Aim. To evaluate the frequency of atypical and malignant meningiomas and analyze recurrence rate; to study the morbidity and mortality of these tumors compared to benign meningiomas. Methods. During 1992–2007, 16 patients with malignant and 16 patients with atypical meningioma were operated in Neurosurgery Department of Thessaloniki's Papanikolaou Hospital. We analyzed tumor histology, location, and extent of surgical resection with respect to tumor reappearance and patients' outcome and compared the behavior of benign versus nonbenign meningiomas. Results. Malignant meningiomas accounted for 4.4% (16 patients) and atypical meningiomas for another 4.4% of the series of patients (353) who were operated for intracranial meningioma at our department that period. Malignant meningiomas recurred at a rate of 75% and atypical meningiomas recurred at a rate of 41.6%. There was a significant association of the histological classification (benign, atypical, and malignant) with recurrence ( ). The recurrence rate after complete resection was 13.8%. The recurrence rate for incomplete resection was 46.7%. Extent of tumor removal was significant to recurrence ( ) for benign as well for atypical and malignant meningiomas. Tumor location ( ) was not significant to recurrence. Conclusions. Atypical and malignant meningiomas appeared at a rate of 8.8% of our series of intracranial meningiomas. They showed a significant predisposition to recur. These rare subtypes have higher morbidity and mortality rates than benign meningiomas. Recurrence depends primarily on the extent of surgical removal and on the histological characterization of the tumor as atypical or malignant. 1. Introduction A small percentage of intracranial meningiomas appear to have a malignant potential [1–3]. These rare histological subtypes characterized as malignant (grade III) and atypical (grade II) exhibit aggressive clinical behavior and are less studied than the classic benign (grade I) tumors [2, 4]. Objective of this study was to evaluate the incidence of atypical and malignant meningiomas and estimate their effect on recurrence, morbidity, and mortality. The postoperative behavior of the meningioma was followed and an effort was made to assess whether tumor’s location, histopathological subtype, and the extent of surgical resection were predictive factors for recurrence. 2. Clinical Material and Methods From 1992 to 2007, thirty-two patients with grade II or III meningioma, were treated surgically by the staff of the Neurosurgical department of Thessaloniki “G. Papanikolaou” Hospital. This study
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