Epidemiologic Data on Meningiomas in Jamaica: The First from the Caribbean

摘要

There is to date no data from the Caribbean regarding the occurrence of meningiomas. This ten year retrospective study examines the epidemiological features of meningiomas at the University Hospital of the West Indies, Jamaica. All meningiomas which were resected at this institution during the study period as well as those discovered at autopsy were included. There were a total of 67 meningiomas. 90% were surgically resected and of these 12% were spinal in location and 88% were intracranial with a male: female ratio of 1:7 and 1:2.8 respectively. Of the intracranial meningiomas, 89% were within the supratentorial compartment. Six percent of the total was malignant (WHO Grade III). Of the 7 documented recurrences, 2 were malignant, 2 were incompletely resected and 1 showed brain invasion histologically. This study is the first to reveal the epidemiological pattern of meningiomas in Kingston, Jamaica and also highlights some important aspects of those which recur. Introduction Meningiomas are neoplasms arising from meningothelial cells which occur in greatest abundance in the arachnoid villi but are also encountered as small clusters throughout the craniospinal space. They have probably affected humans since prehistoric times. The term meningioma was popularized by Harvey Cushing in the early 1900's (1). The majority of these tumors are benign and slow growing and it is thought that most meningiomas have been present for a decade or more at the time of diagnosis. They may present with a variety of symptoms and signs depending on their size and location.Numerous articles have been written over the years from all over the world on various aspects of these lesions; however, information from the Caribbean has been sparse. The present study, the first of its kind in regards to meningiomas, was therefore designed to examine the epidemiological profile of surgically resected and autopsy detected meningiomas at the University Hospital of the West Indies (UHWI), Kingston, Jamaica over a ten year period, 1994 to 2003. A comparative review of these figures with international data is presented along with a brief general review of the epidemiology, biology and classification of this tumor. Materials and Methods The University Hospital of the West Indies (UHWI) is a tertiary care teaching hospital located in Kingston, the capital of the island of Jamaica in the West Indies. All meningiomas entered in the files of the Pathology Department at the UHWI between January 1994 and December 2003 was reviewed. The material was derived from surgically resected specimens done at the UHWI as well as from autopsies performed at this institution within that period. Post mortem cases in which the diagnosis had already been established by histopathology were excluded, as were all cases not derived from the Neurosurgical Unit of the UHWI. As the specimens received from other hospitals have not been included, the results therefore do not necessarily reflect the occurrence of meningiomas in the island as a whole. Classification of all the meningiomas was done according to the standard World Health Organization (WHO) method, 1993. Results During the study period, a total of 67 meningiomas were identified. Of these, 60 (90%) were sent to the Department as surgical resection specimens and 7(10%) were entered into the records as autopsy specimens (Table 1).