BACKGROUND Primary intraosseous meningiomas (PIM) of calvarial origin are a small subset of meningiomas that arise from and occur within the calvarial bone. Its definition is often confused with other forms of non-dural based intracranial meningiomas, which has made previously published retrospective reviews heterogenous, non-specific and sometimes inaccurate. We present a systematic review of calvarial PIM. METHODS Using a systematic search protocol that included databases such as PubMed, Web of Science and Embase, we extracted all human studies on PIM published from inception to December 2017. This systematic review includes case reports and retrospective reviews that specifically described PIM. RESULTS On review of 166 articles identified with the systematic search protocol, 69 articles were analyzed. These comprised of 64 case reports, 1 case series and 4 retrospective reviews. 111 patients with PIM of calvarial origin were analyzed, 58 % of which were females and 42 % males. The mean patient age was 51 years and the frontal bone was the most common tumor location, occurring in 26.1 % of the cases. Surgical resection was the predominant modality of treatment in 97.2 % of the cases, and gross total resection was achieved in 84 % of cases that reported extent of resection. There were no recurrences for grade I meningiomas. However, all grade III meningiomas recurred and 33.3 % of grade II meningiomas showed recurrence with a mean postoperative follow-up interval of 20 months. Statistical analysis using Fisher's exact test showed the recurrence rate to be strongly associated with WHO tumor grade (p-value <0.001). CONCLUSION There is statistically significant increased recurrence rate for calvarial PIM of higher grades, and we recommend close follow-up in those cases. Surgical resection remains the overwhelming treatment of choice for calvarial PIM, and it has a high gross total resection rate and low risk of complications and mortality.

中文翻译：

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颅骨原发性骨内脑膜瘤：系统评价

背景 颅骨起源的原发性骨内脑膜瘤 (PIM) 是起源于颅骨并发生在颅骨内的脑膜瘤的一小部分。它的定义经常与其他形式的非硬脑膜颅内脑膜瘤相混淆，这使得以前发表的回顾性评论异质性、非特异性，有时不准确。我们提出了颅骨 PIM 的系统评价。方法 使用包括 PubMed、Web of Science 和 Embase 等数据库的系统搜索协议，我们提取了从开始到 2017 年 12 月发表的所有关于 PIM 的人类研究。该系统评价包括病例报告和专门描述 PIM 的回顾性评价。结果 对系统检索协议确定的 166 篇文章进行审查，分析了 69 篇文章。这些包括 64 个病例报告，1 个病例系列和 4 个回顾性评论。分析了 111 名颅骨起源的 PIM 患者，其中 58% 为女性，42% 为男性。患者的平均年龄为 51 岁，额骨是最常见的肿瘤位置，发生率为 26.1%。手术切除是 97.2% 病例的主要治疗方式，在报告切除范围的病例中，84% 的病例实现了大体完全切除。I级脑膜瘤没有复发。然而，所有 III 级脑膜瘤都会复发，33.3% 的 II 级脑膜瘤复发，平均术后随访时间为 20 个月。使用 Fisher 精确检验的统计分析表明，复发率与 WHO 肿瘤分级密切相关（p 值 <0.001）。结论 较高级别的颅骨 PIM 的复发率具有统计学意义的显着增加，我们建议对这些病例进行密切随访。手术切除仍然是颅骨 PIM 的首选治疗方法，其总切除率高，并发症和死亡风险低。