[The role of histopathology in the diagnosis and management of intracranial meningiomas. Hospital experience in Kinshasa (Democratic Republic of Congo)].
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INTRODUCTION: Meningiomas are the most common type of intracranial brain tumor and are usually benign. While histopathology is still considered the gold standard for diagnosing and classifying meningiomas, treatment in developing countries heavily relies on computed tomography (CT) and magnetic resonance imaging (MRI). Therefore, it is important to have imaging results that are as accurate as possible. The aim of this study was to determine the contribution of histopathology to the diagnosis of intracranial meningiomas in tertiary healthcare facilities (THFs) in Kinshasa, Democratic Republic of Congo. MATERIALS AND METHODS: We conducted a descriptive, cross-sectional study in THFs with pathology and neurosurgery departments in the city-province of Kinshasa, over a period of ten years. We analyzed 102 patient files of individuals admitted and operated on for a brain tumor.Results. The main complaints were neurological and cephalic deficits and optic nerve damage in 49 (48%) and 23 (22.5%) patients, respectively. The most common diagnostic hypotheses were meningioma (43.1%), brain tumor (27.5%), and expansive intracranial process (13.7%). Eighty-four patients (92.2%) underwent CT scans, and seven (6.9%) underwent MRIs. The most common diagnoses were meningioma in 40 patients (39.2%), brain tumor in 34 patients (33.3%), and glioma in 15 patients (14.7%).Of the 36 patients who underwent histopathological examination, 20 (56%) had meningiomas, and five (14%) had oligodendrogliomas. Of the 20 cases of meningioma diagnosed by histopathology, seven (35%) were fibroblastic meningiomas, and four (20%) were mixed meningiomas. Medical imaging allowed for a meningioma diagnosis in only five cases (25%). Most meningiomas were grade 1 (85%), followed by grade 3 (10%). Conclusion. Despite the importance of histopathology in evaluating and understanding meningioma grade, most of our patients do not undergo this procedure. There is a significant discrepancy between imaging findings and histopathological findings of meningiomas, which requires awareness among various healthcare providers.