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Frosch M, Braun AJ, Grauvogel J, Prinz M, Urbach H, Erny D, Taschner CA. Freiburg Neuropathology Case Conference : A 54-Years-Old Patient with Fatigue, Headaches, and Personality Changes. Clin Neuroradiol 2024; 34:515-521. [PMID: 38753156 PMCID: PMC11130063 DOI: 10.1007/s00062-024-01419-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2024] [Indexed: 05/29/2024]
Affiliation(s)
- M Frosch
- Department of Neuropathology, Medical Centre-University of Freiburg, Breisacherstraße 64, 79106, Freiburg, Germany
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - A J Braun
- Department of Neuroradiology, Medical Centre-University of Freiburg, Freiburg, Germany
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - J Grauvogel
- Department of Neurosurgery, Medical Centre-University of Freiburg, Freiburg, Germany
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - M Prinz
- Department of Neuropathology, Medical Centre-University of Freiburg, Breisacherstraße 64, 79106, Freiburg, Germany
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - H Urbach
- Department of Neuroradiology, Medical Centre-University of Freiburg, Freiburg, Germany
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - D Erny
- Department of Neuropathology, Medical Centre-University of Freiburg, Breisacherstraße 64, 79106, Freiburg, Germany
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - C A Taschner
- Department of Neuroradiology, Medical Centre-University of Freiburg, Freiburg, Germany.
- Faculty of Medicine, University of Freiburg, Freiburg, Germany.
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Inami K, Tsutsumi S, Hashizume A, Yamataka M, Sugiyama N, Ueno H, Ishii H. Dural-based large B-cell lymphoma masquerading as a tentorial meningioma. Radiol Case Rep 2024; 19:1661-1665. [PMID: 38384697 PMCID: PMC10876468 DOI: 10.1016/j.radcr.2024.01.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 01/16/2024] [Accepted: 01/21/2024] [Indexed: 02/23/2024] Open
Abstract
A 53-year-old woman presented with a 2-week history of headache and vertigo. Computed tomography revealed a hyperdense tumor, measuring 30 × 31 × 36 mm in diameter, in the anteromedial parts of the cerebellar hemispheres. Cerebral magnetic resonance imaging 10 days later revealed an apparent extra-axial tumor with broad attachment to the medial tentorium cerebelli and rapid growth to a diameter of 40 × 41 × 46 mm. Cerebral angiography revealed no obvious feeding vessels or tumor stains. The patient underwent biopsy through the left occipital transtentorial route. The histological appearance was consistent with diffuse large B-cell lymphoma. Intracranial lymphoma may present as a dural tumor that mimics a meningioma. Rapid tumor growth incongruous with benign meningiomas should be assumed to be possible lymphoma, and prompt biopsy should be performed.
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Affiliation(s)
- Kasumi Inami
- Department of Neurological Surgery, Juntendo University Urayasu Hospital, Urayasu, Chiba, Japan
| | - Satoshi Tsutsumi
- Department of Neurological Surgery, Juntendo University Urayasu Hospital, Urayasu, Chiba, Japan
| | - Akane Hashizume
- Department of Pathology, Juntendo University Urayasu Hospital, Urayasu, Chiba, Japan
| | - Motoki Yamataka
- Department of Neurological Surgery, Juntendo University Urayasu Hospital, Urayasu, Chiba, Japan
| | - Natsuki Sugiyama
- Department of Neurological Surgery, Juntendo University Urayasu Hospital, Urayasu, Chiba, Japan
| | - Hideaki Ueno
- Department of Neurological Surgery, Juntendo University Urayasu Hospital, Urayasu, Chiba, Japan
| | - Hisato Ishii
- Department of Neurological Surgery, Juntendo University Urayasu Hospital, Urayasu, Chiba, Japan
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Denysenko A, Danilchenko S, Stepanenko A, Chivanov V, Moskalenko R. A Comprehensive Study of Meningioma Biomineralization: Morphological, Crystallographic, and Immunohistochemical Aspects. MICROSCOPY AND MICROANALYSIS : THE OFFICIAL JOURNAL OF MICROSCOPY SOCIETY OF AMERICA, MICROBEAM ANALYSIS SOCIETY, MICROSCOPICAL SOCIETY OF CANADA 2024; 30:392-400. [PMID: 38502789 DOI: 10.1093/mam/ozae020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 01/31/2024] [Accepted: 02/24/2024] [Indexed: 03/21/2024]
Abstract
Biomineralization of brain tissues occurs both in normal and pathological conditions. Dura mater biomineralization is widespread and occurs in 1-72% of cases, depending on the patient's age and research method. The amount of biomineral deposits under the conditions of tumor growth in the meninges only increases, reaching 100% in the case of psammomatous meningiomas. Since calcifications are often found in the meninges, the problem of differential diagnosis with calcified meningiomas arises. A total of 30 samples of meningiomas with signs of biomineralization-dense structure, characteristic crunch, psammoma bodies (group I) and 30 samples of meningiomas without any signs of biomineralization were examined as controls (group II). To detect pathological biomineralization, the meningioma tissue was studied using the methods of macroscopic description, histology, histochemistry, and immunohistochemistry, scanning electron microscopy with microanalysis, and transmission electron microscopy. A significantly higher level of caspase3 and features of the expression of osteoblastic markers (a lower level of OPG expression and a higher level of the presence of RANKL in group I, the absence of fluctuations in the expression of SPARC) may indicate a dystrophic type of development of biomineral deposits in meningiomas.
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Affiliation(s)
- Anastasiia Denysenko
- Department of Pathology, Sumy State University, Kharkivska str, 116, 40007 Sumy, Sumy Region, Ukraine
| | - Sergey Danilchenko
- Department of electronics, general and applied physics, Sumy State University, Kharkivska str, 116, 40007 Sumy, Sumy Region, Ukraine
| | - Andriy Stepanenko
- Institute of Applied Physics, National Academy of Science, Petropavlivska str. 58, 40000 Sumy, Sumy Region, Ukraine
| | - Vadym Chivanov
- Department of electronics, general and applied physics, Sumy State University, Kharkivska str, 116, 40007 Sumy, Sumy Region, Ukraine
| | - Roman Moskalenko
- Department of Pathology, Sumy State University, Kharkivska str, 116, 40007 Sumy, Sumy Region, Ukraine
- Ukrainian-Swedish Reserch Center SUMEYA, Sumy State University, Myru str, 25, 40007 Sumy, Sumy Region, Ukraine
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4
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Yu Y, Gu F, Luo YL, Li SG, Jia XF, Gu LX, Zhang GP, Liao X. The role of tumor parenchyma and brain cortex signal intensity ratio in differentiating solitary fibrous tumors and meningiomas. Discov Oncol 2024; 15:32. [PMID: 38329652 PMCID: PMC10853156 DOI: 10.1007/s12672-024-00883-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 02/01/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Solitary fibrous tumors (SFT) and meningiomas (MA) have similar clinical and radiographic presentations but require different treatment approaches and have different prognoses. This emphasizes the importance of a correct preoperative diagnosis of SFT versus MA. OBJECTIVE In this study, investigated the differences in imaging characteristics between SFT and MA to improve the accuracy of preoperative imaging diagnosis of SFT. METHODS The clinical and imaging data of 26 patients with SFT and 104 patients with MA who were pathologically diagnosed between August 2017 and December 2022, were retrospectively analyzed. The clinical and imaging differences between SFT and MA, as well as between the various pathological grades of SFT, were analyzed. RESULTS Age, gender, cystic change, flow void phenomenon, yin-yang sign, lobulation, narrow base, tumor/cortex signal ratio (TCSR) > 1.0 in T1-weighted imaging (T1WI), TCSR ≥ 1.1 in T2-weighted imaging (T2WI), peritumoral edema, and absence of dural tail sign varied between SFT and MA. As per the receiver operating characteristic (ROC) curve analysis, TCSR > 1 in T1WI has the maximum diagnostic accuracy for SFT. Cranial or venous sinus invasion had a positive effect on SFT (Grade III, World Health Organization (WHO) grading). CONCLUSION Among the many radiological and clinical distinctions between SFT and MA, TCSR ≥ 1 exhibits the highest predictive efficacy for SFT; while cranial or venous sinus invasion may be a predictor of WHO grade III SFT.
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Affiliation(s)
- Yue Yu
- Department of Radiology, The Affiliated Hospital of Guizhou Medical University, 28 Guiyi Street, Yunyan District, Guiyang, 550004, Guizhou, China
| | - Fang Gu
- Department of Radiology, The Second People's Hospital of Guiyang, 547 Jinyang South Road, Guanshanhu District, Guiyang, 550023, Guizhou, China
| | - Yi-Lin Luo
- Department of Radiology, The Second People's Hospital of Guiyang, 547 Jinyang South Road, Guanshanhu District, Guiyang, 550023, Guizhou, China
| | - Shi-Guang Li
- Department of Radiology, The Second People's Hospital of Guiyang, 547 Jinyang South Road, Guanshanhu District, Guiyang, 550023, Guizhou, China
| | - Xiao-Feng Jia
- Department of Radiology, The Second People's Hospital of Guiyang, 547 Jinyang South Road, Guanshanhu District, Guiyang, 550023, Guizhou, China
| | - Liang-Xian Gu
- Department of Radiology, The Second People's Hospital of Guiyang, 547 Jinyang South Road, Guanshanhu District, Guiyang, 550023, Guizhou, China
| | - Guo-Ping Zhang
- Department of Radiology, The Second People's Hospital of Guiyang, 547 Jinyang South Road, Guanshanhu District, Guiyang, 550023, Guizhou, China.
| | - Xin Liao
- Department of Radiology, The Affiliated Hospital of Guizhou Medical University, 28 Guiyi Street, Yunyan District, Guiyang, 550004, Guizhou, China.
- Department of Radiology, Dushan County People's Hospital, No. 1 Ying Shang Road, Baiquan Town, Dushan County, 558299, Guizhou, China.
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Wang P, Liu S, Li X, Liu X, Li S, Wu Z, Cheng X. The usefulness of [ 68 Ga]Ga-DOTA-JR11 PET/CT in patients with meningioma: comparison with MRI. Eur J Nucl Med Mol Imaging 2023; 51:218-225. [PMID: 37682301 DOI: 10.1007/s00259-023-06391-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 08/07/2023] [Indexed: 09/09/2023]
Abstract
PURPOSE Clinical studies of PET imaging using SSTR2 agonists have demonstrated high accuracy and correlation with SSTR2 expression in meningiomas. However, the usefulness of the SSTR2 antagonist with [68 Ga]Ga-DOTA-JR11 is uncertain. To evaluate the diagnostic performance of [68 Ga]Ga-DOTA-JR11 PET/CT and to clarify tumor characteristics in patients with suspected meningiomas. MATERIALS AND METHODS Patients with suspected de novo or recurrent meningioma in complex locations or atypical images were enrolled from August 2021 to October 2022 in prospective study. All patients underwent contrast-enhanced MRI (CE-MRI), [68 Ga]Ga-DOTA-JR11 PET/CT, and histopathological evaluation. Tumor uptake of [68 Ga]Ga-DOTA-JR11 was measured by SUVmax and tumor-endocranium ratio (TBR). Diagnostic performance was compared between PET and MRI. RESULTS Of 36 (50.0 ± 13.0 years of age, 20 women) patients, 32 were histopathologically confirmed meningiomas and four with other tumors. [68 Ga]Ga-DOTA-JR11 uptake was significantly higher in meningioma patients than in those with other tumors (SUVmax: 13.6 ± 7.7 vs. 5.2 ± 3.0, P < 0.001; TBR: 64.2 ± 27.7 vs. 25.0 ± 18.9, P = 0.001). [68 Ga]Ga-DOTA-JR11 PET/CT detected 31 meningiomas, while CE-MRI detected 17 meningiomas of 25 initial diagnosis and 11 recurrent tumors; [68 Ga]Ga-DOTA-JR11 PET had an incremental diagnostic value of 24% (6/25) over MRI in the group of initial diagnosis. There was no statistically significant difference in diagnostic efficacy between PET and MRI (P = 0.45) for all 36 patients. In skull base meningiomas, PET provided a more definitive diagnosis of pituitary involvement (in 12, not in12), compared to MRI (in eight, possible in six, possible not in six, not in four). PET revealed bone involvement in all 14 patients proven by pathology, while MRI identified only 11. CONCLUSIONS [68 Ga]Ga-DOTA-JR11 PET/CT provided high image quality and presented an ideal diagnostic performance in detecting meningioma and evaluating the involvement of the pituitary and bone. The study provides valuable evidence for the use of [68 Ga]Ga-DOTA-JR11 PET/CT as a complementary imaging modality to CE-MRI in the evaluation of meningiomas.
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Affiliation(s)
- Peipei Wang
- Department of Nuclear Medicine, Beijing , Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China
| | - Shuai Liu
- Department of Radiation Oncology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Xiaojie Li
- Department of Neurosurgery, Fengtai District, Beijing Tiantan Hospital, Capital Medical University, No. 119, the West Southern 4Th Ring Road, Beijing, 100073, China
| | - Xing Liu
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Shaowu Li
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
- Department of Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhen Wu
- Department of Neurosurgery, Fengtai District, Beijing Tiantan Hospital, Capital Medical University, No. 119, the West Southern 4Th Ring Road, Beijing, 100073, China.
| | - Xin Cheng
- Department of Nuclear Medicine, Beijing , Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China.
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Panyaping T, Punpichet M, Tunlayadechanont P, Tritanon O. Usefulness of a Rim-Enhancing Pattern on the Contrast-Enhanced 3D-FLAIR Sequence and MRI Characteristics for Distinguishing Meningioma and Malignant Dural-Based Tumor. AJNR Am J Neuroradiol 2023; 44:247-253. [PMID: 36732030 PMCID: PMC10187810 DOI: 10.3174/ajnr.a7780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 01/03/2023] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND PURPOSE Meningiomas are the most common type of extra-axial dural-based tumors; however, malignant dural-based tumors can mimic meningiomas on imaging. The aim of this study was to determine the efficacy of differentiating meningiomas from malignant dural-based tumors by using rim-enhancement patterns on a contrast-enhanced FLAIR sequence and MR imaging characteristics. MATERIALS AND METHODS This retrospective study included 102 patients with meningiomas and 31 patients with malignant dural-based tumors who underwent pretreatment MR imaging. The rim-enhancement patterns on contrast-enhanced FLAIR and MR imaging characteristics, including the dural tail sign, hyperostosis, bony destruction, leptomeningeal enhancement, peritumoral edema, T2-weighted signal intensity, and tumor enhancement were evaluated. RESULTS Complete rim enhancement of the tumor-brain interface on contrast-enhanced FLAIR (contrast-enhanced-FLAIR rim sign) was present in most meningiomas (91/102, 89.2%) and at significantly greater frequency than in malignant dural-based tumors (2/31, 6.5%) (P < .001). Complete contrast-enhanced FLAIR rim enhancement provided high sensitivity (89.2%), specificity (93.5%), and accuracy (90.2%) for diagnosing meningioma. Additionally, hyperostosis was an MR imaging characteristic that suggested a diagnosis of meningioma. In contrast, bony destruction with cortical breakthrough and leptomeningeal enhancement suggested malignant dural-based tumors. There were limitations of meningiomas of <2.0 cm or at cavernous sinus locations that did not demonstrate contrast-enhanced FLAIR rim enhancement. CONCLUSIONS The rim-enhancement pattern on contrast-enhanced FLAIR could help differentiate meningiomas and malignant dural-based tumors. The presence of complete rim enhancement on contrast-enhanced FLAIR was a robust predictive sign for meningioma.
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Affiliation(s)
- T Panyaping
- From the Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thialand
| | - M Punpichet
- From the Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thialand
| | - P Tunlayadechanont
- From the Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thialand
| | - O Tritanon
- From the Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thialand
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Lin Q, Zhu J, Zhang X. Solitary fibrous tumor of the central nervous system invading and penetrating the skull: A case report. Oncol Lett 2023; 25:81. [PMID: 36742362 PMCID: PMC9853498 DOI: 10.3892/ol.2023.13667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 12/20/2022] [Indexed: 01/11/2023] Open
Abstract
Solitary fibrous tumor (SFT) of the central nervous system is a rare spindle cell tumor of mesenchymal origin. The present study reports the case of a 44-year-old male patient with SFT. Magnetic resonance imaging demonstrated that the majority of the intracranial tumors exhibited uneven low signals on T1-weighted imaging (T1WI) and low mixed signals on T2WI, and there was an enhancement on enhanced scanning. Furthermore, the distal part of the left occipital lobe exhibited hypersignals on T1WI and T2WI, and this was significantly enhanced following enhanced scanning. The lower part of the scalp exhibited low signals on T1WI and high signals on T2WI, and there was no notable enhancement following enhanced scanning. Magnetic resonance spectroscopy demonstrated an elevated choline/creatine peak in the solid part of the tumor. Under the microscope, the tumor exhibited characteristic 'staghorn-shaped' blood vessels. As SFT is difficult to differentially diagnose via imaging, immunohistochemical analysis of CD34, vimentin and signal transducer and activator of transcription 6 was performed for the definitive diagnosis of SFT. Of note, surgical resection was the preferred treatment for SFT; however, due to the rarity of the tumor, subsequent adjuvant therapy and prognosis require further investigation.
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Affiliation(s)
- Qiyan Lin
- Department of Neurosurgery, Affiliated Xiaolan Hospital, Southern Medical University, Xiaolan People's Hospital of Zhongshan, Zhongshan, Guangdong 528415, P.R. China
| | - Jiabin Zhu
- Department of Neurosurgery, Affiliated Xiaolan Hospital, Southern Medical University, Xiaolan People's Hospital of Zhongshan, Zhongshan, Guangdong 528415, P.R. China
| | - Xiaofeng Zhang
- Department of Neurosurgery, Affiliated Xiaolan Hospital, Southern Medical University, Xiaolan People's Hospital of Zhongshan, Zhongshan, Guangdong 528415, P.R. China,Correspondence to: Professor Xiaofeng Zhang, Department of Neurosurgery, Affiliated Xiaolan Hospital, Southern Medical University, Xiaolan People's Hospital of Zhongshan, 65 Jucheng Avenue, Zhongshan, Guangdong 528415, P.R. China, E-mail:
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Kuroda K, Tsutsumi S, Kishikawa S, Sugiyama H, Sugiyama N, Ueno H, Ishii H. Atypical convexity meningioma presenting with photophobia and skull erosion. Radiol Case Rep 2023; 18:343-348. [DOI: 10.1016/j.radcr.2022.10.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 10/23/2022] [Indexed: 11/18/2022] Open
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The NXDC-MEN-301 Study on 5-ALA for Meningiomas Surgery: An Innovative Study Design for the Assessing the Benefit of Intra-Operative Fluorescence Imaging. Brain Sci 2022; 12:brainsci12081044. [PMID: 36009108 PMCID: PMC9405714 DOI: 10.3390/brainsci12081044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/03/2022] [Accepted: 08/03/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND 5-aminolevulinic acid (5-ALA; GleolanTM, NX Development Corps., Lexington, USA) is approved for fluorescence-guided resections of suspected malignant gliomas. Experience has demonstrated that meningiomas also show fluorescence, which may be a useful surgical adjunct. We present an innovative design for a multi-center, prospective study to determine the clinical safety and potential benefit of fluorescence-guided resection of meningiomas with utmost bias reduction. METHODS All patients with suspected meningioma (all grades) receive GleolanTM 20 mg/kg 2-4 h prior to surgery supported by fluorescence excitation from a blue light source (Blue400, Zeiss Meditech, Oberkochen, Germany; FL400, Leica Microsystems, Heerbrugg, Switzerland). Surgeons are asked whether a residual tumor can be observed to fluoresce under blue light (BL) after the tumor is no longer recognizable using conventional illumination at the end of surgery. In addition, when faced with tissues of uncertain tissue type (so-called "indeterminate" tissue), this study records how often surgeons make a correct decision based on fluorescence and how this influences surgical strategy. The primary endpoint is the percentage of patients in whom one of these two benefits are observed. Other endpoints include the diagnostic accuracy of fluorescence compared to white light (WL) versus correlative histology. For bias reduction, pertinent data are derived from surgical videos reviewed by independent reviewers blinded to surgeons' assessments of tissue type and fluorescence status. Data will be included from approximately 100 study participants completing the study at approximately 15 centers in the United States, Germany, and Austria. RESULTS As of May 2022, 88 patients have completed the study. No adverse safety signal has been detected. CONCLUSIONS Preliminary data confirm the feasibility of our study design. Accrual is targeted for completion in the third quarter of 2022.
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Sugiyama H, Tsutsumi S, Hashizume A, Inaba T, Ishii H. Are bone erosion and peripheral feeding vessels hallmarks of intracranial solitary fibrous tumor/hemangiopericytoma? Radiol Case Rep 2022; 17:2702-2707. [PMID: 35669225 PMCID: PMC9162938 DOI: 10.1016/j.radcr.2022.04.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 04/25/2022] [Accepted: 04/28/2022] [Indexed: 11/29/2022] Open
Abstract
An 86-year-old man sustained progressive motor weakness in the left lower extremity for 1 month. Cranial computed tomography (CT) revealed an isodense mass in the right parietal lobe, with a smooth-contoured focal erosion in the adjacent parietal bone. The extra-axial tumor appeared isointense on T1- and hyperintense on T2-weighted magnetic resonance imaging with intense enhancement. On three-dimensional CT angiography, the ectatic left occipital artery coursed into the right parietal foramina and connected with a dilated meningeal vessel supplying the tumor. The focal erosion formed in the inner parietal bone was located adjacent to the feeding vessel. A total tumor resection was achieved. The microscopic findings of the resected specimen were consistent with a World Health Organization grade III hemangiopericytoma (HPC). Bone erosion and peripheral feeding vessels may be characteristic findings of intracranial solitary fibrous tumor (SFT)/HPC. Careful interpretation of neuroimages could help detect clues for distinguishing an SFT/HPC masquerading as a meningioma from a true meningioma.
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Affiliation(s)
- Hiroki Sugiyama
- Department of Neurological Surgery, Juntendo University Urayasu Hospital, Urayasu, Chiba, Japan
| | - Satoshi Tsutsumi
- Department of Neurological Surgery, Juntendo University Urayasu Hospital, Urayasu, Chiba, Japan
| | - Akane Hashizume
- Department of Pathology, Juntendo University Urayasu Hospital, Urayasu, Chiba, Japan
| | - Toshihisa Inaba
- Division of Radiological Technology, Juntendo University Urayasu Hospital, Urayasu, Chiba, Japan
| | - Hisato Ishii
- Department of Neurological Surgery, Juntendo University Urayasu Hospital, Urayasu, Chiba, Japan
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Guo M, Chen X, Zhang G, Wang Y. Pontine Myopericytoma: Case Report and Literature Review. Front Oncol 2022; 12:903655. [PMID: 35651813 PMCID: PMC9148993 DOI: 10.3389/fonc.2022.903655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
Myopericytoma (MPC) is a benign soft tissue tumor that develops from perivascular myoid cells and is part of the perivascular tumor group. MPC most commonly occurs in the subcutaneous soft tissues of the extremities, while intracranial MPC is remarkably rare. Herein, we report the case of a 45-year-old woman with myopericytoma who had a 2-week history of recurrent dizziness. Magnetic resonance imaging (MRI) revealed an irregular mass in the pons, with nodular enhancement of the mass on contrast-enhanced scans. The mass was considered a vascular lesion and was highly suspected to be a hemangioblastoma, prompting surgical intervention for the patient. The postoperative pathological report corrected the initial diagnosis, hemangioblastoma, to MPC. Intracranial MPC is extremely rare and there are no detailed imaging sources for this condition; furthermore, MPC occurrence in the pons has not been reported previously. This report presents the etiological characteristics intracranial MPC as visualized through MRI data alongside a comparative discussion on other reported diagnoses that resemble MPC. The case findings will provide a more widespread understanding for radiologists regarding the differential diagnosis of intracranial blood-rich supply lesions.
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Affiliation(s)
| | | | | | - Yongpeng Wang
- Department of Radiology, The Second Affiliated Hospital of Zun Yi Medical University, Zunyi, China
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12
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Prevalence of incidental meningiomas and gliomas on MRI: a meta-analysis and meta-regression analysis. Acta Neurochir (Wien) 2021; 163:3401-3415. [PMID: 34227013 DOI: 10.1007/s00701-021-04919-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 06/14/2021] [Indexed: 01/24/2023]
Abstract
BACKGROUND The chance of incidentally detecting brain tumors is increasing as the utilization of magnetic resonance imaging (MRI) becomes more prevalent. In this background, knowledge is accumulating in relation to the prediction of their clinical sequence. However, their prevalence-especially the prevalence of glioma-has not been adequately investigated according to age, sex, and region. METHOD We systematically reviewed the articles according to the PRISMA statement and calculated the prevalence of meningiomas and diffuse gliomas in adults using a generalized linear mixed model. Specifically, the differences related to age, sex, and region were investigated. RESULTS The pooled prevalence of incidental meningiomas in MRI studies was 0.52% (95% confidence interval (CI) [0.34-0.78]) in 37,697 individuals from 36 studies. A meta-regression analysis showed that the prevalence was significantly higher in elderly individuals, women, and individuals outside Asia; this remained statistically significant in the multivariate meta-regression analysis. The prevalence reached to 3% at 90 years of age. In contrast, the prevalence of gliomas in 30,918 individuals from 18 studies was 0.064% (95%CI [0.040 - 0.104]). The meta-regression analysis did not show a significant relationship between the prevalence and age, male sex, or region. The prevalence of histologically confirmed glioma was 0.026% (95%CI [0.013-0.052]). CONCLUSIONS Most of meningiomas, especially those in elderlies, remained asymptomatic, and their prevalence increased with age. However, the prevalence of incidental gliomas was much lower and did not increase with age. The number of gliomas that developed and the number that reached a symptomatic stage appeared to be balanced.
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Dos Santos ARS, de Souza SR, Corrêa DG. Narrow dural base as an imaging sign for the differential diagnosis of intracranial meningiomas. Neuroradiology 2021; 63:1577-1579. [PMID: 34398276 DOI: 10.1007/s00234-021-02787-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 08/03/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Artur Ramos Sarmet Dos Santos
- Department of Radiology, Federal Fluminense University, Avenida Marquês de Paraná, 303, Niterói, RJ, 24033-900, Brazil
| | - Simone Rachid de Souza
- Department of Pathology, Federal University of Rio de Janeiro, Rua Profossor Rodolpho Paulo Rocco, 255, Cidade Universitária da Universidade Federal Do Rio de Janeiro, Rio de Janeiro, RJ, 21941-617, Brazil
| | - Diogo Goulart Corrêa
- Department of Radiology, Federal Fluminense University, Avenida Marquês de Paraná, 303, Niterói, RJ, 24033-900, Brazil.
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Ogasawara C, Philbrick BD, Adamson DC. Meningioma: A Review of Epidemiology, Pathology, Diagnosis, Treatment, and Future Directions. Biomedicines 2021; 9:biomedicines9030319. [PMID: 33801089 PMCID: PMC8004084 DOI: 10.3390/biomedicines9030319] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 03/15/2021] [Accepted: 03/15/2021] [Indexed: 12/19/2022] Open
Abstract
Meningiomas are the most common intracranial tumor, making up more than a third of all primary central nervous system (CNS) tumors. They are mostly benign tumors that can be observed or preferentially treated with gross total resection that provides good outcomes. Meningiomas with complicated histology or in compromising locations has proved to be a challenge in treating and predicting prognostic outcomes. Advances in genomics and molecular characteristics of meningiomas have uncovered potential use for more accurate grading and prediction of prognosis and recurrence. With the study and detection of genomic aberrancies, specific biologic targets are now being trialed for possible management of meningiomas that are not responsive to standard surgery and radiotherapy treatment. This review summarizes current epidemiology, etiology, molecular characteristics, diagnosis, treatments, and current treatment trials.
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Affiliation(s)
- Christian Ogasawara
- Department of Surgery, University of Hawaii School of Medicine, Honolulu, HI 96813, USA;
| | - Brandon D. Philbrick
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, GA 30322, USA;
| | - D. Cory Adamson
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, GA 30322, USA;
- Department of Neurosurgery, Atlanta VA Medical Center, Atlanta, GA 30322, USA
- Correspondence: ; Tel.: +1-(919)-698-3152
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