ĐẶC ĐIỂM LÂM SÀNG, HÌNH ẢNH HỌC VÀ KẾT QUẢ PHẪU THUẬT U MÀNG NÃO ĐỘ II, III TẠI BỆNH VIỆN ĐA KHOA TRUNG ƯƠNG CẦN THƠ NĂM 2024–2026

Abstract

Background: WHO grade II and III meningiomas are central nervous system neoplasms characterized by rapid progression, invasiveness, and high recurrence rates. Radical surgical resection is pivotal for disease control. Objectives: To describe clinical, imaging characteristics, and surgical outcomes of WHO grade II and III meningiomas at Can Tho Central General Hospital (2024–2026). Materials and Methods: A prospective longitudinal study was conducted on 30 consecutive patients postoperatively diagnosed with WHO grade II and III meningiomas via histopathology (WHO 2016) at Can Tho Central General Hospital between 2024 and 2026. Results: The mean patient age was 58.2 ± 11.8 years, with 53.3% aged > 60 years and a female predominance of 73.3%. The most frequent presenting symptoms upon admission were headache (70.0%) and seizures (26.7%), while 23.3% were incidentally detected. On neuroimaging, 86.7% of tumors were located at the cranial convexity, 53.3% exhibited heterogeneous contrast enhancement, 56.7% had irregular margins, 90.0% demonstrated extensive peritumoral brain edema, 83.3% had dural tail sign, and 26.7% had bone invasion. The extent of surgical resection achieved Simpson grade I in 56.7% and Simpson grade II in 43.3% of cases. At the 3-month postoperative followup, 100.0% of patients were alive with no tumor progression or residue detected on follow-up magnetic resonace imaging, and 73.3% achieved favorable neurological recovery (KPS ≥ 80). A convexity tumor location was significantly associated with achieving Simpson I total resection (p = 0.024). Conclusion: Maximal microsurgical resection is an effective treatment modality for WHO grade II and III meningiomas, facilitating favorable functional recovery. A cranial convexity location serves as a statistically significant favorable factor for achieving Simpson grade I complete resection.