Altunrende ME, Göker B, Dolgun M, Akçakaya MO, Kasımcan MÖ, Şencan F, Hamamcıoğlu MK, Kırış T. Intracranial cystic meningiomas: A series of six patients.
Neurocirugia (Astur) 2019;
30:159-166. [PMID:
30792109 DOI:
10.1016/j.neucir.2019.01.003]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 10/10/2018] [Accepted: 01/14/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE
Although meningiomas are the most common primary non-glial intracranial tumors, cystic meningiomas are quite rare. This study presents six cases in order to discuss the radiological and pathological features of cystic meningiomas.
PATIENTS AND METHODS
Six patients with cystic meningiomas were included in the study. All patients underwent a cranial computed tomography scan and magnetic resonance imaging (MRI) evaluation, pre- and postoperatively.
RESULTS
All patients presented with long standing headache dating back at least two years. There was no gender predominance in our series. Radiological evaluation revealed two parasagittal and two convexity meningiomas located at the frontal region. Two lesions were located at the tuberculum sellae and the foramen magnum. All of the tumors were totally excised (Simpson Grade I or II). Pathology results included meningothelial meningioma in three patients, angiomatous meningioma in two patients, and metaplastic meningioma in one patient. In two patients, the cystic meningiomas were resected with the use of sodium fluorescein (Na-Fl) under a YELLOW 560nm microscope filter. Na-Fl was found to be very useful in demonstrating the brain-tumor interface, and it was especially effective in resecting the cyst wall of the peritumoural cystic meningiomas. None of the patients had any complications, and no recurrences were noted in any of the patients within the mean follow-up period of 51 months (range: 16-102 months).
CONCLUSION
It is important to note MRI changes specific to cystic meningioma and include meningiomas in the differential diagnosis of intracranial cystic lesions. The use of sodium fluorescein (Na-Fl) under a YELLOW 560nm microscope filter is a useful tool to differentiate the brain-tumor interface, as well as to identify the cyst wall in order to fully resect the tumor with the cystic component to avoid recurrence and achieve better clinical results.
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