A recurrent meningothelial meningioma within a fascial dural graft with increased proliferative activity.
4 affiliations
- 1Department of Neurosurgery, Shizuoka Welfare Hospital, Shizuoka, Japan.
- 2Department of Neurosurgery, Teikyo University Mizonokuchi Hospital, Kawasaki, Japan.
- 3Department of Diagnostic Pathology, Teikyo University Mizonokuchi Hospital, Kawasaki, Japan.
- 4Department of Neurosurgery, Kasugai General Rehabilitation Hospital, Fuefuki, Japan.
Abstract
Background
The standard surgical treatment for meningiomas is gross total resection of the tumor with the involved dura mater, followed by dural reconstruction using either an artificial dural substitute or autologous fascia. Nevertheless, recurrence may occur even after gross total resection, most commonly owing to microscopic residual tumor cells at the dural margins or within the adjacent bone. Conversely, recurrence within the reconstructed dura itself is exceedingly rare.Case description
A 63-year-old man visited our hospital because of progressive disorientation. Magnetic resonance imaging (MRI) revealed a cyst-associated extra-axial tumor in the right temporal region accompanied by extensive cerebral edema. Gross total resection was achieved, and the dura was reconstructed using Gore-Tex. Histopathological examination revealed a meningothelial meningioma with a low proliferative index (Ki-67 labeling index, 2%). One month postoperatively, a surgical site infection necessitated removal of the dural substitute and bone flap, followed by duraplasty using autologous fascia lata. Twenty months after the initial surgery, MRI demonstrated tumor recurrence arising within the fascia lata graft. The recurrent tumor and fascial graft were resected en bloc in the second surgery. Histopathological analysis demonstrated tumor infiltration into the fascial graft and a markedly increased proliferative index (Ki-67 labeling index, 15%), indicating increased proliferative activity compared with the initial tumor.Conclusion
This case highlights the possibility of meningioma recurrence within an autologous fascial graft used for dural reconstruction, suggesting that the reconstructed dural graft may serve as a potential substrate for tumor growth. Careful long-term radiological surveillance should therefore be considered following meningioma resection.
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BibTeX
@article{yamada2026recurrent,
title = {{A recurrent meningothelial meningioma within a fascial dural graft with increased proliferative activity.}},
author = {Shoko Merrit Yamada and Yusuke Tomita and Naotaka Iwamoto and Tatsuya Aso and Mikiko Takahashi and Hiroshi Takahashi},
journal = {Surgical neurology international},
year = {2026},
month = oct,
doi = {10.25259/sni_822_2026},
url = {https://europepmc.org/article/MED/42974555},
note = {CC BY-NC-SA},
}
RIS
TY - JOUR
TI - A recurrent meningothelial meningioma within a fascial dural graft with increased proliferative activity.
AU - Shoko Merrit Yamada
AU - Yusuke Tomita
AU - Naotaka Iwamoto
AU - Tatsuya Aso
AU - Mikiko Takahashi
AU - Hiroshi Takahashi
PY - 2026
DA - 2026/10/23
JO - Surgical neurology international
DO - 10.25259/sni_822_2026
UR - https://europepmc.org/article/MED/42974555
AB - Background The standard surgical treatment for meningiomas is gross total resection of the tumor with the involved dura mater, followed by dural reconstruction using either an artificial dural substitute or autologous fascia. Nevertheless, recurrence may occur even after gross total resection, most commonly owing to microscopic residual tumor cells at the dural margins or within the adjacent bone. Conversely, recurrence within the reconstructed dura itself is exceedingly rare.Case description A 63-year-old man visited our hospital because of progressive disorientation. Magnetic resonance imaging (MRI) revealed a cyst-associated extra-axial tumor in the right temporal region accompanied by extensive cerebral edema. Gross total resection was achieved, and the dura was reconstructed using Gore-Tex. Histopathological examination revealed a meningothelial meningioma with a low proliferative index (Ki-67 labeling index, 2%). One month postoperatively, a surgical site infection necessitated removal of the dural substitute and bone flap, followed by duraplasty using autologous fascia lata. Twenty months after the initial surgery, MRI demonstrated tumor recurrence arising within the fascia lata graft. The recurrent tumor and fascial graft were resected en bloc in the second surgery. Histopathological analysis demonstrated tumor infiltration into the fascial graft and a markedly increased proliferative index (Ki-67 labeling index, 15%), indicating increased proliferative activity compared with the initial tumor.Conclusion This case highlights the possibility of meningioma recurrence within an autologous fascial graft used for dural reconstruction, suggesting that the reconstructed dural graft may serve as a potential substrate for tumor growth. Careful long-term radiological surveillance should therefore be considered following meningioma resection.
SN - 2229-5097
SN - 2152-7806
ER -