The investigation of incidental meningiomas also sheds light on the management of larger tumors. A retrospective analysis of 150 patients with incidental large and giant anterior skull base meningiomas found no significant differences in surgical complications or functional outcomes between the two groups, suggesting that size alone may not dictate surgical approach (ref: Li doi.org/10.1007/s11060-020-03484-x/). This finding aligns with the need for individualized treatment strategies based on comprehensive molecular profiling rather than solely on tumor size. Overall, these studies underscore the critical role of molecular and genetic profiling in enhancing diagnostic accuracy and tailoring therapeutic interventions for meningioma patients.

Moreover, advancements in imaging techniques have improved preoperative diagnosis, particularly for temporal bone meningiomas. Radiologic signs such as "hairy" trabecular hyperostosis and the dural tail sign have been emphasized as critical indicators for accurate diagnosis (ref: Zeleník doi.org/10.1007/s00405-020-06110-8/). The introduction of a novel histopathological classification based on dural invasion further aids in understanding tumor behavior and potential aggressiveness (ref: Murase doi.org/10.1136/jclinpath-2020-206592/). These findings collectively highlight the importance of integrating surgical techniques with advanced imaging and histopathological insights to enhance patient outcomes in meningioma management.

Furthermore, the exploration of novel therapeutic agents, such as quercetin, has shown promise in inducing apoptosis in meningioma cells through specific molecular pathways, indicating potential for targeted therapies (ref: Hu doi.org/10.1016/j.etap.2020.103439/). The landscape of immune cell gene expression in meningiomas also presents a unique opportunity for understanding tumor-immune interactions, particularly in differentiating skull base meningiomas from convexity tumors (ref: Zador doi.org/10.1038/s41598-020-65365-7/). Collectively, these studies highlight the evolving landscape of predictive factors and biomarkers in meningiomas, paving the way for personalized treatment strategies.

Additionally, a systematic review and meta-analysis investigating apparent diffusion coefficient (ADC) values in meningiomas revealed only a moderate inverse correlation between ADC values and tumor cellularity, suggesting that ADC may not be a reliable predictor of tumor aggressiveness (ref: Meyer doi.org/10.1016/j.jns.2020.116975/). The exploration of total DNA methylation as a biomarker of tumor malignancy further emphasizes the need for comprehensive diagnostic approaches that integrate molecular data with traditional imaging techniques (ref: Barciszewska doi.org/10.1186/s12885-020-06982-3/). These advancements in imaging and diagnostic methodologies are essential for improving the accuracy of meningioma diagnoses and guiding therapeutic decisions.

Contrarily, a study examining the immunohistochemical expression of SPARC found no correlation with invasion across different grades of meningiomas, suggesting that traditional markers may not always predict tumor behavior effectively (ref: Rooprai doi.org/10.21873/anticanres.14289/). Furthermore, proteomic analyses have identified sex-based differences in grade I meningiomas, indicating that biological variations may influence tumor characteristics and responses to treatment (ref: Silva doi.org/10.1038/s41598-020-67113-3/). These findings collectively underscore the complexity of meningioma histopathology and the need for ongoing research to refine classification and prognostic models.

Moreover, the surgical treatment of temporal bone meningiomas has been enhanced by recognizing key radiologic signs that improve preoperative diagnosis, which is crucial for successful outcomes (ref: Zeleník doi.org/10.1007/s00405-020-06110-8/). The introduction of techniques such as tentorial peeling during transpetrosal approaches aims to protect critical structures like the temporal lobe, thereby reducing the risk of complications (ref: Vidal doi.org/10.1093/ons/). These advancements in clinical management highlight the ongoing efforts to optimize surgical techniques and improve patient outcomes in meningioma treatment.

Additionally, the differentiation of suprasellar meningiomas from non-functioning pituitary macroadenomas based on metabolic characteristics underscores the importance of understanding tumor biology in clinical decision-making (ref: Ding doi.org/10.1186/s12885-020-06852-y/). Furthermore, the exploration of therapeutic agents such as quercetin, which induces apoptosis in meningioma cells through specific molecular pathways, presents new avenues for targeted therapy (ref: Hu doi.org/10.1016/j.etap.2020.103439/). Collectively, these studies emphasize the significance of integrating tumor biology and immune response into the clinical management of meningiomas, paving the way for personalized treatment approaches.