Meningioma

From Dog
Immunostaining of a canine meningioma tissue
Canine cystic meningioma viewed by MRI
Surgical removal of a well-circumscribed intracranial meningioma

Meningioma is the most common primary brain tumor in dogs, followed by astrocytomas[1].

Meningioma are usually in older dogs (> 5 years), with a median age of 9 years. These tumors commonly affect long-nosed breeds and Golden Retrievers.

The tumor behaves differently to meningiomas in cats, which are usually more circumscribed and respond well to surgical excision.

An association between choroid plexus papilloma and meningioma has been reported[2].

Clinically affected dogs usually present with neurological disease that is insidious in onset, but often present acutely with ataxia, hemiparesis, laryngeal paralysis, myokymia[3] and seizures[4]. Severity of clinical symptoms depends on the growth rate and location of the meningioma, peritumoral edema, intracranial pressure, and compensatory mechanisms within the brain. Because meningiomas arise outside of the brain parenchyma, they cause a mass effect as they slowly compress normal brain tissue[5][6].

Other clinical signs in dogs include blindness and behavior changes[7].

Cystic meningioma, a pathologic variant of meningiomas, have been reported associated with the olfactory lobes and are usually the result of tumor necrosis, isolation of CSF, or fluid production by the tumor itself[8].

Although the cause of meningiomas is unknown, a high proportion of progesterone receptors has also been found in canine meningioma cells[9]. Lower progesterone expression has been shown to correlate with early recurrence and a high proliferation index[10].

Diagnosis is based on computed tomography (CT) or magnetic resonance imaging (MRI) findings. The diagnosis requires that the mass be extraaxial (i.e., outside of the brain parenchyma), either with a dural attachment or confined strictly within a ventricle[11][12].

Definitive diagnosis of meningioma requires tissue biopsy[13].

A differential diagnosis would include other brain tumors, especially gliomas.

Palliative therapy, usually corticosteroids, reduced CSF production and tumor-associated brain edema; this therapy may be required for the lifetime of the patient[14]. If the meningioma causes seizures, anticonvulsant therapy is also indicated[15].

Surgical removal is usually indicated in most cases, as growth is invariably continuous by the tumor[16]. Postcraniotomy radiation therapy can prolong survival significantly[17].

Recent advances in immunotherapy have shown promise with use of autologous tumor cell lysate combined with toll-like receptor ligands, resulting in strong antibody-secreting plasma cells into the brain around the tumor in post-treatment dogs[18].

References

  1. Dewey CW. (2003) Encephalopathies: disorders of the brain. In: Dewey CW, ed. A Practical Guide to Canine and Feline Neurology. Ames: Iowa State University Press; pp:127-136
  2. Espino L et al (2009) First report of the simultaneous occurrence of choroid plexus papilloma and meningioma in a dog. Acta Vet Hung 57(3):389-397
  3. Holland CT et al (2010) Unilateral facial myokymia in a dog with an intracranial meningioma. Aust Vet J 88(9):357-361
  4. McDermott MW, Quinones-Hinosa A, Fuller GN, et al (2002) Meningiomas. In: Levin VA, ed. Cancer in the Nervous System. Oxford, UK: University Press; pp:269-299
  5. Oakley RE, Patterson JS. (2003) Tumors of the central and peripheral nervous system. In: Slatter D, ed. Textbook of Small Animal Surgery. Philadelphia: Elsevier Science; p:2405-2425
  6. Snyder JM, Shofer FS, Van Winkle TJ, et al (2006) Canine intracranial primary neoplasia: 173 cases (1986-2003). J Vet Intern Med 12(3):669-675
  7. Axlund TW, McGlasson ML, Smith AN. (2002) Surgery alone or in combination with radiation therapy for treatment of intracranial meningiomas in dogs: 31 cases (1989-2002). JAVMA 221(11):1597-1600
  8. Kitagawa M, Kanayama K, Sakai T. (2002) Cystic meningioma in a dog. J Small Anim Pract 43(6):272-274
  9. Adamo PF, Cantile C, Steinberg H. (2003) Evaluation of progesterone and estrogen receptor expression in 15 meningiomas of dogs and cats. Am J Vet Res 64(10):1310-1318
  10. Mandara MT, Ricci G, Rinaldi L, et al (2002) Immunohistochemical identification and image analysis quantification of oestrogen and progesterone receptors in canine and feline meningioma. J Comp Pathol 127(3):214-218
  11. O'Brien DP, Axlund TW. (2005) Brain disease. In: Ettinger SJ, Feldman EC, eds. Textbook of Veterinary Internal Medicine. St. Louis: Elsevier; pp:830-833
  12. Halpin SF. (2000) Supratentorial tumours. In: Gillespie JE, Jackson A, eds. MRI and CT of the Brain. London: Arnold; pp:122-125
  13. Koblik PD, LeCouteur RA, Higgins RJ, et al (1994) CT-guided brain biopsy using a modified Pelorus mark III stereotactic system: experience with 50 dogs. Vet Radiol Ultrasound 40(4):434-440
  14. Adamo PF, Forrest LF, Dubielzig R. (2004) Canine and feline meningiomas: diagnosis, treatment and prognosis. Compend Contin Educ Pract Vet 27:951-966
  15. Adamo PF, Forrest LF, Dubielzig R. (2004) Canine and feline meningiomas: diagnosis, treatment and prognosis. Compend Contin Educ Pract Vet 27:951-966
  16. Bagley RS. (2005) Fundamentals of Veterinary Clinical Neurology. Ames, Iowa: Blackwell Publishing
  17. Bagley RS. (2004) Coma, stupor and behavioural change. In: Platt SR, Olby NJ, eds. BSAVA Manual of Canine and Feline Neurology. Gloucester, UK: BSAVA; pp:126-128
  18. Andersen BM et al (2013) Vaccination for Invasive Canine Meningioma Induces in Situ Production of Antibodies Capable of Antibody-Dependent Cell-Mediated Cytotoxicity. Cancer Res Mar 7