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Correlation of vascular endothelial growth factor messenger RNA expression with peritumoral vasogenic cerebral edema in meningiomas

Steven N. Kalkanis Neurosurgical and Neuroradiology Services, Brigham and Women's Hospital, Boston, Massachusetts; The Brain Tumor Center, Brigham and Women's Hospital, Children's Hospital, and Dana Farber Cancer Institute, Boston, Massachusetts; and Departments of Surgery and Radiology, Harvard Medical School, Boston, Massachusetts

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 B.A.
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Rona S. Carroll Neurosurgical and Neuroradiology Services, Brigham and Women's Hospital, Boston, Massachusetts; The Brain Tumor Center, Brigham and Women's Hospital, Children's Hospital, and Dana Farber Cancer Institute, Boston, Massachusetts; and Departments of Surgery and Radiology, Harvard Medical School, Boston, Massachusetts

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 Ph.D.
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Jianping Zhang Neurosurgical and Neuroradiology Services, Brigham and Women's Hospital, Boston, Massachusetts; The Brain Tumor Center, Brigham and Women's Hospital, Children's Hospital, and Dana Farber Cancer Institute, Boston, Massachusetts; and Departments of Surgery and Radiology, Harvard Medical School, Boston, Massachusetts

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Amir A. Zamani Neurosurgical and Neuroradiology Services, Brigham and Women's Hospital, Boston, Massachusetts; The Brain Tumor Center, Brigham and Women's Hospital, Children's Hospital, and Dana Farber Cancer Institute, Boston, Massachusetts; and Departments of Surgery and Radiology, Harvard Medical School, Boston, Massachusetts

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 M.D.
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Peter McL. Black Neurosurgical and Neuroradiology Services, Brigham and Women's Hospital, Boston, Massachusetts; The Brain Tumor Center, Brigham and Women's Hospital, Children's Hospital, and Dana Farber Cancer Institute, Boston, Massachusetts; and Departments of Surgery and Radiology, Harvard Medical School, Boston, Massachusetts

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 M.D., Ph.D.
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Volume 85: Issue 6
DOI link:
https://doi.org/10.3171/jns.1996.85.6.1095
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✓ Intracranial meningiomas are often complicated by peritumoral vasogenic cerebral edema, which appears to result from increased microvascular permeability and extravasation of proteinaceous and plasma fluid into the adjacent peritumoral space. The source of such edema has long been mysterious. The contents of this paper support the concept that vascular endothelial growth factor (VEGF) production plays a significant role in edema formation.

Vascular endothelial growth factor messenger RNA expression has been found in a wide range of intracranial neoplasms, including malignant gliomas, metastatic melanomas, meningiomas, and other benign tumors. Several studies have confirmed the importance of VEGF in tumorigenesis, neovascularization, and edema production.

This study tests the hypothesis that the presence of peritumoral edema in meningiomas is positively correlated with increased expression of VEGF mRNA. To investigate this hypothesis, 31 meningioma specimens were subjected to Northern blot analysis, hybridization with a complementary DNA VEGF probe, and laser densitometry to determine the relative levels of VEGF mRNA expression. Magnetic resonance imaging was then used in a double-blind fashion to correlate the neuropathological tissue samples with the presence of preoperative peritumoral edema.

Of 31 patients studied, 14 exhibited no edema and 17 exhibited some level of peritumoral fluid accumulation. There was a marked increase in VEGF expression in patients with edema (p = 0.0004, Wilcoxon-Mann-Whitney rank-sum test). Meningiomas with peritumoral edema exhibited 3.4 times the level of VEGF mRNA as those without edema.

These data demonstrate a strong link between VEGF mRNA expression and peritumoral edema and indicate that VEGF expression is an important factor in the etiology of edema around meningiomas.

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Contributor Notes

Address reprint requests to: Steven N. Kalkanis, B.A., and Rona S. Carroll, Ph.D., Brigham and Women's Hospital, 221 Longwood Avenue, Room 121, Boston, Massachusetts 02115.
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