1
|
Tauziède-Espariat A, Masliah-Planchon J, Sievers P, Sahm F, Dangouloff-Ros V, Boddaert N, Hasty L, Aboubakr O, Métais A, Chrétien F, Roux A, Pallud J, Blauwblomme T, Beccaria K, Bourdeaut F, Puget S, Varlet P. A comprehensive histomolecular characterization of meningioangiomatosis: Further evidence for a precursor neoplastic lesion. Brain Pathol 2024:e13259. [PMID: 38565263 DOI: 10.1111/bpa.13259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 03/21/2024] [Indexed: 04/04/2024] Open
Abstract
Meningioangiomatosis (MAM) remains a poorly understood lesion responsible for epileptic disease. In the past, MAM was primarily described in the context of neurofibromatosis type 2 before being mainly reported sporadically. Moreover, the malformative or tumoral nature is still debated. Because a subset of MAM are associated with meningiomas, some authors argue that MAM corresponds to an infiltration pattern of these tumors. For these reasons, MAM has not been added to the World Health Organization (WHO) Classification of Central Nervous System Tumors as a specific entity. In the present study, we characterized a series of pure MAM (n = 7) and MAM associated with meningiomas (n = 4) using histopathology, immunohistochemistry, genetic (fluorescent in situ and DNA sequencing analyses), and epigenetic (DNA-methylation profiling) data. We evidenced two distinct morphological patterns: MAM with a fibroblastic-like pattern having few lesional cells, and MAM with a more cellular pattern. A subset was associated with the genetic alterations previously reported in meningiomas (such as a KMT2C mutation and a hemizygous deletion of chromosome 22q including the NF2 gene). The DNA-methylation profile, using a t-distributed stochastic neighbor embedding analysis, evidenced that MAM (pure or associated with meningiomas) clustered in a separate group from pediatric meningiomas. The present results seem to suggest that MAM represents a neoplastic lesion and encourage the further study of similar additional series so that it may be included in a future WHO classification.
Collapse
Affiliation(s)
- Arnault Tauziède-Espariat
- Department of Neuropathology, GHU Paris-Psychiatrie et Neurosciences, Sainte-Anne Hospital, Paris, France
| | - Julien Masliah-Planchon
- Institut Curie, Laboratory of Somatic Genetics, PMDT, Paris Sciences Lettres Research University, Paris, France
| | - Philipp Sievers
- Department of Neuropathology, Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Consortium for Translational Cancer Research (DKTK), German Cancer Research Center DKFZ, Heidelberg, Germany
| | - Felix Sahm
- Department of Neuropathology, Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Consortium for Translational Cancer Research (DKTK), German Cancer Research Center DKFZ, Heidelberg, Germany
| | - Volodia Dangouloff-Ros
- Pediatric Radiology Department, Hôpital Necker Enfants Malades, AP- HP, France
- Université Paris Cité, UMR 1163, Institut Imagine and INSERM U1299, Paris, France
| | - Nathalie Boddaert
- Pediatric Radiology Department, Hôpital Necker Enfants Malades, AP- HP, France
- Université Paris Cité, UMR 1163, Institut Imagine and INSERM U1299, Paris, France
| | - Lauren Hasty
- Department of Neuropathology, GHU Paris-Psychiatrie et Neurosciences, Sainte-Anne Hospital, Paris, France
| | - Oumaima Aboubakr
- Department of Neuropathology, GHU Paris-Psychiatrie et Neurosciences, Sainte-Anne Hospital, Paris, France
| | - Alice Métais
- Department of Neuropathology, GHU Paris-Psychiatrie et Neurosciences, Sainte-Anne Hospital, Paris, France
- Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Ima-Brain team, Paris, France
| | - Fabrice Chrétien
- Department of Neuropathology, GHU Paris-Psychiatrie et Neurosciences, Sainte-Anne Hospital, Paris, France
| | - Alexandre Roux
- Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Ima-Brain team, Paris, France
- Department of Neurosurgery, GHU Paris-Psychiatrie et Neurosciences, Sainte-Anne Hospital, Paris, France
| | - Johan Pallud
- Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Ima-Brain team, Paris, France
- Department of Neurosurgery, GHU Paris-Psychiatrie et Neurosciences, Sainte-Anne Hospital, Paris, France
| | - Thomas Blauwblomme
- Department of Pediatric Neurosurgery, Necker Hospital, APHP, Université Paris Descartes, Paris, France
| | - Kévin Beccaria
- Department of Pediatric Neurosurgery, Necker Hospital, APHP, Université Paris Descartes, Paris, France
| | - Franck Bourdeaut
- SIREDO Center Care, Innovation, Research In Pediatric, Adolescent and Young Adult Oncology, Curie Institute and Paris Descartes University, Paris, France
| | - Stéphanie Puget
- Department of Neurosurgery, CHU Martinique, Fort-de-France, France
| | - Pascale Varlet
- Department of Neuropathology, GHU Paris-Psychiatrie et Neurosciences, Sainte-Anne Hospital, Paris, France
- Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Ima-Brain team, Paris, France
| |
Collapse
|
2
|
Ge R, Yang J, Yin X, Wang J. Case report: Meningioma associated with meningioangiomatosis mimicking invasive meningioma. Front Neurol 2023; 14:1200827. [PMID: 37448750 PMCID: PMC10336209 DOI: 10.3389/fneur.2023.1200827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 06/15/2023] [Indexed: 07/15/2023] Open
Abstract
Meningioangiomatosis (MA) is a rare malformation or hamartomatous lesion in the central nervous system, characterized by a plaque-like mass within the leptomeninges and cerebral cortex. An even rarer condition is MA complicated with meningiomas. We herein report a case of meningioma associated with MA that might be erroneously interpreted as a higher-grade lesion or an invasion by preoperative radiologic and postoperative histological examinations.
Collapse
Affiliation(s)
- Rong Ge
- Ningbo Clinical Pathology Diagnosis Center, Ningbo, China
| | - Jun Yang
- Ningbo Clinical Pathology Diagnosis Center, Ningbo, China
| | - Xiangang Yin
- Ningbo Clinical Pathology Diagnosis Center, Ningbo, China
| | - Jingya Wang
- Surgery Center, The Affiliated People’s Hospital of Ningbo University, Ningbo, China
| |
Collapse
|
3
|
Hassan O, Ghanchi H, DeLos Reyes K, Raghavan R, Minasian T. Pediatric Temporal Lobe Meningioma With Meningioangiomatosis Mimicking Invasive Meningioma. Cureus 2021; 13:e18819. [PMID: 34804676 PMCID: PMC8592784 DOI: 10.7759/cureus.18819] [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] [Accepted: 10/16/2021] [Indexed: 12/02/2022] Open
Abstract
Meningiomas combined with meningioangiomatosis (MA-M) present similarly to more invasive lesions because of their appearance on neuroimaging. These lesions are especially rare in pediatric patients and suggestive imaging can help identify them for differential diagnosis. An 11-year-old male child who presented with diplopia and a headache was found to have an edematous invasive appearing temporal lobe mass on magnetic resonance imaging. Despite the lesion’s appearance, it was completely resected and found to be a benign MA-M upon histopathologic examination. The present case demonstrated a rare meningioma with meningioangiomatosis that appeared to be a higher grade or invasive lesion upon initial imaging in a pediatric patient. A review of the literature was performed on patients who presented similarly. Despite the rarity of this condition in children, neuroimaging should be carefully examined prior to surgical resection of similar masses in preparation for highly vascular tissue, and post-operative course can be better anticipated when MA-M is considered during differential diagnosis.
Collapse
Affiliation(s)
- Omron Hassan
- Clinical Sciences, Touro University Nevada College of Osteopathic Medicine, Henderson, USA
| | - Hammad Ghanchi
- Neurosurgery, Riverside University Health System Medical Center, Moreno Valley, USA
| | | | - Ravi Raghavan
- Neuropathology, Loma Linda University Medical Center, Loma Linda, USA
| | - Tanya Minasian
- Neurosurgery, Loma Linda University Medical Center, Loma Linda, USA
| |
Collapse
|
4
|
Makary MS, Kobalka P, Giglio P, Slone HW. Meningioangiomatosis: Clinical, Imaging, and Histopathologic Characteristics. J Clin Imaging Sci 2020; 10:36. [PMID: 32637227 PMCID: PMC7332468 DOI: 10.25259/jcis_39_2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 05/26/2020] [Indexed: 11/04/2022] Open
Abstract
Meningioangiomatosis is a rare benign lesion involving the central nervous system. Radiographic appearance can be highly variable which makes pre-operative diagnosis difficult. In this report, we describe meningioangiomatosis in a previously healthy 17-year-old woman who presented with seizures and continued headache and dizziness. This patient presented with a predominately calcified lesion on imaging and eventually underwent near total resection. Meningioangiomatosis is difficult to preoperatively identify, but is an important consideration as prognosis with surgical resection is typically good.
Collapse
Affiliation(s)
- Mina S Makary
- Department of Radiology, Division of Neuroradiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Peter Kobalka
- Department of Pathology, Division of Neuropathology, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Pierre Giglio
- Department of Neurology, Division of Neuro-Oncology, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - H Wayne Slone
- Department of Radiology, Division of Neuroradiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| |
Collapse
|
5
|
Meningioma with rhabdoid features combined with meningioangiomatosis in infancy: a novel combination. Childs Nerv Syst 2020; 36:1311-1314. [PMID: 31897634 DOI: 10.1007/s00381-019-04486-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 12/19/2019] [Indexed: 10/25/2022]
Abstract
Meningioangiomatosis is a rare histologically distinct abnormality that is occasionally associated with intracranial meningioma. The rhabdoid variant of meningioma is also uncommon and is classified as a World Health Organization Grade III tumour. We report a case of meningioangiomatosis in conjunction with a meningioma with prominent rhabdoid features, in an infant male who underwent complete surgical resection of the lesion. The patient has been followed up for 6 years with no disease recurrence. To our knowledge, this is the first report in the literature describing meningioangiomatosis combined with a meningioma with rhabdoid features.
Collapse
|
6
|
Dantio MC, Dennis AJ, Bergman RL. Surgical Treatment of Suspected Meningioangiomatosis in the Thoracolumbar Spinal Cord. J Am Anim Hosp Assoc 2020; 56:e56401. [PMID: 32412338 DOI: 10.5326/jaaha-ms-6874] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A 5 yr old male neutered Labrador retriever was evaluated for an 8 wk history of a slowly progressive abnormal hind limb gait that did not respond to treatment with nonsteroidal anti-inflammatories. Initial examination findings were mild pelvic limb ataxia and moderate right pelvic limb lameness. A computed tomography with a myelogram was performed and showed a suspected intramedullary spinal mass. MRI was conducted and supported the computed tomography with myelogram findings of a possible intradural spinal mass at L1. A left-sided hemilaminectomy followed by a durotomy at L1 was performed and a firm, tan mass was removed. The histopathologic findings indicated a vascular proliferation most suggestive of a rare proliferative disorder of leptomeningeal blood vessels termed meningioangiomatosis. Although the dog's signs initially worsened after surgery and he was nonambulatory with marked paraparesis, he regained ambulation within 3-4 wk after the operation. Eighteen months after surgery, he was ambulatory with mild hind limb ataxia with no progression of signs. This case suggests that surgical resection of lesions of suspected meningioangiomatosis can result in improvement of clinical signs with a good long-term prognosis.
Collapse
Affiliation(s)
- Marie C Dantio
- From Carolina Veterinary Specialists, Rock Hill, South Carolina (M.C.D., R.L.B.); and IDEXX, Westbrook, Maine (A.J.D.)
| | - Amanda J Dennis
- From Carolina Veterinary Specialists, Rock Hill, South Carolina (M.C.D., R.L.B.); and IDEXX, Westbrook, Maine (A.J.D.)
| | - Robert L Bergman
- From Carolina Veterinary Specialists, Rock Hill, South Carolina (M.C.D., R.L.B.); and IDEXX, Westbrook, Maine (A.J.D.)
| |
Collapse
|
7
|
Roux A, Mellerio C, Lechapt-Zalcman E, Still M, Zerah M, Bourgeois M, Pallud J. Left Frontal Meningioangiomatosis Associated with Type IIIc Focal Cortical Dysplasia Causing Refractory Epilepsy and Literature Review. World Neurosurg 2018; 114:281-288. [DOI: 10.1016/j.wneu.2018.03.145] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Revised: 03/20/2018] [Accepted: 03/21/2018] [Indexed: 01/29/2023]
|
8
|
Donovan DJ, Thavapalan V. Pediatric Meningeal Tumors of the Sylvian Fissure Region without Dural Attachment: A Series of Three Patients and Review of the Literature. Surg J (N Y) 2016; 2:e31-e36. [PMID: 28824987 PMCID: PMC5553465 DOI: 10.1055/s-0036-1584166] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 03/24/2016] [Indexed: 11/19/2022] Open
Abstract
Pediatric meningeal tumors are rare, but those in the region of the sylvian fissure without dural attachment are extremely rare, with only 24 previously reported cases in the world literature. In this series, we report two additional cases of sylvian fissure meningioma without dural attachment and one case of perisylvian meningioangiomatosis in the medial temporal lobe. All three patients presented with complex partial seizures, but the diagnosis was delayed in each case because the symptoms were misinterpreted to be behavioral rather than epileptic. The seizures were eventually confirmed with electroencephalogram, and subsequent imaging showed enhancing masses within the sylvian fissure region that were at least partially calcified in all three cases. Each patient underwent craniotomy. In the first case, gross total resection was achieved, and in the second case, a small residual portion of tumor was densely calcified and adherent to the middle cerebral artery branches. Both of these were World Health Organization (WHO) grade I meningiomas. The third patient underwent biopsy and limited resection of meningioangiomatosis. No dural attachments were noted in any of the tumors, but one of the meningiomas was intraparenchymal in location, surrounding the sylvian fissure in both the frontal and temporal lobes, which has been described in only a small number of these cases previously. The patients underwent pre- and postsurgical neuropsychiatric testing and did not experience any significant cognitive deficits. At 10-year follow-up, the patient who had gross total resection of the tumor has had no recurrence and is seizure-free without anticonvulsant medications. The incompletely resected intraparenchymal meningioma in the second patient recurred after 5 years, however, and at repeat surgery was found to have transformed to a WHO grade II tumor. Radiation therapy was delivered and the tumor has been stable for 2 years, but the patient continues to have occasional seizures despite medication. The patient with meningioangiomatosis has had no further growth and has excellent control of seizures but remains on medication. We review the clinical presentation of these rare tumors and discuss the treatment, outcomes, and possible relationship of meningiomas to meningioangiomatosis.
Collapse
Affiliation(s)
- Daniel Joseph Donovan
- Department of Surgery, University of Hawaii-John A. Burns School of Medicine, Honolulu, Hawaii
| | - Varoon Thavapalan
- Department of Neurological Surgery, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania
| |
Collapse
|
9
|
Zhang C, Wang Y, Wang X, Zhang JG, Li JJ, Hu WH, Zhang K. Sporadic meningioangiomatosis with and without meningioma: analysis of clinical differences and risk factors for poor seizure outcomes. Acta Neurochir (Wien) 2015; 157:841-53; discussion 853. [PMID: 25757842 DOI: 10.1007/s00701-015-2375-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 02/19/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Meningioangiomatosis (MA) is a rare cerebral lesion. Sporadic MA occasionally combines with meningioma (MA-M). The aim of the present study was to clarify whether MA-M and pure MA have clinical differences and to determine risk factors for unsatisfactory seizure outcomes in sporadic MA. METHODS We reported 14 sporadic MA cases in our center and conducted a literature review. We compared the demographic, clinical, imaging, electrophysiological and pathological features and surgical outcomes. Logistic regression analysis was performed to evaluate the risk factors for poor seizure outcomes. RESULTS MA-M cases showed a more prominent male predilection (4.2 times vs. 1.6 times, p = 0.04), a shorter duration of symptoms (2.8 ± 0.8 years vs. 5.2 ± 0.6 years, p = 0.02), and a lower seizure incidence (53.6 % vs. 89.3 %, p < 0.001) as compared to pure MA. A gyriform alteration on imaging was exclusively associated with pure MA. The Ki-67 was higher in the meningioma component than in the MA component in MA-M (1.2 ± 0.3 % vs. 6.1 ± 1.1 %, p < 0.001). Lesions located in the temporal lobe predicted poor seizure outcomes (p = 0.02, OR = 4.4, 95 % confidence interval, 1.24-15.89). CONCLUSION Clinical differences may be caused by the different biological natures. MA-M seems to be a neoplastic lesion, while pure MA seems to be a non-neoplastic lesion. Long-term follow-up is required for MA-M. Because the coexistence of hippocampal sclerosis may explain the poor seizure outcomes of MA located in the temporal lobe, it is important to identify underlying hippocampal sclerosis and to perform complete resection.
Collapse
Affiliation(s)
- Chao Zhang
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, No. 6, Tian Tan Xi Li, Beijing, 100050, China
| | | | | | | | | | | | | |
Collapse
|
10
|
Familial syndromes associated with intracranial tumours: a review. Childs Nerv Syst 2014; 30:47-64. [PMID: 24193148 DOI: 10.1007/s00381-013-2309-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2013] [Accepted: 10/15/2013] [Indexed: 12/15/2022]
Abstract
BACKGROUND Most cancers of the central nervous system (CNS) occur sporadically in the absence of any known underlying familial disorder or multi-systemic syndrome. Several syndromes are associated with CNS malignancies, however, and their recognition has significant implications for patient management and prognosis. Patients with syndrome-associated CNS malignancies often have multiple tumours (either confined to one region or distributed throughout the body), with similar or different histology. OBJECTIVE This review examines syndromes that are strongly associated with CNS cancers: the phakomatosis syndromes, familial syndromes such as Li-Fraumeni and familial polyposis syndromes and dyschondroplasia.
Collapse
|
11
|
Abstract
Meningioangiomatosis consists of benign hamartomatous lesions of the brain and the leptomeninges, which typically present with seizure. Management is predicated on resection and control of seizures with medication. Lesions are typically solitary. Multifocal meningioangiomatosis is extremely rare, with only 2 cases reported in adults and none in children. The authors report the first case, to their knowledge, of multifocal meningioangiomatosis in a child. This unique case highlights therapeutic challenges associated with these lesions and demonstrates that multifocality is possible in the pediatric population. This finding has implications for diagnosis and follow-up for children afflicted with these tumors.
Collapse
Affiliation(s)
- Osama Jamil
- Departments of Neurosurgery, Children’s Hospital Boston, Harvard Medical School
| | - Shakti Ramkissoon
- Departments of Pathology, Children’s Hospital Boston, Harvard Medical School
| | - Rebecca Folkerth
- Departments of Pathology, Children’s Hospital Boston, Harvard Medical School
| | - Edward Smith
- Departments of Neurosurgery, Children’s Hospital Boston, Harvard Medical School
| |
Collapse
|
12
|
Clinicopathological features of meningioangiomatosis associated with meningioma: a case report with literature review. Case Rep Oncol Med 2012. [PMID: 23198201 PMCID: PMC3502778 DOI: 10.1155/2012/296286] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Aim. To analyze the clinicopathological features of meningioangiomatosis (MA) associated with meningioma. Methods. We present one case of MA associated with meningioma. Histopathological examination and immunohistochemistry were used. Results. The age of the patient was 33-year-old man. Histopathologically, MA was characterized by vascular proliferation with perivascular meningothelial cells and/or fibroblast proliferation, entrapped glial islands. In addition, MA was associated with transitional meningioma. The patient was alive without evidence of recurrence at 18 months after mass resection. Conclusion. MA associated with meningioma is an extremely rare lesion. The differential diagnosis includes cortical invasion by meningioma and intracerebral schwannoma. Patients with MA associated with meningioma often have a good prognosis after operation.
Collapse
|
13
|
Abstract
Modern epilepsy started in India in 1995 at Sri Chitra Tirunal Institute of Medical Science and Technology, Trivandrum and at All India Institute of Medical Sciences, New Delhi. At both centres the attempt was to get the program going with patients having surgically remediable epilepsy syndromes -who could be evaluated with non invasive investigations. The mainstay of the evaluation was a good quality epilepsy specific MRI and video EEG coupled with a SPECT study and a neuropsychological evaluation. Concordance of the focus on all investigations was critical to a good outcome. There were several problems on the way - but they were managed keeping in consideration our local needs and requirements. Intraoperative electocorticography was done and good outcomes attained. The critical determinants of success were the formation of a team with various interdisciplinary specialists and a strong will to succeed.
Collapse
Affiliation(s)
- V P Singh
- Department of Neurosurgery, Indraprastha Apollo Hospital, New Delhi, India
| |
Collapse
|
14
|
Meningioangiomatosis: a case report and literature review emphasizing diverse appearance on different imaging modalities. Case Rep Neurol Med 2011; 2011:361203. [PMID: 22937336 PMCID: PMC3420442 DOI: 10.1155/2011/361203] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2011] [Accepted: 06/20/2011] [Indexed: 11/23/2022] Open
Abstract
Purpose. Meningioangiomatosis (MA) is a rare, benign lesion that commonly mimics other intracranial malformations in clinical presentation and appearance on imaging. The case presented and the literature review performed highlight the importance of combining MRI and CT results to better characterize intracranial lesions and including MA on the list of differential diagnoses of patients presenting with seizures. Methods. The case described is of a 19-year-old male with a 10-year history of worsening seizures refractory to multiple drug regimens. MRI revealed an atypical vascular malformation. The patient underwent surgical resection of the epileptogenic cortex. Results. Although the radiologic impression of the lesion was a vascular malformation, pathological examination revealed MA. A literature search performed highlights the variability of the appearance of MA on CT and MRI and suggests the utility of the T2 GRE sequence in illustrating the presence of calcification and, in a lesion with other characteristic features, the diagnosis of MA. Conclusion. MA can be a difficult diagnosis to make based on imaging findings alone. However, in a patient with a characteristic history and presentation, the presence of a calcified mass on CT and MRI brain susceptibility artifact on a T2 GRE sequence may suggest MA.
Collapse
|
15
|
Shi HJ, Zhao SL, Tian XY, Li Z, Huang Q, Li B. Meningioangiomatosis-associated meningioma misdiagnosed as glioma by radiologic and intraoperative histological examinations. Brain Tumor Pathol 2011; 28:347-52. [DOI: 10.1007/s10014-011-0045-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2011] [Accepted: 05/24/2011] [Indexed: 11/29/2022]
|
16
|
Pediatric meningioma: current approaches and future direction. J Neurooncol 2011; 104:1-10. [DOI: 10.1007/s11060-010-0503-3] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2010] [Accepted: 12/13/2010] [Indexed: 01/09/2023]
|
17
|
Chen YY, Tiang XY, Li Z, Luo BN, Huang Q. Sporadic meningioangiomatosis-associated atypical meningioma mimicking parenchymal invasion of brain: a case report and review of the literature. Diagn Pathol 2010; 5:39. [PMID: 20565869 PMCID: PMC2904739 DOI: 10.1186/1746-1596-5-39] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2010] [Accepted: 06/18/2010] [Indexed: 11/10/2022] Open
Abstract
Meningioangiomatosis is a rare hamartomatous lesion or meningiovascular malformation in brain. In extremely rare condition, meningioma may occur together with meningioangiomatosis, and only 19 cases have been described in English literature until now. We now report a case of meningioangiomatosis-associated meningioma with atypical and clear cell variant. A 34-year-old man presented a 3-month history of progressive numbness and weakness of his left lower extremity. He had no stigmata of neurofibromatosis type 2. Magnetic resonance imaging (MRI) revealed multifocal lesions in the right frontoparietal lobe. The lesions were totally removed. Microscopically, parts of lesions were atypical and clear cell meningioma corresponding to WHO grade II. The adjacent brain parenchyma showed the histological features of meningioangiomatosis. Neoplastic cells in atypical meningioma area were immunoreactive to epithelial membrane antigen (EMA) with high MIB-1 index of up to 20%. However, the spindle cells in meningioangiomatosis area were negative for EMA with low MIB-1 index of up to 1%. The diagnosis of atypical meningioma associated with sporadic meningioangiomatosis was made. To our knowledge, this is the first case of a meningioangiomatosis-associated meningioma with atypical and clear cell variant component to be described. The patient had been followed-up for 11 months without adjuvant radiotherapy or chemotherapy. No tumor recurrence was found during this period. Meningioangiomatosis-associated meningioma is more likely to occur in younger patients and histologically to mimic parenchymal invasion of brain. We suggest that postoperative radiotherapy or chemotherapy should be given careful consideration to avoid over-treatment due to erroneously interpret as malignant meningioma.
Collapse
Affiliation(s)
- Yan-Yang Chen
- Department of Pathology, the First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Road II, Guangzhou 510080, China
| | | | | | | | | |
Collapse
|
18
|
Arcos A, Serramito R, Santín J, Prieto A, Gelabert M, Rodriguez-Osorio X, Reyes R. Meningioangiomatosis: clinical-radiological features and surgical outcome. Neurocirugia (Astur) 2010; 21:461-6. [DOI: 10.1016/s1130-1473(10)70098-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
19
|
Kim SH, Yoon SH, Kim JH. A case of infantile meningioangiomatosis with a separate cyst. J Korean Neurosurg Soc 2009; 46:252-6. [PMID: 19844627 DOI: 10.3340/jkns.2009.46.3.252] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2008] [Revised: 03/10/2009] [Accepted: 08/17/2009] [Indexed: 11/27/2022] Open
Abstract
Meningioangiomatosis (MA) is a rare congenital tumor that occurs mostly in 5-15 year old children. There have been only 5 cases previously reported that described the cystic nature within these tumors. We present a case of a MA accompanied by a separate macrocyst. A normally developed 2 year-old female patient presented with partial and generalized seizures. The brain computerized tomogram and magnetic resonance imaging revealed the presence of a calcified mass accompanied by a cyst in the right parietal area, surrounded by low density and high attenuation edema and hemorrhage. Upon right parietal craniotomy, a 1.6 cm x 1.2 cm x 0.5 cm sized plate-like, gray-white, slightly hard mass was seen and it was completely excised. Approximately 1 cm from the mass in the anterior lateral direction, a cyst was found and subsequent biopsy of the cyst wall revealed no tumor tissue, and therefore the cyst was not removed. Pathologic report demonstrated the meningioangiomatosis. Follow up examination 2 years later showed no recurrence of the tumor, and there was no evidence of neurological deficits. Authors suggest that cysts that arise in the surrounding tissues of tumors may not be tumor cysts, and do not require surgical removal.
Collapse
Affiliation(s)
- Seong Ho Kim
- Department of Neurosurgery, College of Medicine, Yeungnam University, Daegu, Korea
| | | | | |
Collapse
|
20
|
Ginel PJ, Blanco B, Pérez J, Zafra R, Novales M, Pérez-Écija RA. Meningioangiomatosis associated with fibrous meningioma in a dog. Vet Rec 2009; 164:756-8. [DOI: 10.1136/vr.164.24.756] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
| | | | - J. Pérez
- Department of Pathology; School of Veterinary Medicine; University of Córdoba; Spain
| | - R. Zafra
- Department of Pathology; School of Veterinary Medicine; University of Córdoba; Spain
| | - M. Novales
- Department of Animal Medicine and Surgery
| | - R. A. Pérez-Écija
- Department of Pathology; School of Veterinary Medicine; University of Córdoba; Spain
| |
Collapse
|