ArticleActa neuropathologica communications2025
Integrated molecular and detailed anatomical profiling identifies a prognostically adverse subtype of posterior fossa meningiomas: high-risk copy number alterations are associated with midline predilection and predict poor prognosis.
Article in Acta neuropathologica communications, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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7 citing papers in PubMed.
- Modeling meningioma in vitro in the omics era.Human cell · 2026Review
- Comparative molecular profiles of distinct tumor components in recurrent tentorial meningioma after stereotactic radiosurgery: a case report implicating acquired aggressive alterations associated with WHO grade progression.Brain tumor pathology · 2026Article
- Optic nerve sheath meningioma exhibits neural niche-associated transcriptomic features and rare copy number variation-linked evolution.Brain pathology (Zurich, Switzerland) · 2026Article
- TANC1::HTRA1 and KPNA4::WWTR1 fusions in non-vestibular intracranial schwannomas.Acta neuropathologica · 2026Article
- Targeted and Personalized Therapy for Difficult Benign Brain Tumors: A Review.Journal of personalized medicine · 2026Review
- Molecular insights into prognostic model for meningiomas treated with stereotactic radiosurgery: negative impacts of 1q gain on tumor control and survival.Acta neuropathologica communications · 2025Article
- Two molecular subtypes of skull base meningiomas with extracranial extension.Acta neuropathologica communications · 2025Article
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Abstract
Anatomical localization of meningiomas has been increasingly linked to their genetic alterations. However, studies focusing specifically on the genomic landscape and clinical implications of posterior fossa meningiomas remain limited. In this study, we investigated the genetic, anatomical, and clinical characteristics of posterior fossa meningiomas, aiming to clarify the association between genetic alterations, precise tumor localization, and prognosis. Whole-exome sequencing was performed on 132 consecutive tumors to identify driver mutations and copy number alterations (CNAs). Tumor localization was carefully assessed based on dural attachment, arterial supply, and intraoperative findings. Based on driver mutations and CNAs, tumors were classified into three molecular groups: Group A (no Merlin pathway alterations, n = 71 (54%)), Group B (NF2 mutation/22q loss without high-risk CNAs, n = 45 (34%)), and Group C (high-risk CNAs, n = 16 (12%)). Notably, Group C showed a strong anatomical predilection, with 81% arising from midline structures, including the medial incisura and clivus. Group C tumors were significantly associated with poor progression-free survival following gross total resection (P = 0.023), and this remained significant even when the analysis was anatomically restricted to tumors located in the medial incisura and clivus (P = 0.0003). In multivariable analysis, Group C (P = 0.020, HR 6.60) and preoperative tumor volume > 10 cc (P = 0.044, HR 9.41) independently predicted poor prognosis. Overall, the results demonstrated that approximately 10% of posterior fossa meningiomas harbored high-risk CNAs, predominantly in midline locations, and were associated with worse clinical outcomes. CNA profiling in addition to the identification of driver mutations may provide a valuable tool for risk stratification and decision-making regarding adjuvant therapy in posterior fossa meningiomas.
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