206 Spinal Meningioma: An Institutional Case Series With Preliminary Results of Molecular Profiling

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INTRODUCTION: Spinal meningiomas have historically been considered similar entities to intracranial meningiomas, but recent developments in molecular profiling have identified unique features. METHODS: Retrospective study of patients undergoing resection of spinal meningioma between 2010–2022 at our institution. Patient, radiographic, and clinical characteristics were reviewed and analyzed with standard statistical methods. Molecular profiling was conducted on three tumors. RESULTS: A total of 33 tumors were resected in 26 patients. Median follow-up was 39.5 (0–149) months. Twenty-five (89.3%) procedures were in female patients. The median age at surgery was 62 (18–84) years. The median tumor was 1.9 (0.9–9) cm. Six tumors (18.2%) were in the cervical region, 28 (48.5%) were thoracic, and 2 (6.1%) were lumbar. Sixteen (48.5%) tumors were located dorsally, 11 (33.3%) ventrally, and six (18.2%) extended dorsoventrally. Gross total resection was achieved in 25 (75.8%) tumors. Median progression-free survival was 139 months. On histological analysis of 28 tumors, 26 (92.9%) were WHO grade 1 and 2 (7.1%) were WHO Grade 3 with a median Ki-67 of 3 (1–20)%. Fourteen (50.0%) tumors were psammomatous, seven (25%) were meningothelial, two (7.1%) were anaplastic, and one was transitional. Molecular profiling was available for three tumors. All three were negative for TERT promoter mutations and exhibited loss of chromosome 22. Chromosomal microarray analysis also detected gains in chromosomes 3p, 9, 11, 12, and 20 and loss of chromosomes 16 and 19 in Tumor 1. Tumor 3 also showed loss of chromosomes 12p and X, with copy-neutral loss of heterozygosity affecting chromosomes 5q, 7q, and 14q. CONCLUSIONS: Preliminary molecular profiling studies of spinal meningiomas show features distinct from intracranial meningiomas, so there is a need for their further molecular characterization.

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