• Benedito Jamilson Araújo Pereira, Nogueira de Almeida Antônio A Departamento de Neurologia, Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brasil; Divisão de Neurocirurgia Funcional IPQ, H, Pires de Aguiar Paulo Henrique PH Departamento de Neurologia, Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brasil., Wellingson Silva Paiva, Manoel Jacobsen Teixeira, and Nagahashi Marie Suely Kazue SK Departamento de Neurologia, Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brasil..
• Departamento de Neurologia, Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brasil. Electronic address: benedito.jamilson@hotmail.com.
• World Neurosurg. 2019 Feb 1; 122: e1536-e1541.

ObjectiveTo review the published data to create a more comprehensive natural history of multiple meningiomas (MM).MethodsA review of MM published until now was carried out through a Medline search up to August 2018. The use of the "multiple meningiomas" keyword returned 278 articles, and the characteristics analyzed in our present cohort were searched on those publications. Articles without detailed description of clinical findings, neuroimaging confirmation of tumor multiplicity, follow-up at least of 5 years, and clear description of clinical findings were excluded. We added series to this review.Results293 patients with MM were analyzed: 220 women and 73 men, with a total of 932 tumors (3.1 tumors per patient). The majority of tumors were located in the convexity (653% to 74.5%). The total number of tumors treated was 429 (43.9%): 338 (78.8%) by surgical resection and 91 (21.2%) by radiotherapy. Histopathologic description was available in 303 of 429 cases, being grade I in 272 (90.3%) cases, with a predominance of the meningothelial subtype (30.7%). Tumor recurrence was described in 32 (8.07%) among 397 and only 10 deaths (3.4%) of 281 reported cases, where this characteristic was evaluated.ConclusionsWorld Health Organization grade I predominance was observed among multiple meningiomas in similarity to single meningiomas. Only a fraction of MM patients (43.89%) needed treatment. A benign tumor behavior was corroborated by the observed low frequency of recurrence and mortality.Copyright © 2018 Elsevier Inc. All rights reserved.

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