. Their clinical presentation, neuroimaging studies, treatment and follow-up were
investigated. The age of patients ranged from 24 to 72 years with a mean of 51.8 years. The clinical presentation was non-specific and
de-pended on the location of the tumor and was mainly due to the mass effect. On computed tomography (CT) scanning, AMs showed slightly
hyperintensity. On magnetic resonance imaging (MRI), AMs demonstrated hypointensity on T1-weighted images (T1WI), hyperintensity on
T2-weighted images (T2WI), slight hypointensity on diffusion-weighted images (DWI), enhancement on postcontrast T1WI, peritumoral edema,
and rich signal voids of vessels in the tumor. On histology, all tumors exhibited abundant blood vessels with at least focal classic
meningothelial differentiation. Thirteen, eight, and six cases were achieved Simpson grade I, II and III-IV resection respectively. Nineteen cases
were followed for 8 to 125 months with a mean of 47.9 months. Four patients with residual tumor were treated with postoperative radiation
therapy and all of them had stable disease. One patient with Simpson grade II resection was not treated with radiation therapy and developed
recurrent tumor in 5 years. In conclusion, angiomatous meningiomas have relative high male to female ratio, more frequent peritumoral
edema, and rich blood vessels. Gross total resection is still the treatment of choice. These patients with residual tumor after surgery can
benefit from radiation therapy. Overall, the prognosis of AMs are as good as other benign meningiomas. (IJCEP1302003).

Keywords: Angiomatous meningioma, computed tomography (CT), magnetic resonance imaging (MRI), surgery, radiation therapy

Address correspondence to: Dr. Yuguang Liu, Department of Neurosurgery, Qilu Hospital of Shandong University, Brain Science Research
Institute of Shandong University, Jinan, Shandong Province, P.R. China. Tel: 86-13506402089; E-mail: NS3000@126.com or