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Idowu OI, Oshola H, Emiogun EF. An unexpected diagnosis of malignant supratentorial intraparenchymal cystic meningioma mimicking high-grade glioma: case report and literature review. J Surg Case Rep 2023; 2023:rjad062. [PMID: 36846848 PMCID: PMC9946772 DOI: 10.1093/jscr/rjad062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 01/18/2023] [Accepted: 01/24/2023] [Indexed: 02/24/2023] Open
Abstract
Meningiomas are generally dura-based extra axial tumours without cystic components, whereas high-grade gliomas are intra-axial with or without cystic component. This case describes an adult female who presented with clinical and radiological features suggestive of a high-grade astrocytoma; however, histology diagnosis was papillary meningioma (World Health Organization Grade III). A 58-year-old female presented with a 4-month history of recurrent generalized tonic-clonic seizures and a 1-week history of altered sensorium. Her Glasgow Coma Scale Score was 10. Magnetic resonance image revealed a large intra-axial heterogeneous solid mass with multiple cystic areas in the right parietal lobe. She subsequently had craniotomy and tumour excision and the histologic diagnosis was papillary meningioma (WHO Grade III). Rarely, meningioma can present as an intra-axial tumour and may mimic other lesions like high-grade astrocytoma.
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Affiliation(s)
- Olufemi I Idowu
- Division of Neurological Surgery, Department of Surgery, Lagos State University Teaching Hospital (LASUTH), Ikeja, Lagos, Nigeria
| | - Hammed Oshola
- Division of Neurological Surgery, Department of Surgery, Lagos State University Teaching Hospital (LASUTH), Ikeja, Lagos, Nigeria
| | - Edobor F Emiogun
- Correspondence address. Department of Pathology and Forensic Medicine, Lagos State University College of Medicine, Lagos State University, Ikeja, Lagos 100271, Nigeria. Tel: +234806 673 7227; E-mail:
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Diagnostic and Therapeutic Strategy in Anaplastic (Malignant) Meningioma, CNS WHO Grade 3. Cancers (Basel) 2022; 14:cancers14194689. [PMID: 36230612 PMCID: PMC9562197 DOI: 10.3390/cancers14194689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/12/2022] [Accepted: 09/22/2022] [Indexed: 11/21/2022] Open
Abstract
Simple Summary Only 1% of all meningioma diagnosis is classified as malignant (anaplastic) meningioma. Due to their rarity, clinical management of these tumors presents several gaps. In this review, we investigate current knowledge of anaplastic meningioma focusing on their pathological and radiological diagnosis, molecular assessment, and loco-regional and systemic management. Despite the current marginal role of systemic therapy, it is possible that the increasing knowledge of molecular altered pathways of the disease will lead to the development of novel effective systemic treatments. Abstract Background: Meningiomas are the most common primary central nervous system malignancies accounting for 36% of all intracranial tumors. However, only 1% of meningioma is classified as malignant (anaplastic) meningioma. Due to their rarity, clinical management of these tumors presents several gaps. Methods: We carried out a narrative review aimed to investigate current knowledge of anaplastic meningioma focusing on their pathological and radiological diagnosis, molecular assessment, and loco-regional and systemic management. Results: The most frequent genetic alteration occurring in meningioma is the inactivation in the neurofibromatosis 2 genes (merlin). The accumulation of copy number losses, including 1p, 6p/q, 10q, 14q, and 18p/q, and less frequently 2p/q, 3p, 4p/q, 7p, 8p/q, and 9p, compatible with instability, is restricted to NF2 mutated meningioma. Surgery and different RT approaches represent the milestone of grade 3 meningioma management, while there is a marginal role of systemic therapy. Conclusions: Anaplastic meningiomas are rare tumors, and diagnosis should be suspected and confirmed by trained radiologists and pathologists. Despite the current marginal role of systemic therapy, it is possible that the increasing knowledge of molecular altered pathways of the disease will lead to the development of novel effective systemic treatments.
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Papic V, Lasica N, Jelaca B, Vuckovic N, Kozic D, Djilvesi D, Fimic M, Golubovic J, Pajicic F, Vulekovic P. Primary Intraparenchymal Meningiomas: A Case Report and a Systematic Review. World Neurosurg 2021; 153:52-62. [PMID: 34242832 DOI: 10.1016/j.wneu.2021.06.139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 06/27/2021] [Accepted: 06/28/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Primary intraparenchymal meningiomas are exceedingly rare and often challenging to diagnose, given their misleading radiologic features. It is hypothesized that they arise from the cap cells of the pia mater that enter the brain via penetrating blood vessels during brain development. We systematically reviewed and analyzed previously reported features of primary intraparenchymal meningiomas in terms of radiography, presenting symptoms, and histopathology. METHODS A literature search of the Web of Science and PubMed databases and crossed references was performed in March 2021, per PRISMA guidelines, with no restrictions regarding publication date. Data regarding demographic features, clinical, radiographic, and histopathologic characteristics were extracted. RESULTS A total of 52 patients (including the reported case) were included in this review. The mean age was 21.1 years (range, 0.3-66 years) with a male/female ratio of 1.9:1. The most common localizations of intraparenchymal meningiomas were in the frontal (30.8%) and temporal (21.2%) lobes. Cyst formation was more readily observed and was noted in 51.4% of patients. Histopathology showed a higher incidence of World Health Organization grade II (14/52, 26.9%) and World Health Organization grade III (7/52, 13.5%) of primary intraparenchymal meningiomas. CONCLUSIONS We present a comprehensive analysis of every reported primary intraparenchymal meningioma. Because of their rarity and capacity to mimic other more common intra-axial tumors, they represent a diagnostic challenge. This systematic review highlights the importance of paying attention to atypical intra-axial lesions, with a particular reflection on the discrepancy between clinical characteristics and imaging features.
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Affiliation(s)
- Vladimir Papic
- Clinic of Neurosurgery, Clinical Center of Vojvodina, Novi Sad, Serbia; Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Nebojsa Lasica
- Clinic of Neurosurgery, Clinical Center of Vojvodina, Novi Sad, Serbia; Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Bojan Jelaca
- Clinic of Neurosurgery, Clinical Center of Vojvodina, Novi Sad, Serbia; Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
| | - Nada Vuckovic
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia; Pathology and Histology Center, Clinical Center of Vojvodina, Novi Sad, Serbia
| | - Dusko Kozic
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia; Center for Diagnostic Imaging, Oncology Institute of Vojvodina, Sremska Kamenica, Serbia
| | - Djula Djilvesi
- Clinic of Neurosurgery, Clinical Center of Vojvodina, Novi Sad, Serbia; Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Miroslav Fimic
- Department of Neurosurgery, Institute for Child and Youth Health Care of Vojvodina, Novi Sad, Serbia
| | - Jagos Golubovic
- Clinic of Neurosurgery, Clinical Center of Vojvodina, Novi Sad, Serbia; Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Filip Pajicic
- Clinic of Neurosurgery, Clinical Center of Vojvodina, Novi Sad, Serbia; Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Petar Vulekovic
- Clinic of Neurosurgery, Clinical Center of Vojvodina, Novi Sad, Serbia; Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
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Guo H, Liang H, Wang J, Wen S, Wang Y, Wang Y, Ma Z. Giant Intraparenchymal Meningioma in a Female Child: Case Report and Literature Review. Cancer Manag Res 2021; 13:1989-1997. [PMID: 33658857 PMCID: PMC7920497 DOI: 10.2147/cmar.s294224] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 01/29/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Intraparenchymal meningiomas without dural attachment are extremely rare, especially in female children. To our knowledge, fibrous intraparenchymal meningioma located in the temporal lobe has never been reported in female children. The significance in the differential diagnosis of lesions in the temporal lobe should be emphasized. CASE PRESENTATION A 12-year-old girl was admitted to our hospital, complaining of recurrent generalized seizures for 2 months. Magnetic resonance imaging demonstrated a solid lesion located in the temporal lobe. The lesion underwent gross total resection. Histopathological examination indicated that the lesion was a fibrous meningioma. Postoperative rehabilitation was uneventful. CONCLUSION This case report presents an extremely unusual intraparenchymal fibrous meningioma of the temporal lobe with peritumoral edema and reviewed 21 intraparenchymal meningioma cases in children and to discuss the clinical presentation and treatment, differential diagnosis, and radiological features.
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Affiliation(s)
- Huachao Guo
- Department of Neurosurgery, Henan University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou, People’s Republic of China
| | - Hao Liang
- Department of Neurosurgery, Henan University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou, People’s Republic of China
| | - Jiaguang Wang
- Department of Neurosurgery, Henan University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou, People’s Republic of China
| | - Shuo Wen
- Department of Neurosurgery, Henan University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou, People’s Republic of China
| | - Yong Wang
- Department of Neurosurgery, Henan University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou, People’s Republic of China
| | - Yushe Wang
- Department of Neurosurgery, Henan University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou, People’s Republic of China
| | - Zhen Ma
- Department of Neurosurgery, Henan University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou, People’s Republic of China
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Cao H, Jiang B, Zhao Y, Fan C. A rare subtype of meningioma: Case series of anaplastic meningioma and review of the literature. Medicine (Baltimore) 2018; 97:e11019. [PMID: 29879067 PMCID: PMC5999497 DOI: 10.1097/md.0000000000011019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Accepted: 05/18/2018] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Anaplastic meningioma, a rare subtype of meningioma, has malignant morphological characteristics and a World Health Organization (WHO) grade of III. PATIENT CONCERNS In this report, we present findings from 6 cases of anaplastic meningioma. DIAGNOSES Pathological examination of the tumors, including hematoxylin and eosin staining and immunohistochemical staining, was performed. Of the six cases of anaplastic meningioma, two were recurrent tumors from original seminoma with a WHO grade of I. Histologically, three cases had carcinoma-like morphology, one case had sarcoma-like morphology, and two had two kinds of tissue structures: carcinoma-like tumor cell nests and areas with spindle tumor cells. Necrosis was detected in most cases (5/6). Ki67 index was high and varied from 20% to 70%. INTERVENTIONS All the patients received surgery. 3 patients received adjuvant radiotherapy. 1 patient received chemotherapy. OUTCOMES 4 patients had no recurrence at follow-up of 19, 30, 46 and 54 months after the last surgery. 1 patient had recurrence 3 months after the last surgery. 1 patient died 12 days after the last surgery. LESSONS This malignant subtype can be secondary to a WHO grade I meningioma after a long quiescent period. Necrosis was common in the tumor tissues, and Ki67 index was usually high. For patients with a history of meningioma, including benign cases, regular physical examination is important for early detection of tumor recurrence and malignant transformation.
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Affiliation(s)
- Hongyi Cao
- Department of Pathology, First Affiliated Hospital and College of Basic Medical Sciences of China Medical University
| | - Biying Jiang
- Department of Pathology, First Affiliated Hospital and College of Basic Medical Sciences of China Medical University
| | - Yang Zhao
- Department of Hepatobiliary and Spleenary Surgery, The Affiliated Shengjing Hospital, China Medical University, Shenyang, China
| | - Chuifeng Fan
- Department of Pathology, First Affiliated Hospital and College of Basic Medical Sciences of China Medical University
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Liu X, Zhang Y, Zhang S, Tao C, Ju Y. Intraparenchymal Atypical Meningioma in Basal Ganglia Region in a Child: Case Report and Literature Review. J Korean Neurosurg Soc 2017; 61:120-126. [PMID: 29354244 PMCID: PMC5769854 DOI: 10.3340/jkns.2015.0609.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 10/24/2015] [Accepted: 10/25/2015] [Indexed: 02/05/2023] Open
Abstract
Intraparenchymal meningiomas without dural attachment are extremely rare, especially when they occur in basal ganglia region in child. An 8-year-old boy was admitted at our hospital, complaining of recurrent headache and vomiting for 3 months. Neurological examination showed impaired vision and mild paresis of the left extremities. Magnetic resonance imaging demonstrated a lesion located in the right basal ganglia region extending to superasellar cistern with solid, multiple cystic and necrotic components. Computed tomography revealed calcification within the mass. Due to the anterior cerebral artery involvement, a subtotal resection was achieved and postoperative radiotherapy was recommended. Histopathological examination indicated that the lesion was an atypical meningioma. The postoperative rehabilitation was uneventful. Mildly impaired vision and motor weakness of left extremities improved significantly and the patient returned to normal life after surgery. To our knowledge, intraparenchymal atypical meningioma in basal ganglia extending to superasellar cistern was never reported. The significance in differential diagnosis of lesions in basal ganglia should be emphasized.
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Affiliation(s)
- Xiaowei Liu
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China
| | - Yuekang Zhang
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China
| | - Si Zhang
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China
| | - Chuanyuan Tao
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China
| | - Yan Ju
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China
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Huntoon K, Pluto CP, Ruess L, Boué DR, Pierson CR, Rusin JA, Leonard J. Sporadic pediatric meningiomas: a neuroradiological and neuropathological study of 15 cases. J Neurosurg Pediatr 2017; 20:141-148. [PMID: 28548617 DOI: 10.3171/2017.3.peds16502] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Sporadic meningiomas have been classified in many different ways. Radiographically, these lesions can be described as occurring in either typical or atypical locations. The purpose of this study was to determine if there are any histopathological differences between sporadic meningiomas that arise in these varying locations in children. METHODS The neuroimaging, histopathological findings, and clinical records in patients with sporadic pediatric meningiomas not associated with neurofibromatosis Type 2 or prior radiation therapy were retrospectively reviewed. Tumors were classified by radiological findings as either typical or atypical, and they were categorized histopathologically by using the latest WHO nomenclature and grading criteria. RESULTS Fifteen sporadic meningiomas in pediatric patients were biopsied or resected at the authors' institution between 1989 and 2013. Five (33%) were typical in radiographic appearance and/or location and 10 (67%) were atypical. Four (80%) typical meningiomas were WHO Grade I tumors. Most (60%) of the atypical meningiomas were WHO Grade II or III. CONCLUSIONS This study is the largest series of sporadic pediatric meningiomas in atypical locations to date. Although sporadic meningiomas are relatively infrequent in children, those with atypical imaging, specifically those with apparently intraparenchymal and intraosseous locations, may be more common than previously recognized. In this study, pediatric sporadic meningiomas arising in atypical locations, in particular intraparenchymal meningiomas, may be of higher histopathological grade. The authors' findings should alert clinicians to the potential for more aggressive clinical behavior in these tumors.
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Affiliation(s)
| | | | | | - Daniel R Boué
- Pathology, The Ohio State University Wexner Medical Center; Departments of.,Pathology and Laboratory Medicine, and
| | - Christopher R Pierson
- Pathology, The Ohio State University Wexner Medical Center; Departments of.,Pathology and Laboratory Medicine, and.,Department of Biomedical Education and Anatomy, The Ohio State University College of Medicine, Columbus, Ohio; and
| | | | - Jeffrey Leonard
- Departments of 1 Neurological Surgery.,Neurosurgery, Nationwide Children's Hospital; and
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8
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Atypical Growth Pattern of an Intraparenchymal Meningioma. Case Rep Radiol 2016; 2016:7985402. [PMID: 27752384 PMCID: PMC5056287 DOI: 10.1155/2016/7985402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Revised: 08/30/2016] [Accepted: 09/07/2016] [Indexed: 12/01/2022] Open
Abstract
Meningiomas are the most common primary nonneuroglial extra-axial neoplasms, which commonly present as spherical or oval masses with a dural attachment. Meningiomas without dural attachment are rare and, according to their locations, are classified into 5 varieties, including intraventricular, deep Sylvain fissure, pineal region, intraparenchymal, or subcortical meningiomas. To the best of our knowledge, intraparenchymal meningioma with cerebriform pattern has never been reported. In this paper, we report a 34-year-old Chinese male patient who presented with paroxysmal headaches and progressive loss of vision for 10 months and blindness for 2 weeks. A thorough physical examination revealed loss of bilateral direct and indirect light reflex. No other relevant medical history and neurologic deficits were noted. Computed tomography and magnetic resonance imaging scans showed an irregular mass with a unique cerebriform pattern and extensive peritumoral edema in the parietal-occipital-temporal region of the right cerebral hemisphere. The initial diagnosis was lymphoma. Intraoperatively, the tumor was completely buried in a sulcus in the parietal-occipital-temporal region without connecting to the dura. The histological diagnosis was intracranial meningioma based on pathological examination. Therefore, when an unusual cerebriform growth pattern of a tumor is encountered, an intraparenchymal meningioma should be considered as a differential diagnosis.
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Ohba S, Abe M, Hasegawa M, Hirose Y. Intraparenchymal Meningioma: Clinical, Radiologic, and Histologic Review. World Neurosurg 2016; 92:23-30. [DOI: 10.1016/j.wneu.2016.04.098] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 04/24/2016] [Accepted: 04/25/2016] [Indexed: 11/25/2022]
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10
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Lucchesi M, Buccoliero AM, Scoccianti S, Guidi M, Farina S, Fonte C, Favre C, Genitori L, Sardi I. A successful case of an anaplastic meningioma treated with chemotherapy for soft tissue sarcomas. CNS Oncol 2016; 5:131-6. [PMID: 27226409 DOI: 10.2217/cns-2016-0005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Malignant meningioma has a bad prognosis. Surgery and radiotherapy are the most effective therapeutic options, without an established role for chemotherapy. We report a case of 2-year-old male child with diagnosis of postoperative relapse of a malignant meningioma. Considering the rapid progression, the young age and the lack of effective therapeutic alternatives, the patient underwent multidisciplinary anticancer treatment with a protocol made for soft tissue sarcomas (EpSSG NRSSTS 2005 protocol), with positive outcome. This case represents a successful management of an anaplastic meningioma with a multimodal treatment, including chemotherapy, in a pediatric patient.
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Affiliation(s)
- Maurizio Lucchesi
- Neuro-Oncology Unit, Department of Pediatric Oncology, Anna Meyer Children's University Hospital, Florence, Italy
| | - Anna M Buccoliero
- Pathology Unit, Anna Meyer Children's University Hospital, Florence, Italy
| | | | - Milena Guidi
- Neuro-Oncology Unit, Department of Pediatric Oncology, Anna Meyer Children's University Hospital, Florence, Italy
| | - Silvia Farina
- Neuro-Oncology Unit, Department of Pediatric Oncology, Anna Meyer Children's University Hospital, Florence, Italy
| | - Carla Fonte
- Neuro-Oncology Unit, Department of Pediatric Oncology, Anna Meyer Children's University Hospital, Florence, Italy
| | - Claudio Favre
- Neuro-Oncology Unit, Department of Pediatric Oncology, Anna Meyer Children's University Hospital, Florence, Italy
| | - Lorenzo Genitori
- Neurosurgery Unit, Department of Neuroscience, Anna Meyer Children's University Hospital, Florence, Italy
| | - Iacopo Sardi
- Neuro-Oncology Unit, Department of Pediatric Oncology, Anna Meyer Children's University Hospital, Florence, Italy
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11
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Abstract
The following is a report on a rare parenchyma meningioma and the computed tomography (CT) and magnetic resonance imaging (MRI) findings. To our knowledge, this was the first characterization of magnetic resonance spectroscopy (MRS) in a parenchyma meningioma. Three days after initial presentation, a 14-year-old female student reported feeling tingling in her cheek, grading 3 to 4 points. Two hours later, the tingling had disappeared. The patient was admitted to hospital with stable vital signs and no abnormal presentations upon physical examination. A routine CT scan of the brain showed a quasicircular region of the left occipital lobe was homogenous hyperdense and an arcualia calcification was found on the lesion's margin and the boundary was ill-defined. Further MRI and contrast-enhanced scanning of the brain showed that a lobulated nidus with abnormal signaling was present in the left occipital lobe and was approximately 1.9 × 2.0 cm. Hypointensity on T1-weighted imaging and a slight hyperintensity on T2-weighted imaging was also observed. A short T2 signal appeared on the margin and a few longer T2 edema zones appeared around the nidus, whereas the lesion showed homogenous enhancement. MRS was characterized by a slight or moderate increase of a choline (Cho) peak and a small reduction of the N-acetyl aspartate (NAA) peak. After completing the preoperative preparation, the excision of the supratentorial deep lesions was performed on the patient. The pathology led to a diagnosis of a left occipital lobe meningioma, WHO I. The patient was followed-up for 14 months postoperation, and had no reoccurrences. Intraparenchymal meningioma rarely occurs in brain parenchyma, and is characterized by lesions with abundant blood supply and requires a glioma to be identified. MRS is a potential tool for preoperative diagnosis of intraparenchymal meningioma.
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Affiliation(s)
- Wenjie Liang
- From the Department of Radiology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang, China
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Bansal D, Diwaker P, Gogoi P, Nazir W, Tandon A. Intraparenchymal Angiomatous Meningioma: A Diagnostic Dilemma. J Clin Diagn Res 2015; 9:ED07-8. [PMID: 26557529 DOI: 10.7860/jcdr/2015/15950.6602] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 08/26/2015] [Indexed: 11/24/2022]
Abstract
Meningioma arises from the arachnoid cap cells of the cerebrum. Intraparenchymal meningiomas or meningiomas without dural attachment are rare. We report a case of 40-year-old male who presented with a history of headache, dizziness and gradual loss of vision since one year. Clinicoradiological diagnosis of a high grade glioma was considered. Tumour was excised and haematoxylin and eosin stained sections revealed a tumour comprised predominantly of variable sized blood vessels showing hyalinization in a background of plump spindle cells with oval vesicular nuclei. In view of these features angiomatous meningioma was suspected. However, to confirm the diagnosis, a panel of immunohistochemical markers including vimentin, EMA and GFAP was done and a final diagnosis of angiomatous meningioma was offered. Angiomatous meningioma is a rare variant of meningioma and even much rarer in the intraparenchymal location. Angiomatous meningioma should be considered in the differential diagnosis of highly vascular intraparenchymal brain tumours.
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Affiliation(s)
- Divya Bansal
- Senior Resident, Department of Pathology, University College of Medical Sciences, GTB Hospital , Dilshad Garden, Delhi, India
| | - Preeti Diwaker
- Assistant Professor, Department of Pathology, University College of Medical Sciences, GTB Hospital , Dilshad Garden, Delhi, India
| | - Priyanka Gogoi
- Associate Professor, Department of Pathology, University College of Medical Sciences, GTB Hospital , Dilshad Garden, Delhi, India
| | - Wazid Nazir
- Specialist, Department of Neurosurgery, University College of Medical Sciences, GTB Hospital , Dilshad Garden, Delhi, India
| | - Anupama Tandon
- Associate Professor, Department of Radiology, University College of Medical Sciences, GTB Hospital , Dilshad Garden, Delhi, India
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