Meningiomas, the most prevalent primary intracranial tumors, exhibit a complex biology that remains inadequately understood, particularly regarding their malignant progression. Recent studies have focused on identifying molecular mechanisms and potential therapeutic targets. For instance, a study employing single-cell transcriptome analysis across various meningioma samples revealed that secreted clusterin plays a crucial role in inhibiting tumorigenesis by modulating tumor cells and macrophages (ref: Ke doi.org/10.1093/neuonc/). Another study highlighted the role of RACK1 in promoting meningioma progression through the activation of the NF-κB pathway, emphasizing the need for targeted therapies for higher-grade meningiomas (ref: Maalim doi.org/10.3390/cancers16040767/). Furthermore, the increased expression of CD44 in higher-grade meningiomas was significantly associated with clinical features such as tumor volume and peritumoral brain edema, suggesting its potential as a biomarker for malignancy (ref: Sawaya doi.org/10.3171/2023.11.JNS231884/). Additionally, a gain-of-function mutation in AKT1 was shown to enhance hexokinase 2 levels and reduce oxidative stress, linking metabolic alterations to inflammatory responses in meningioma cells (ref: Singh doi.org/10.1016/j.cyto.2024.156535/). These findings collectively underscore the intricate interplay of genetic, molecular, and inflammatory factors in meningioma biology, paving the way for novel therapeutic strategies. The exploration of oncolytic virotherapy in canine models has also provided insights into potential treatments for human meningiomas. A Phase I/II trial involving an engineered Newcastle Disease Virus demonstrated promising immunological responses and anti-tumor effects in dogs with intracranial tumors, suggesting a translational avenue for future human applications (ref: Rossmeisl doi.org/10.3390/cancers16030564/). This research theme illustrates the ongoing efforts to elucidate the molecular underpinnings of meningioma malignancy and the potential for innovative therapeutic interventions.

The management of meningiomas, particularly those located in challenging anatomical regions, has been the focus of recent clinical studies aimed at improving surgical outcomes and patient prognosis. A single-center study on jugum sphenoidale meningiomas revealed that the fronto-lateral and pterional approaches were the predominant surgical techniques employed, with outcomes indicating the need for tailored surgical strategies based on tumor location (ref: Dokponou doi.org/10.1016/j.wneu.2024.02.008/). Another study compared the effectiveness of preoperative embolization using diluted N-butyl-2-cyanoacrylate, finding that embolization significantly reduced intraoperative blood loss in larger tumors, thus supporting its use in select cases (ref: Omura doi.org/10.1016/j.clineuro.2024.108178/). Additionally, a retrospective cohort study evaluated the comparative effectiveness of unilateral hemilaminectomy versus bilateral laminectomy for spinal meningiomas, highlighting the less invasive approach's potential to achieve similar outcomes with reduced morbidity (ref: Said doi.org/10.1227/ons.0000000000001099/). These findings reflect a growing emphasis on optimizing surgical techniques and preoperative strategies to enhance patient outcomes in meningioma treatment. The integration of advanced surgical approaches and careful patient selection is crucial in addressing the challenges posed by meningiomas, particularly in complex cases. The ongoing evaluation of these strategies will contribute to the development of evidence-based guidelines for the management of meningiomas, ultimately aiming to improve survival rates and quality of life for affected patients.

Accurate imaging and diagnostic methodologies are critical for the effective management of brain tumors, including meningiomas. Recent advancements have introduced novel techniques to enhance tumor classification and diagnosis. A study proposed an innovative approach that integrates Gray-Level Co-Occurrence Matrix (GLCM) and Local Binary Pattern (LBP) features for quantitative analysis of tumor images, significantly improving classification accuracy for gliomas, meningiomas, and pituitary tumors (ref: Dheepak doi.org/10.3389/fonc.2023.1248452/). Additionally, FT-Raman spectroscopy combined with machine learning has emerged as a promising diagnostic tool, offering a quicker alternative to traditional histopathology, which is often time-consuming (ref: Tołpa doi.org/10.1016/j.nano.2024.102737/). Moreover, a comparative analysis of imaging characteristics between solitary fibrous tumors and meningiomas has provided insights into differentiating these tumor types, which is essential for preoperative planning (ref: Yu doi.org/10.1007/s12672-024-00883-8/). The use of endoscope-assisted microsurgery for posterior fossa skull base meningiomas has also been highlighted, demonstrating improved surgical outcomes and reduced invasiveness (ref: Nowak doi.org/10.1227/ons.0000000000001093/). These advancements in imaging and diagnostic approaches underscore the importance of integrating innovative technologies to enhance the accuracy and efficiency of brain tumor diagnosis and treatment.

Recent comparative studies have shed light on the associations between meningiomas and other tumor types, particularly breast cancer. A systematic review and meta-analysis revealed a bidirectional association, indicating that women with a history of breast cancer have an increased risk of developing meningiomas, and vice versa. The standardized incidence ratios (SIR) were found to be 1.27 for breast cancer followed by meningioma and 1.32 for meningioma followed by breast cancer, suggesting a significant correlation that warrants further investigation (ref: Goh doi.org/10.1111/ans.18898/). This finding emphasizes the need for heightened surveillance in patients with a history of either condition. In addition, a study on canine meningiomas demonstrated that they can be classified into three distinct DNA methylation groups that mirror the molecular characteristics of human meningiomas, indicating potential translational insights for understanding meningioma biology across species (ref: Zakimi doi.org/10.1007/s00401-024-02693-2/). Furthermore, the diagnostic approach to spinal cord neoplasms has been reviewed, highlighting the importance of recognizing common primary and metastatic tumors to optimize patient management (ref: McFaline-Figueroa doi.org/10.1212/CON.0000000000001375/). These comparative studies underscore the interconnectedness of tumor types and the implications for clinical practice and research in understanding tumor behavior and patient outcomes.

The tumor microenvironment and its interaction with the immune system play a crucial role in the progression and treatment response of meningiomas. Recent studies have utilized advanced techniques to analyze the immunological landscape in patients with glioblastoma, providing insights that may be applicable to meningioma research. High-dimensional mass cytometry revealed correlations between immune cell type abundance and clinical outcomes, emphasizing the importance of peripheral immune status in relation to intracranial pathology (ref: Dusoswa doi.org/10.3389/fimmu.2024.1343484/). Another study highlighted the significance of considering competing risks in recurrence analysis of intracranial meningiomas, revealing that only a small percentage of recent literature has employed appropriate methodologies to account for these factors (ref: Mirian doi.org/10.1007/s11060-024-04572-y/). Moreover, the Ki-67 labeling index has been identified as a predictive marker for tumor progression patterns and survival in patients with atypical meningiomas following stereotactic radiosurgery. The study reported that patients with low Ki-67 indices had significantly better local control rates and disease-specific survival compared to those with higher indices (ref: Umekawa doi.org/10.1007/s11060-023-04537-7/). These findings highlight the critical role of the tumor microenvironment and immune response in shaping clinical outcomes, underscoring the need for further research to elucidate these complex interactions and their implications for therapeutic strategies.

Innovations in surgical techniques for meningioma resection have been pivotal in improving patient outcomes, particularly for complex cases. A study focusing on torcula Herophili meningiomas emphasized the challenges posed by the intricate regional anatomy, revealing that careful surgical planning and execution are essential for achieving optimal resection and progression-free survival (ref: Birua doi.org/10.1016/j.wneu.2024.02.030/). Another investigation into the transcortical approach for giant falcine meningiomas demonstrated that this technique can effectively widen the operative corridor, facilitating tumor resection while minimizing damage to surrounding brain tissue (ref: Luther doi.org/10.1016/j.wneu.2024.02.046/). Additionally, the prognostic implications of genetic mutations have been explored, with findings indicating that POLR2A mutations are associated with poor outcomes in cerebellopontine angle meningiomas, highlighting the importance of genetic profiling in surgical decision-making (ref: Okano doi.org/10.1227/neu.0000000000002873/). These advancements in surgical techniques and the integration of genetic insights into clinical practice underscore the ongoing evolution of meningioma management, aiming to enhance surgical efficacy and patient prognosis.

The exploration of genetic and epigenetic factors in meningioma progression has gained momentum, revealing critical insights into tumor biology and potential therapeutic targets. A study identified a gain-of-function mutation in AKT1 that was associated with increased hexokinase 2 levels and diminished oxidative stress in meningioma cells, suggesting a link between metabolic alterations and inflammatory responses (ref: Singh doi.org/10.1016/j.cyto.2024.156535/). Additionally, the role of RACK1 in promoting meningioma progression through the NF-κB pathway was highlighted, indicating that targeting this pathway may offer new therapeutic avenues for higher-grade meningiomas (ref: Maalim doi.org/10.3390/cancers16040767/). Furthermore, a nationwide cohort study investigated the impact of adjuvant radiotherapy on high-grade spinal meningiomas, revealing no significant benefits associated with its use, which raises questions about current treatment paradigms and emphasizes the need for personalized approaches based on genetic and clinical characteristics (ref: El-Hajj doi.org/10.1093/noajnl/). These findings underscore the importance of understanding the genetic and epigenetic landscape of meningiomas to inform treatment strategies and improve patient outcomes.