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Cai Q, Wang S, Zheng M, Qin H, Feng D. Intraparenchymal atypical meningioma in the posterior fossa: a case report and literature review. Br J Neurosurg 2023; 37:1167-1170. [PMID: 33595378 DOI: 10.1080/02688697.2021.1884651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 01/28/2021] [Indexed: 10/22/2022]
Abstract
Intraparenchymal meningiomas without dural attachments are extremely rare. A 32-year-old female adult was admitted to our hospital, complaining of occasional dizziness. The patient had no neurological deficits. MRI demonstrated a lesion with mild edema located in the left cerebellar parenchyma. CT revealed calcification within the mass. Gross total resection was achieved. The histopathological examination indicated that the lesion was an atypical meningioma (WHO-II). We herein report an extremely rare case of an intraparenchymal meningioma located in the left cerebellar hemisphere. The significance of the differential diagnosis of lesions in the cerebellum should be emphasized.
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Affiliation(s)
- Qing Cai
- Department of Neurosurgery, Tangdu hospital, The Fourth Military Medical University, Xi'an, People's Republic of China
| | - Shoujie Wang
- Department of Neurosurgery, Tangdu hospital, The Fourth Military Medical University, Xi'an, People's Republic of China
| | - Min Zheng
- Department of Neurosurgery, Tangdu hospital, The Fourth Military Medical University, Xi'an, People's Republic of China
| | - Huaizhou Qin
- Department of Neurosurgery, Tangdu hospital, The Fourth Military Medical University, Xi'an, People's Republic of China
| | - Dayun Feng
- Department of Neurosurgery, Tangdu hospital, The Fourth Military Medical University, Xi'an, People's Republic of China
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2
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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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3
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Khojah O, Aljohani S, Aldahlawi A, Samkari A, Alzahrani M. Intraparenchymal meningioma in the parieto-occipital region: A case report of a diagnostically challenging tumor. Surg Neurol Int 2023; 14:135. [PMID: 37151446 PMCID: PMC10159323 DOI: 10.25259/sni_131_2023] [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: 02/08/2023] [Accepted: 03/29/2023] [Indexed: 05/09/2023] Open
Abstract
Background Intraparenchymal meningioma is a rare entity of one of the most common brain tumors. It is challenging to diagnose preoperatively due to the vague clinical presentation and absence of stereotypical radiological features. These atypical features might mislead the differential to favor high-grade gliomas or brain metastasis. Case Description We describe a case of a 46-year-old male who presented with vertigo, right-sided sensorineural hearing loss, and bilateral blurred vision. Contrast-enhanced magnetic resonance imaging of the brain revealed a large parieto-occipital contrast-enhanced mass with a multi-loculated cystic component and diffusion restriction but without dural attachment. A gross total reaction was achieved, and the histopathological results yielded a World Health Organization Grade I meningioma diagnosis. The patient exhibited no signs of recurrence after 2 years of follow-up. Conclusion Intraparenchymal meningiomas are difficult to identify without histopathological assessment. We emphasize the importance of considering this diagnosis when outlining an initial differential as it may direct management planning. Total surgical resection is the best treatment modality for such cases; however, radiotherapy is a valuable option. The prognosis of intraparenchymal meningiomas is generally favorable.
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Affiliation(s)
- Osama Khojah
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
- Department of Medicine, Ministry of the National Guard-Health Affairs, Jeddah, Saudi Arabia
| | - Sara Aljohani
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Abdulaziz Aldahlawi
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
- Department of Neurosurgery, King Abdulaziz Medical City, National Guard Health Affairs, Jeddah, Saudi Arabia
| | - Alaa Samkari
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
- Department of Anatomical Pathology, King Abdulaziz Medical City, National Guard Health Affairs, Jeddah, Saudi Arabia
| | - Moajeb Alzahrani
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
- Department of Neurosurgery, King Abdulaziz Medical City, National Guard Health Affairs, Jeddah, Saudi Arabia
- Corresponding author: Moajeb Alzahrani, Department of Neurosurgery, King Abdulaziz Medical City, National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.
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Diyora B, Kukreja S, Dhal G, Devani K, Patel M, Wankhede R. Extra-Axial Cystic Meningioma without Dural Attachment in an Adult: Case Report and Review of Literature. Asian J Neurosurg 2022; 17:173-177. [PMID: 36120614 PMCID: PMC9473807 DOI: 10.1055/s-0042-1751010] [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] [Indexed: 11/17/2022] Open
Abstract
Intraparenchymal meningiomas, meningiomas without dural attachment, and cystic meningioma are atypical and extremely rare, especially in adults. Only four cases of intraparenchymal cystic meningioma without dural attachment have been reported. A 47-year-old female presented with an altered sensorium. She had a progressive bifrontal headache for 2 months. Computed tomography scan of the brain showed an 8 cm × 6 cm cystic lesion with a solid component in the left frontoparietal region with a midline shift. The solid part of the lesion was enhancing on contrast but the cyst rim was not. Intraoperatively, the cyst was filled with amber-colored fluid, which was drained, and the solid component was completely excised. Histopathological examination of the solid tumor component confirmed cystic meningioma. At 2 years of follow-up, she has no evidence of recurrence. We report the fifth case of this very rare entity and review the literature.
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Affiliation(s)
- Batuk Diyora
- Department of Neurosurgery, Lokmanya Tilak Municipal General Hospital, Sion, Mumbai, Maharashtra, India
| | - Sanjay Kukreja
- Department of Neurosurgery, Lokmanya Tilak Municipal General Hospital, Sion, Mumbai, Maharashtra, India
| | - Gagan Dhal
- Department of Neurosurgery, Lokmanya Tilak Municipal General Hospital, Sion, Mumbai, Maharashtra, India
| | - Kavin Devani
- Department of Neurosurgery, Lokmanya Tilak Municipal General Hospital, Sion, Mumbai, Maharashtra, India
| | - Mehool Patel
- Department of Neurosurgery, Lokmanya Tilak Municipal General Hospital, Sion, Mumbai, Maharashtra, India
| | - Ravi Wankhede
- Department of Neurosurgery, Lokmanya Tilak Municipal General Hospital, Sion, Mumbai, Maharashtra, India
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Cazzato G, Internò V, Cimmino A, Messina R, Tucci M, Lettini T, Resta L, Ingravallo G. Papillary Meningioma: Case Presentation with Emphasis on Surgical and Medical Therapy of a Rare Variant of Meningioma. Diseases 2021; 9:diseases9030063. [PMID: 34562970 PMCID: PMC8482187 DOI: 10.3390/diseases9030063] [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: 07/19/2021] [Revised: 09/10/2021] [Accepted: 09/13/2021] [Indexed: 02/05/2023] Open
Abstract
Meningioma is one of the most frequent neoplasms of all in the central nervous system. Different variants are known, and of these some have peculiar characteristics, both from a morphological point of view and from a biological point of view. Here, we present a rare case of relapsed papillary meningioma in a young patient, focusing on histological characteristics, medical-surgical therapy and focusing on the risk of progression and/or recurrence of the lesion if not completely eradicated. Finally, we provide detailed molecular characteristics of the case in question.
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Affiliation(s)
- Gerardo Cazzato
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari Aldo Moro, 70124 Bari, Italy; (A.C.); (T.L.); (L.R.)
- Correspondence: (G.C.); (G.I.); Tel.: +39-340-5203641 (G.C.)
| | - Valeria Internò
- Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, 70124 Bari, Italy; (V.I.); (M.T.)
| | - Antonietta Cimmino
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari Aldo Moro, 70124 Bari, Italy; (A.C.); (T.L.); (L.R.)
| | - Raffaella Messina
- Neurosurgery Unit, Department of Basic Medical Science, Neurosciences and Sense Organs, “Aldo Moro” University of Bari Medical School, 70124 Bari, Italy;
| | - Marco Tucci
- Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, 70124 Bari, Italy; (V.I.); (M.T.)
| | - Teresa Lettini
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari Aldo Moro, 70124 Bari, Italy; (A.C.); (T.L.); (L.R.)
| | - Leonardo Resta
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari Aldo Moro, 70124 Bari, Italy; (A.C.); (T.L.); (L.R.)
| | - Giuseppe Ingravallo
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari Aldo Moro, 70124 Bari, Italy; (A.C.); (T.L.); (L.R.)
- Correspondence: (G.C.); (G.I.); Tel.: +39-340-5203641 (G.C.)
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6
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Zhang GS, Zhang YY, He F, Ou ML, Wang LK, Liao L, Ran RJ, Xiang HH, Chen JH, Wang SJ. Primary intracranial papillary meningioma: Analysis of factors of prognosis and systematic review. J Clin Neurosci 2021; 91:118-124. [PMID: 34373015 DOI: 10.1016/j.jocn.2021.06.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 06/14/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Papillary meningioma is rare and displays an aggressive clinical behavior with poor prognosis. Therefore, we performed an extensive literature review to evaluate the adverse factors and treatment strategy of survival. METHOD We performed Ovid, Medline, Embase, Pubmed, Web of Science and Cochrane database queries for articles published between 1938 and 2019 with the search term "WHO grade III meningioma" or "papillary meningioma" and "central nervous system", "cerebral", or "intracranial". RESULTS After a careful evaluation, a total of 19 studies were included. The entire cohort included the 67 patients, 34 (50.7%) were male and 33 (49.3%) were female with a mean age of 32.6 ± 2.1 years ranging from 4.5 months to 74 years. Gross total resection was achieved in 48 (71.6%) cases, and 29 (51.8%) patients received postoperative radiation. The mean follow-up period was 42.3 ± 4.4 months (range, 2-197 months). Thirty-six (53.7%) patients happened to recurrences, 11 (16.4%) patients happened to extracranial metastasis and 25 (37.3%) patients died. Univariate analysis revealed that the MIB > 5% trended toward a shorter time to recurrence (p = 0.084). Gross total resection was associated with favorable progression-free survival (p = 0.007) and overall survival (p = 0.001). Postoperative radiation was associated with favorable progression-free survival (p = 0.001). CONCLUSIONS Gross total resection and adjuvant radiation were recommended as the initial treatment option for patients with papillary meningioma.
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Affiliation(s)
- Gui-Sheng Zhang
- Department of Neurosurgery, Minda Hospital of Hubei Minzu University, Enshi, China
| | - Yan-Yan Zhang
- Department of Neurosurgery, Liao Cheng The Third People's Hospital, Liaocheng, Shandong 252000, China
| | - Feng He
- Department of Neurosurgery, Minda Hospital of Hubei Minzu University, Enshi, China
| | - Ming-Liang Ou
- Department of Neurosurgery, Minda Hospital of Hubei Minzu University, Enshi, China
| | - Lian-Kai Wang
- Department of Neurosurgery, Minda Hospital of Hubei Minzu University, Enshi, China
| | - Liang Liao
- Department of Neurosurgery, Minda Hospital of Hubei Minzu University, Enshi, China
| | - Rui-Jin Ran
- Department of Neurosurgery, Minda Hospital of Hubei Minzu University, Enshi, China
| | - Hui-Hua Xiang
- Department of Neurosurgery, Minda Hospital of Hubei Minzu University, Enshi, China
| | - Jun-Hui Chen
- Department of Neurosurgery, Minda Hospital of Hubei Minzu University, Enshi, China
| | - Shang-Jun Wang
- Department of Neurosurgery, Jining NO.1 People's Hospital, Affiliated Jining NO.1 People's Hospital of Jining Medical University, Jining Medical University, Jining 272011, Shandong, China.
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7
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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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Papillary meningioma of the central nervous system: a SEER database analysis. Neurosurg Rev 2021; 44:2777-2784. [PMID: 33415520 DOI: 10.1007/s10143-020-01449-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 11/06/2020] [Accepted: 11/23/2020] [Indexed: 02/08/2023]
Abstract
Papillary meningioma (PM) is a rare central nervous system tumor. We aimed to analyze the characteristics and outcomes of patients with PM (WHO grade III) and identify risk factors that influence survival using the Surveillance, Epidemiology, and End Results (SEER) database. Clinical characteristics, tumor features, and outcomes of 108 PM patients included in the SEER database between 1990 and 2016 were retrieved. Risk factors related to prognosis of PM were assessed by Kaplan-Meier curves and the Cox proportional hazards model. All 108 patients, including 65 males and 43 females (1.5:1), with a median age of 52 years (range, 9 to > 85 years) had undergone surgical resection. Gross total resection (GTR) was achieved in 50%, and 50% underwent subtotal resection (STR). While 55.6% underwent postoperative radiation therapy, 48% did not. The median disease-specific survival (DSS) was 128 months, and the 5-year DSS rate was 77%. In multivariate analysis, age ≤ 52 years and GTR were both independently associated with higher probability of DSS (p = 0.033 and p = 0.029, respectively). Stratification analysis showed that postoperative radiotherapy had no significant impact on the DSS, irrespective of resection extent (p = 0.172). Our SEER analysis showed that age and extent of resection were prognostic factors for PM, but race, tumor size, gender, chemotherapy, and postoperative radiotherapy did not significantly impact DSS of PM patients. There was no significant improvement in survival of patients who underwent radiotherapy and GTR, or radiotherapy and STR, compared with GTR or STR alone.
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9
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Cheng Z, Chao Q, Zhang H, Wang DW, Shu HS. Intraventricular cystic papillary meningioma: A case report and literature review. Medicine (Baltimore) 2020; 99:e21514. [PMID: 32756190 PMCID: PMC7402910 DOI: 10.1097/md.0000000000021514] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 06/04/2020] [Accepted: 07/01/2020] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION Papillary meningioma is an extremely rare malignant lesion with high degree of invasiveness, high recurrence rate, and perivascular pseudopapillary structure. The incidence of cystic degeneration in papillary meningiomas is relatively low, and cystic papillary meningiomas growing in the ventricle are even rarer. Here, we present a case of cystic meningioma and review the literature to propose the diagnosis, treatment, immunohistochemical features, and prognosis of the same. PATIENT CONCERNS In July 2013, a 35-year-old male Chinese patient presented with dizziness that lasted for a week, without relief. Magnetic resonance imaging (MRI) revealed a 2.0 cm × 1.5 cm × 3.0 cm-sized mass located in the left lateral ventricle trigone. The tumor was small and likely non-malignant. Therefore, the patient received conservative treatment and regular follow-ups. In June 2017, the patient experienced sudden severe headache, dizziness, and vomiting. DIAGNOSIS AND INTERVENTION MRI revealed that the mass in the left lateral ventricle trigone had increased to 5.0 cm × 7.0 cm × 8.0 cm over 4 years. The patient underwent surgical resection via the left parietal-occipital approach. Two months postoperatively, the patient received 60 Gy local radiotherapy. The postoperative histopathology suggested that the mass was a cystic papillary meningioma. OUTCOMES Two years after the operation, the patient was asymptomatic, and no recurrence of the lesion was noted on MRI. CONCLUSION The diagnosis of intraventricular cystic papillary meningioma depends mainly on its histology and imaging features. Total resection and adjuvant radiotherapy can result in a relatively good prognosis of patients with intraventricular cystic papillary meningiomas.
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Zhang J, Chen X, Li D. Papillary meningioma with a history of renal clear cell carcinoma and lung adenocarcinoma: a case report. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2019; 12:2728-2732. [PMID: 31934104 PMCID: PMC6949566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 05/22/2019] [Indexed: 06/10/2023]
Abstract
Papillary meningioma is a rare subtype of malignant meningiomas. The case of papillary meningioma is extremely rarer than other tumors that may pose a diagnostic dilemma to the pathologist. Here we report a rare case of papillary meningioma following renal clear cell carcinoma and lung adenocarcinoma and suggest a useful indicator for accurate diagnosis. A 52-year-old female patient was diagnosed with renal clear cell carcinoma and lung adenocarcinoma two and half years ago, respectively. Four years ago, she presented with nausea, dizziness, and left ear pain when her headache was severe. The symptoms became progressively worse and more frequent, so she was subjected to left cerebellar craniotomy for resection of the tumor. On the basis of its morphologic and immunohistochemical features, the tumor was diagnosed as a papillary meningioma. Papillary meningioma needs to be differentiated from other intracranial tumors. Early diagnosis of papillary meningioma could significantly reduce the progression of subsequent invasion and mortality.
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Affiliation(s)
- Jing Zhang
- Department of Pathology, First Affiliated Hospital of Zhengzhou UniversityZhengzhou, Henan, China
| | - Xu Chen
- Department of Pathology and Pathophysiology, School of Basic Medicine, Zhengzhou UniversityZhengzhou, Henan, China
| | - Daoming Li
- Department of Pathology, First Affiliated Hospital of Zhengzhou UniversityZhengzhou, Henan, China
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11
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World Health Organization Grade III (Nonanaplastic) Meningioma: Experience in a Series of 23 Cases. World Neurosurg 2018; 112:e754-e762. [DOI: 10.1016/j.wneu.2018.01.149] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Revised: 01/17/2018] [Accepted: 01/18/2018] [Indexed: 11/18/2022]
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12
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Uzunoglu I, Kizmazoglu C, Rezanko TA, Yuceer N. Intraparenchymal supratentorial papillary meningioma: a case report. Br J Neurosurg 2018; 35:241-243. [PMID: 29564936 DOI: 10.1080/02688697.2018.1454887] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Although intraparenchymal meningiomas have rarely been reported in the literature, the papillary type has been reported only as infratentorial. Here we report the case of a 21-year-old female patient with intraparenchymal lesion. To our knowledge, this case describes the first report of a patient with a supratentorial intraparenchymal papillary meningioma.
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Affiliation(s)
- Inan Uzunoglu
- Department of Neurosurgery, Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey
| | - Ceren Kizmazoglu
- Department of Neurosurgery, Dokuz Eylül University School of Medicine, Izmir, Turkey
| | - Turkan Atasever Rezanko
- Department of Pathology, Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey
| | - Nurullah Yuceer
- Department of Neurosurgery, Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey
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13
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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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15
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Cisterna magna meningiomas without dural attachment: Report of two cases. Neurol Neurochir Pol 2017; 51:247-251. [DOI: 10.1016/j.pjnns.2017.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2015] [Revised: 12/14/2016] [Accepted: 02/09/2017] [Indexed: 11/23/2022]
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16
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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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17
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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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18
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Gonzalez-Quarante LH, Ruiz-Juretschke F, Iza-Vallejo B, Scola-Pliego E, Poletti D, Sola Vendrell E. Expanded Endoscopic Transclival Approach for Resection of a Chordoid Meningioma without Dural Attachment (MWODA) Located in the Prepontine Cistern. World Neurosurg 2016; 91:675.e5-675.e10. [DOI: 10.1016/j.wneu.2016.04.102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 04/17/2016] [Accepted: 04/21/2016] [Indexed: 10/21/2022]
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19
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Yu Y, Xu H, Wang Y, Zhao G. Papillary meningioma of the jugular foramen: A case report. Oncol Lett 2015; 10:3655-3659. [PMID: 26788186 DOI: 10.3892/ol.2015.3785] [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: 05/24/2014] [Accepted: 03/09/2015] [Indexed: 11/06/2022] Open
Abstract
Papillary meningioma (PM) is a rare histological variant of intracranial meningioma, which displays an aggressive behavior and its management is difficult. The present study reported the case of a 21-year-old male patient, who presented with headaches and dizziness. Upon neurological examination, left hypoglossal nerve palsy and left cerebellar signs were observed. Computed tomography and magnetic resonance imaging scans of the brain revealed a high-density mass in the left jugular foramen area. Following an uneventful complete surgical resection of the tumor, a definitive diagnosis of Grade III PM was determined based on the histopathological findings, according to the World Health Organization classification. CT scanning one day after surgery confirmed that the tumor had been completely resected, and after four years of follow-up, no evidence of transformation or recurrence was observed.
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Affiliation(s)
- Ying Yu
- Department of Neurosurgery, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Haiyang Xu
- Department of Neurosurgery, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Yubo Wang
- Department of Neurosurgery, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Gang Zhao
- Department of Neurosurgery, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
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20
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Fong C, Nagasawa DT, Chung LK, Voth B, Cremer N, Thill K, Ung N, Gopen Q, Yang I. Systematic Analysis of Outcomes for Surgical Resection and Radiotherapy in Patients with Papillary Meningioma. J Neurol Surg B Skull Base 2015. [PMID: 26225311 DOI: 10.1055/s-0035-1548742] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Introduction Papillary meningiomas (PMs) are characterized by their aggressive nature and high rate of recurrence. Due to their rarity, studies examining the relationship between treatment and clinical outcomes for this disease are limited. Gross total resection (GTR) with or without radiotherapy (RT) is considered the standard treatment; however, when GTR is not feasible, subtotal resection (STR) followed by RT may be an effective alternative. In this study, we analyzed the clinical outcomes in patients who either underwent GTR alone, GTR followed by RT, STR alone, or STR followed by RT. Methods A systematic analysis was performed to identify PM patients with sufficient follow-up and outcome data, as measured by recurrence. Patient data lacking extent of resection, follow-up, or recurrence information were excluded. Results A total of 29 patients with PM were treated with resections (23 GTRs and 6 STRs).The mean age and mean follow-up of patients in this study were 32.3 years and 42.1 months, respectively. Of these patients, 58.6% experienced recurrence. Overall, 47.8% of patients who underwent GTR experienced recurrence. These patients also demonstrated improved survival compared with STR. Among patients whose tumors were only partially excised, a recurrence rate of 83% was observed. Conclusion Our results confirm that GTR results in fewer recurrences compared with STR, supporting GTR as the treatment of choice for PM. Furthermore, GTR in conjunction with RT resulted in improved survival compared with GTR alone. When GTR was not feasible, STR with RT was associated with improved survival compared with STR alone. Future studies with more outcome data are needed to elucidate the optimal treatment for this rare disease.
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Affiliation(s)
- Christina Fong
- Department of Neurological Surgery, University of California, Los Angeles, Los Angeles, California, United States
| | - Daniel T Nagasawa
- Department of Neurological Surgery, University of California, Los Angeles, Los Angeles, California, United States
| | - Lawrance K Chung
- Department of Neurological Surgery, University of California, Los Angeles, Los Angeles, California, United States
| | - Brittany Voth
- Department of Neurological Surgery, University of California, Los Angeles, Los Angeles, California, United States
| | - Nicole Cremer
- Department of Neurological Surgery, University of California, Los Angeles, Los Angeles, California, United States
| | - Kimberly Thill
- Department of Neurological Surgery, University of California, Los Angeles, Los Angeles, California, United States
| | - Nolan Ung
- Department of Neurological Surgery, University of California, Los Angeles, Los Angeles, California, United States
| | - Quinton Gopen
- Department of Head and Neck Surgery, University of California, Los Angeles, Los Angeles, California, United State
| | - Isaac Yang
- Department of Neurological Surgery, University of California, Los Angeles, Los Angeles, California, United States
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21
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Jadik S, Stan AC, Dietrich U, Pietilä TA, Elsharkawy AE. Intraparenchymal meningioma mimicking cavernous malformation: a case report and review of the literature. J Med Case Rep 2014; 8:467. [PMID: 25547419 PMCID: PMC4320455 DOI: 10.1186/1752-1947-8-467] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 11/25/2014] [Indexed: 11/25/2022] Open
Abstract
Introduction A primary intraparenchymal meningioma located in the subcortical region of the brain without a dural attachment is extremely rare. To the best of our knowledge, this is the first report showing that meningioma can mimic cavernous malformations. Case presentation We present the case of a 42-year-old German man who presented to our institution with seizure. Both computed tomography and magnetic resonance imaging scans showed characters of an intra-axial subcortical lesion with a ‘popcorn’ appearance and hemosiderin deposits in the right parietal lobe. The initial diagnosis was cavernous malformation. Intraoperatively, the lesion presented as a subcortical mass that had no connection to the dura or the ventricle. The histological diagnosis showed a WHO Grade 1 ‘raddled’ psammomatous meningioma with extensive metaplastic ossification. A literature review of 29 cases of intraparenchymal meningiomas regarding their clinical presentations, location and management was performed. Conclusions Meningiomas can be found in any region of the brain with and without dural attachment. Intraparenchymal meningiomas can have multiple entities mimicking their presentation. Caution must be used regarding the preoperative differential diagnosis.
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Affiliation(s)
| | | | | | | | - Alaa Eldin Elsharkawy
- Department of Neurosurgery, University of Kiel, Arnold-Heller-Str,3, Haus 41, 24105 Kiel, Germany.
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22
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Simal Julian JA, Sanromán Álvarez P, Miranda Lloret P, Plaza Ramirez E, Pérez Borreda P, Botella Asunción C. Full endoscopic endonasal transclival approach: meningioma attached to the ventral surface of the brainstem. Neurocirugia (Astur) 2014; 25:140-4. [PMID: 24685579 DOI: 10.1016/j.neucir.2013.10.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 10/21/2013] [Accepted: 10/27/2013] [Indexed: 11/18/2022]
Abstract
BACKGROUND Intracranial meningiomas without dural attachment (MWODA) are rare entities. We present the first case published, to the best of our knowledge, regarding a MWODA attached to the ventral surface of the brainstem. This location makes the patient subsidiary to treatment through an expanded endonasal transclival approach. CLINICAL PRESENTATION A 16-year-old female with suspected diagnosis of recurrence of a clear cell meningioma (CCM) at a distance from the initial lesion, located on the premedullary cistern. The patient underwent a pure endoscopic low transclival approach. The attachment to the ventral surface of the brainstem was confirmed intraoperatively. Postoperative MRI confirmed gross total resection and treatment was complemented with adjuvant fractionated stereotactic radiotherapy. No complications related to the procedure were observed. CONCLUSION MWODA may appear attached to the ventral brainstem. The expanded endonasal approach to the clivus provides a critical anatomical advantage in the treatment of medial lesions, even ventral meningiomas, to the lower cranial nerves. Reconstruction principles must be strictly respected to reduce complications.
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23
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Biological and demographic profile of meningiomas in a cohort of Egyptian patients: impact on tumor recurrence. ScientificWorldJournal 2013; 2013:375139. [PMID: 24459428 PMCID: PMC3888722 DOI: 10.1155/2013/375139] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Accepted: 10/03/2013] [Indexed: 12/02/2022] Open
Abstract
Objective. This work was designed to study the biological and demographic characteristics of meningiomas and their impact on tumor recurrence in Egyptian patients. Material and Methods. A cohort of 265 Egyptian patients with meningioma was studied. Immunohistochemistry for VEGF, Ki67, PR, CD20, and CD3 was performed. Statistical analysis was used to detect independent predictors of recurrence. Results. Adults represented 98.9% of cases, with female preponderance (M : F ratio = 1 : 2.4). Histologically, 78.10% of cases were grade I, 19.20% were grade II, and 2.60% were grade III. Transitional variant was the most common (43.40%). VEGF expression (38.50% of cases) correlated positively with perifocal edema, tumor size, and proliferative index (PI). PR expression (64.5% of cases) correlated inversely with the PI (mean 3.75). Lymphocytic aggregates were detected in 7.20% of cases, with a mean CD20 : CD3 ratio of 1 : 10.1. In a multivariate analysis, only tumor size, PR expression and necrosis predicted recurrence independently. Using ROC curve, size was the best predictor of tumor recurrence with a cut-off point of >6 cm and an excellent negative predictive value (97.6%). Conclusions. Meningiomas in our region showed some distinctive clinicopathological and demographic criteria. Tumor size was found to be the best recurrence predictor factor of meningioma.
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24
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Yang G, Chen X, Li CG, Zhang DM, Zhang WG, Shi CB, Zhao SG. Multiple meningiomas characterized by benign and malignant tumor entities. CNS Neurosci Ther 2013; 19:984-6. [PMID: 24165389 DOI: 10.1111/cns.12179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Revised: 08/18/2013] [Accepted: 08/19/2013] [Indexed: 11/29/2022] Open
Affiliation(s)
- Guang Yang
- Department of Neurosurgery, First Affiliated Hospital of Harbin Medical University, Harbin, China; Institute of Brain Science, Harbin Medical University, Harbin, China
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25
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The vitamin D receptor (VDR) gene polymorphisms in Turkish brain cancer patients. BIOMED RESEARCH INTERNATIONAL 2013; 2013:295791. [PMID: 23691496 PMCID: PMC3652122 DOI: 10.1155/2013/295791] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Revised: 01/30/2013] [Accepted: 03/25/2013] [Indexed: 01/11/2023]
Abstract
Objective. It has been stated that brain cancers are an increasingly serious issue in many parts of the world. The aim of our study was to determine a possible relationship between Vitamin D receptor (VDR) gene polymorphisms and the risk of glioma and meningioma. Methods. We investigated the VDR Taq-I and VDR Fok-I gene polymorphisms in 100 brain cancer patients (including 44 meningioma cases and 56 glioma cases) and 122 age-matched healthy control subjects. This study was performed by polymerase chain reaction-based restriction fragment length polymorphism (RF LP). Results. VDR Fok-I ff genotype was significantly increased in meningioma patients (15.9%) compared with controls (2.5%), and carriers of Fok-I ff genotype had a 6.47-fold increased risk for meningioma cases. There was no significant difference between patients and controls for VDR Taq-I genotypes and alleles. Conclusions. We suggest that VDR Fok-I genotypes might affect the development of meningioma.
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26
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Wang DJ, Zheng MZ, Gong Y, Xie Q, Wang Y, Cheng HX, Mao Y, Zhong P, Che XM, Jiang CC, Huang FP, Zheng K, Li SQ, Gu YX, Bao WM, Yang BJ, Wu JS, Xie LQ, Tang HL, Zhu HD, Chen XC, Zhou LF. Papillary meningioma: clinical and histopathological observations. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2013; 6:878-88. [PMID: 23638219 PMCID: PMC3638098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/26/2013] [Accepted: 03/13/2013] [Indexed: 06/02/2023]
Abstract
Papillary meningioma is a rare subtype of malignant meningiomas, which is classified by the World Health Organization as Grade III. Because of lack of large sample size case studies, many of the specific characteristics of papillary meningioma are unclear. This study investigated by retrospective analysis the clinical, radiological and histopathological findings of 17 papillary meningioma patients who underwent surgical resection or biopsy, to assess the characteristics of papillary meningioma. Eight female and nine male patients were included, with a mean age of 40 (range: 6 to 55) years. Tumors were mostly located in the cerebral convexity and showed irregular margins, absence of a peritumoral rim, heterogeneous enhancement and severe peritumoral brain edema on preoperative images. Brain invasion was often confirmed during the operations, with abundant to exceedingly abundant blood supply. Intratumoral necrosis and mitosis was frequently observed on routinely stained sections. The average MIB-1 labeling index was 6.9%. Seven cases experienced tumor recurrence or progression, while seven patients died 6 to 29 months after operation. Radiation therapy was given in 52.9% of all cases. Univariate analysis showed that only the existence of intratumoral necrosis and incomplete resection correlated with tumor recurrence. The 3-year progression free survival was 66.7% after gross total resection and 63.6% for other cases. The 3-year mortality rate was 50% after gross total resection and 63.6% for other cases. Papillary meningioma has specific clinical and histopathological characteristics. Tumor recurrence (or progression) and mortality are common. Gross total tumor resection resulted in less recurrence and mortality.
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Affiliation(s)
- Dai-Jun Wang
- Department of Neurosurgery, Huashan Hospital, Fudan UniversityShanghai 200040, China
| | - Ming-Zhe Zheng
- Department of Neurosurgery, Huashan Hospital, Fudan UniversityShanghai 200040, China
| | - Ye Gong
- Department of Neurosurgery, Huashan Hospital, Fudan UniversityShanghai 200040, China
| | - Qing Xie
- Department of Neurosurgery, Huashan Hospital, Fudan UniversityShanghai 200040, China
| | - Yin Wang
- Department of Neuropathology, Huashan Hospital, Fudan UniversityShanghai 200040, China
| | - Hai-Xia Cheng
- Department of Neuropathology, Huashan Hospital, Fudan UniversityShanghai 200040, China
| | - Ying Mao
- Department of Neurosurgery, Huashan Hospital, Fudan UniversityShanghai 200040, China
| | - Ping Zhong
- Department of Neurosurgery, Huashan Hospital, Fudan UniversityShanghai 200040, China
| | - Xiao-Ming Che
- Department of Neurosurgery, Huashan Hospital, Fudan UniversityShanghai 200040, China
| | - Cheng-Chuan Jiang
- Department of Neurosurgery, Huashan Hospital, Fudan UniversityShanghai 200040, China
| | - Feng-Ping Huang
- Department of Neurosurgery, Huashan Hospital, Fudan UniversityShanghai 200040, China
| | - Kang Zheng
- Department of Neurosurgery, Huashan Hospital, Fudan UniversityShanghai 200040, China
| | - Shi-Qi Li
- Department of Neurosurgery, Huashan Hospital, Fudan UniversityShanghai 200040, China
| | - Yu-Xiang Gu
- Department of Neurosurgery, Huashan Hospital, Fudan UniversityShanghai 200040, China
| | - Wei-Min Bao
- Department of Neurosurgery, Huashan Hospital, Fudan UniversityShanghai 200040, China
| | - Bo-Jie Yang
- Department of Neurosurgery, Huashan Hospital, Fudan UniversityShanghai 200040, China
| | - Jing-Song Wu
- Department of Neurosurgery, Huashan Hospital, Fudan UniversityShanghai 200040, China
| | - Li-Qian Xie
- Department of Neurosurgery, Huashan Hospital, Fudan UniversityShanghai 200040, China
| | - Hai-Liang Tang
- Department of Neurosurgery, Huashan Hospital, Fudan UniversityShanghai 200040, China
| | - Hong-Da Zhu
- Department of Neurosurgery, Huashan Hospital, Fudan UniversityShanghai 200040, China
| | - Xian-Cheng Chen
- Department of Neurosurgery, Huashan Hospital, Fudan UniversityShanghai 200040, China
| | - Liang-Fu Zhou
- Department of Neurosurgery, Huashan Hospital, Fudan UniversityShanghai 200040, China
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