referensi meningioma
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A role for the p53 pathway in the pathology of meningiomas withNF2lossZeNan Chang
Introduction
Arising from the arachnoid coverings of the brain and spinal cord, meningiomas account for1520% of primary neoplasms of the central nervous system, and have an estimated annual
incidence of about 6 per 100,000 individuals [1].
Meningiomas have long been known to exhibit receptors to sexual steroids [44], suggesting
that hormonal influences may explain the sexually dimorphic characteristics of this disease.
However, discrepancies on the proliferative effects of sexual hormones on meningiomas and
failure of variations in sexual receptor expression to explain the increased prevalence of
meningiomas in women suggests that more complex factors are at play [45].
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Sukri Rahman
Meningioma merupakan tumor jinak yang biasanya ditemukan pada meningen otak dan medula spinalis, sangat
jarang ditemukan di ekstrakranial.
Meningioma adalah tumor jinak, dengan pertumbuhan tumor yang lambat dan biasanya terjadi di daerah
intrakranial.1,3,5
Menurut Longstreth Jr dkk2 angka kejadian meningioma 6 per 1000 populasi atau sekitar 13-26% dari keseluruhan
tumor intrakranial. Meningioma yang terjadi di ekstrakranial merupakan kasus yang sangat jarang, diperkirakan
antara 1-2% dari keseluruhan kejadian meningioma.
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Meningiomas: causes and risk factorsJILL S. BARNHOLTZ-SLOAN, PH.D.,1 AND CAROL KRUCHKO, B.A.2
MENINGIOMAS account for 30% of all primary brain
tumor diagnoses in adults in the United States.9
The overall age-adjusted incidence rate is 4.52 per
100,000.9 Although age-adjusted incidence rates are reportedly
similar across racial groups, the incidence in women is
approximately twice that in men (Table 1).9 The incidence
increases with increasing age, peaking in the seventh and
eighth decades of life; these tumors are very rare in children(Fig. 1).9 It is currently estimated that 83% of all meningiomas
are microscopically confirmed.36 The incidence
of both diagnostically and nondiagnostically confirmed
meningiomas increased between 1985 and 1999;36 on average
the incidence of nondiagnostically confirmed meningiomasincreased significantly at 4.1% per year (95% CI
2.55.6) potentially reflecting both the increased use of
improved imaging techniques such as MR imaging and increasednumbers of meningiomas treated with observation
or primary radiotherapy rather than through surgical intervention.
The vast majority of meningiomas are considered histologically
benign (92.8%); only 2.2% are defined as uncertain
or atypical, and 5% as malignant.9 Five-year survival
rates are high for this tumor type (reported to be anywherefrom 70 to 95%)60,77,94 and therefore the estimated population
prevalence (number of individuals living with this
tumor) is relatively high, 50.4 per 100,000.15 Long survival
times coupled with potentially significant neurocognitive
and physical deficits could lead to significant medical costs
over time. The estimated average years of potential life lost in persons with meningiomas is 13 years,providing further
evidence of the long-term burden of this disease.110
In addition to increasing age, the most consistent factorassociated with risk of meningioma is exposure to ionizing
radiation; many other environmental, lifestyle and genetic
risk factors have been studied with inconclusive results.12Some of the factors that have been studied are endogenous
and exogenous hormone use,11,13,33,41,49,51,97,113 cell phone use,10,28,
30,31,40,42,46,55,65,100 and genetic variants or polymorphisms.
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DIAGNOSIS AND TREATMENT OF ATYPICAL ANDANAPLASTIC MENINGIOMAS: A REVIEWAshok Modha, M.D.
Between 13 and 26% of all intracranial
tumors are meningiomas (9, 12, 24, 29, 48).Meningiomas occur mostly in middle-aged
or elderly patients, but they can also occurin younger patients with dysgenetic syndromessuch as neurofibromatosis Type 2
(NF2). The annual incidence rate is approximately6 per 100,000 (19) but some tumorsare only discovered during autopsy. Often,
they are diagnosed incidentally on brain imagingfor unrelated complaints. A minorityof these tumors demonstrate histopathologicaland clinical features suggesting an aggressive
potential. These are the atypicaland anaplastic meningiomas. The formerconstitute between 4.7 and 7.2% of meningiomas,
whereas the latter account for 1.0 to2.8% (9, 12, 24, 48). Some series have shownthat up to 2% of all benign meningiomastransform into malignant forms (2, 51),whereas up to 28.5% of all recurrent benign
meningiomas will be found to be atypical oranaplastic (2, 18, 19). Hug et al. (17) reportedthat the annual incidence of these tumors inthe United States is approximately 150 to
225. There is a wide range in the prevalence
data for these malignant forms because variable
pathological criteria exist for their classification.Benign meningiomas are more
prevalent in women, but atypical and anaplasticforms seem to be more common in men (29). The atypicaland anaplastic forms are also more
common in the cerebral convexities (29).Atypical meningiomas have been reported to occur aftercranial irradiation for other tumors or conditions. These are
usually found in younger patients (3). This complicationwasfirst reported in 1953, in a child receiving radiation therapyfor
an optic glioma (17). Subsequently, children undergoingcranialradiation for medulloblastomas, astrocytomas, leukemia,
and lymphoma have all been reported to developmeningiomas(17). These tumors have also been noted in patients whoreceived low doses of irradiation fortinea capitis or afterexperimental
radiation treatments during World War II (17).Dental x-rays have also been implicated (17). Often,multiplemeningiomas are found in patients with these risk factors
(3).
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Risk of meningioma amongusers of high doses of cyproterone acetate as comparedwith the general population: evidence from a population-based cohortstudyMiguel Gil,1
Meningiomas are mostly benign, slow growing tumoursoriginating from the arachnoid cap cells. Meningiomas
have an annual incidence ranging from 3 to 8 per 100 000person-years in the different series, occur more frequentlyin women and its incidence increases with age [1, 2].