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Introduccion: los meningiomas son tumores intracraneales frecuentes, correspondiendo aproximadamente al 34% de estas neoplasias; actualmente se recomienda realizar graduacion histologica a traves de los criterios de la OMS; segun esta, los meningiomas grado-I tienen un curso indolente. Sin embargo, un grupo limitrofe de meningiomas grado-I (20%) puede comportarse de forma agresiva. Objetivos: encontrar caracteristicas clinico-patologicas y caracteristicas morfologicas tanto citologicas como arquitecturales, diferentes a las contempladas como criterios de graduacion por la OMS, que puedan asociarse a un comportamiento biologico agresivo, representado por un mayor grado segun la OMS, en Cartagena (Colombia). Material y metodos: se seleccionaron 123 casos de meningiomas, entre los anos 2001 y 2012 en la Fundacion Centro Colombiano de Epilepsia y Enfermedades Neurologicas – FIRE. Fueron reclasificados segun los criterios OMS actuales, se determinaron las variables clinico-epidemiologicas y caracteristicas histopatologicas (presencia de borlas meningoteliales, cuerpos de Psammoma celulas xantomizadas, inflamacion cronica, fibrosis, atipia nuclear, perdida del patron arquitectural clasico). El grado de relacion entre las caracteristicas histopatologicas y clinico-epidemiologicas con el grado tumoral, se estimo a traves de un modelo de regresion logistica donde el grado tumoral segun la OMS fue la variable dependiente. Resultados: edad promedio de los pacientes 51,63 (DS:14,57) anos; las mujeres sobrepasaron a los hombres con una razon de 3,7 a 1. Los meningiomas de la region frontal y temporal fueron los mas comunes, especialmente los localizados en el hemisferio derecho. No se encontro asociacion entre la localizacion del tumor, lado y el sexo, tampoco entre localizacion, lado y grado. La distribucion de los subtipos histologicos y caracteristicas patodiagnosticas entre hombres y mujeres fue similar, sin diferencias significativas entre estos. El analisis del modelo de regresion logistica mostro que las variables histologicas 1.) Ausencia del patron arquitectural clasico (perdida de cohesividad celular) y 2.) Atipia nuclear se asociaron con el grado tumoral, y esto tiene una validez estadisticamente significativa. Conclusiones: las variables histopatologicas mostradas por el modelo de regresion logistica no estan actualmente incluidas en la graduacion histologica de la OMS, y es posible que puedan ser empleadas como criterios de graduacion de los meningiomas mas agresivos. Aunque la clasificacion y los criterios de graduacion actuales de la OMS son validos y su aplicacion es recomendada, es importante desarrollar estudios que permitan descifrar el potencial papel de estas variables como factores pronosticos en la evolucion clinica de este tipo de tumores. Rev.cienc.biomed. 2015;6(1):68-78 PALABRAS CLAVE Meningioma; Sistema nervioso central; Mitosis; Patologia. SUMMARY Introduction: meningiomas are the most common intracranial tumors, corresponding to approximately 34% of these neoplasms. WHO grading criteria are currently the recommended approach for these tumors, according to this, grade I meningiomas have an indolent course. However, a borderline group of grade I meningiomas (20%) may behave aggressively. Objectives: the aim of this study was to find clinical - pathological and morphological characteristics both cytological and architectural, other than those referred as graduation criteria by WHO, which may be associated with aggressive biological behavior, represented by a higher degree according to WHO, in Cartagena (Colombia). Material and Methods: we selected 123 cases of meningiomas between 2001 and 2012 in the Colombian Foundation Center for Epilepsy and Neurological Diseases (FIRE), were reclassified according to the current WHO criteria, clinical - epidemiological and histopathological features (presence of meningothelial whorls, Psammoma bodies, xantomized cells, chronic inflammation, fibrosis, nuclear atypia, loss of classic architectural pattern) were determined. The degree of relationship between histopathologic features and clinical - epidemiological with tumor grade, was estimated using a logistic regression model where tumor grade, according to WHO, was the dependent variable. Results: the average age of the patients was 51.63 ± 14.57 years, and women outnumbered men in a ratio of 3.7 to 1. Meningiomas of the frontal and temporal regions were the most common, especially those located in the right hemisphere. No association between tumor location, side and sex, or between location, side and grade. The distribution of histologic subtypes and pathodiagnostic characteristics between men and women was similar, with no significant differences between them. The analysis of the logistic regression model showed that histological variables: 1.) Absence of classic architectural pattern (loss of cellular cohesiveness) and 2.) Nuclear atypia are associated with tumor grade, and this is statistically significant. Conclusions: histopathological variables shown by the regression are not currently included in the WHO histologic grade, and it is possible that they can be used as ranking criteria more aggressive meningiomas. While sorting and grading criteria current WHO are valid and its application is recommended, it is important to develop studies to decipher the potential role of these variables as prognostic factors in the clinical course of these tumors. Rev.cienc.biomed. 2015;6(1):68-78 KEYWORDS Meningiomas; Central Nervous System; Mitosis; Pathology.

Características clinicopatológicas y criterios de graduación OMS en 123 casos de meningiomas en Cartagena de indias, Colombia (2001 – 2010)