Intracranial Meningiomas in Madagascar : A 4-Year Clinicopathological Study of 27 Cases

Background: Meningiomas are the most common primary intracranial tumors worldwide; however, data from lowresource settings such as Madagascar remain limited. The aim of this study was to determine the epidemiological, clinical, and histopathological profiles of meningiomas diagnosed at the study site. Methods: We conducted a retrospective descriptive study of 27 histologically confirmed meningiomas diagnosed in an anatomical pathology laboratory between January 2022 and December 2025. Demographic, clinical, and histopathological features were analyzed and compared with international data. Results: During the study period, 27 cases were included. The cohort included 20 females and 7 males (female-to-male ratio: 2.9:1), with a mean age of 45.98 ± 15.37 years (range: 2.5–63 years). Clinical presentation included intracranial hypertension in 10 cases and suspected brain tumor in 17 cases. Tumor location was frontal (n=5), posterior fossa (n=2), and cerebellopontine angle (n=1), while the remaining cases were unspecified. Histologically, 25 tumors (92.6%) were WHO grade I, including meningothelial (n=12), angiomatous (n=7), fibrous (n=3), psammomatous (n=2), and microcystic (n=1) subtypes, whereas 2 cases (7.4%) were atypical (grade II). Conclusion: This study highlights a predominance of benign meningiomas and female patients, consistent with global trends. The younger age at diagnosis and symptomatic presentation likely reflect demographic characteristics and limited access to neuroimaging in Madagascar.