Meningiomas with Rhabdoid or Papillary Components : Prognosis and Comparison with Anaplastic Meningiomas

Abstract

Papillary and rhabdoid meningiomas are pathologically World Health Organization (WHO) grade III. Any correlation between clinical prognosis and pathologic component is not clear. We analyzed the prognoses of patients with meningiomas with a rhabdoid or papillary component compared to those of patients with anaplastic meningiomas. From 1994 to June 2013, 14 anaplastic meningiomas, 6 meningiomas with a rhabdoid component, and 5 meningiomas with papillary component were pathologically diagnosed. We analyzed magnetic resonance imaging (MRI) findings, extent of removal, adjuvant treatment, progression-free survival (PFS), overall survival (OS), and pathologic features of 14 anaplastic meningiomas (group A), 5 meningiomas with a predominant (≥50%) papillary or rhabdoid component (group B1), and 6 meningiomas without a predominant (<50%) rhabdoid or papillary component (group B2). Homogeneous enhancement on MRI was associated with improved PFS compared to heterogeneous enhancement (p=0.025). Depending on pathology, the mean PFS was 134.9±31.6 months for group A, 46.6±13.4 months for group B1, and 118.7±19.2 months for group B2. The mean OS was 138.5±24.6 months for group A and 59.7±16.8 months for group B1. All recurrent tumors were of the previously diagnosed pathology, except for one tumor from group B1, which recurred as an atypical meningioma without a papillary component. Group B1 tumors showed a more aggressive behavior than group B2 tumors. In group B2 cases, the pathologic findings of non-rhabdoid/papillary portion could be considered for further adjuvant treatment.

Keywords: Anaplastic; Meningioma; Papillary; Prognosis; Rhabdoid.

Fig. 1. Variables predicting progression-free survival and overall survival. A : Homogenous enhancement was associated with better PFS (172.3±26.8 months) than heterogeneous enhancement (48.4±10.3 months; p=0.025). B : The mean PFS was 134.9±31.6 months for patients with group A anaplastic meningioma, 46.6±13.4 months for those who had group B1 meningiomas with ≥50% papillary or rhabdoid components (group B1), and 118.7±19.2 months for those who had group B2 meningiomas with <50% rhabdoid or papillary components (p=0.514). C : The mean OS was 138.5±24.6 months for patients with group A anaplastic meningiomas and 59.7±16.8 months for those with group B1 meningiomas having ≥50% papillary or rhabdoid components. There was the different OS (p=0.05 for group B1 ≥50% papillary or rhabdoid components compared to group B2 <50% rhabdoid or papillary components). PFS : progression-free survival, OS : overall survival.