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Yang J, Wan W, Liu W, Jiao J, Jia Q, Zhong N, Yang X, Xiao J. Two novel cases of spinal clear cell meningioma with vertebra involvement. J Orthop Sci 2021; 26:919-925. [PMID: 30545721 DOI: 10.1016/j.jos.2018.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 10/04/2018] [Accepted: 11/05/2018] [Indexed: 11/16/2022]
Affiliation(s)
- Jian Yang
- Department of Orthopedic Oncology, Changzheng Hospital, Navy Medical University, Fengyang Rd 415#, Huangpu District, Shanghai, China
| | - Wei Wan
- Department of Orthopedic Oncology, Changzheng Hospital, Navy Medical University, Fengyang Rd 415#, Huangpu District, Shanghai, China
| | - Weibo Liu
- Department of Orthopedic Oncology, Changzheng Hospital, Navy Medical University, Fengyang Rd 415#, Huangpu District, Shanghai, China; Department of Spine Surgery, Qingdao Central Hospital, Siliunan Rd 127#, Shibei District, Qingdao, Shandong Province, China
| | - Jian Jiao
- Department of Orthopedic Oncology, Changzheng Hospital, Navy Medical University, Fengyang Rd 415#, Huangpu District, Shanghai, China
| | - Qi Jia
- Department of Orthopedic Oncology, Changzheng Hospital, Navy Medical University, Fengyang Rd 415#, Huangpu District, Shanghai, China
| | - Nanzhe Zhong
- Department of Orthopedic Oncology, Changzheng Hospital, Navy Medical University, Fengyang Rd 415#, Huangpu District, Shanghai, China
| | - Xinghai Yang
- Department of Orthopedic Oncology, Changzheng Hospital, Navy Medical University, Fengyang Rd 415#, Huangpu District, Shanghai, China.
| | - Jianru Xiao
- Department of Orthopedic Oncology, Changzheng Hospital, Navy Medical University, Fengyang Rd 415#, Huangpu District, Shanghai, China.
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Navalkele P, Guzman M, Kirby A, Pinz H, Kemp J. Familial Pediatric Clear Cell Meningioma With Germline SMARCE1 Mutation in the United States. J Neuropathol Exp Neurol 2021; 79:1250-1252. [PMID: 33085974 PMCID: PMC7577515 DOI: 10.1093/jnen/nlaa115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Pournima Navalkele
- Department of Pediatrics, Cardinal Glennon Children's Hospital, St. Louis University, St. Louis, Missouri
| | - Miguel Guzman
- Department of Pathology, Cardinal Glennon Children's Hospital, St. University, St. Louis University, St. Louis, Missouri
| | - Amelia Kirby
- Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Hailey Pinz
- Department of Genetics, Cardinal Glennon Children's Hospital, St. Louis University, St. Louis, Missouri
| | - Joanna Kemp
- Department of Neurosurgery, Saint Louis University Hospital, St. Louis University, St. Louis, Missouri
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TSUCHIYA T, IKEDA S, ISOO A, SAKAKIBARA H, KUMADA S, KOMORI T, TAKAI K. Intraoperative Anatomical Findings in Pediatric Clear Cell Meningioma of the Lumbar Spine: Case Report and Literature Review. NMC Case Rep J 2021; 8:519-527. [PMID: 35079512 PMCID: PMC8769484 DOI: 10.2176/nmccrj.cr.2020-0356] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 02/24/2021] [Indexed: 11/20/2022] Open
Abstract
Clear cell meningioma (CCM) is a WHO classification Grade II meningioma. It is a very rare disease, of which only 41 cases of spinal cord CCM in children have been reported to date. CCMs sometimes do not have the “dural attachment” that is usually found in meningiomas, and our understanding of the origin of CCMs is therefore controversial. We hereby present a case of pediatric CCM of the lumbar spine, in which we examined intraoperatively, the detailed anatomical location of the tumor. The case is a 10-year-old boy, who presented to our hospital with a 2-month history of lower back and bilateral lower extremity pain upon waking, which gradually worsened. Lumbar spine CT and MRI revealed an intradural extramedullary tumor at the L3 vertebral level, and surgery was performed to remove it. The tumor was in close contact with the dura mater, and also in contact with the cauda equina via the arachnoid. The tumor was likely located primarily between the dura mater and arachnoid. The pathological diagnosis was CCM, with an MIB-1 index of less than 1%. His back pain and bilateral lower extremity pain improved after surgery, and he was discharged from our hospital. Postoperative radiation therapy was not performed. Based on this case, we suggest that intraoperative examination of the anatomical location of these tumors and accumulation of relevant experience are important to elucidate the embryological mechanisms of this rare disease.
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Affiliation(s)
- Takahiro TSUCHIYA
- Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, Fuchu, Tokyo, Japan
| | - Syunsuke IKEDA
- Department of Neurosurgery, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan
| | - Ayako ISOO
- Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, Fuchu, Tokyo, Japan
| | - Hiroshi SAKAKIBARA
- Department of General Pediatrics, Tokyo Metropolitan Children's Medical Center, Fuchu, Tokyo, Japan
| | - Satoko KUMADA
- Department of Neuropediatrics, Tokyo Metropolitan Neurological Hospital, Fuchu, Tokyo, Japan
| | - Takashi KOMORI
- Laboratory Medicine and Pathology, Tokyo Metropolitan Neurological Hospital, Fuchu, Tokyo, Japan
| | - Keisuke TAKAI
- Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, Fuchu, Tokyo, Japan
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Hao Z, Hu S, Yu NZ. Rare intraspinal clear cell meningioma in children: a case report and literature review. J Int Med Res 2020; 48:300060520952266. [PMID: 33135529 PMCID: PMC7780564 DOI: 10.1177/0300060520952266] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Meningioma of the spinal canal is very rare. Clear cell meningioma (CCM) with special histological features occurs more commonly in the spinal cord. A review of the published English-language literature identified 40 reported cases of children with intraspinal CCM and this current report presents an additional case of a 3-year-old child with confirmed lumbar CCM. The current case underwent gross total resection of the CCM. At 9 months after the operation, lumbar magnetic resonance imaging was undertaken and confirmed the absence of tumour recurrence. The child was able to walk normally again. During this period, the child did not receive adjuvant treatments such as radiotherapy and chemotherapy. An evaluation of the 41 cases demonstrated the following: (i) there was no significant difference between the recurrence rate of females and males; (ii) there was a significant difference in the recurrence rate based on the extent of resection (gross total resection versus partial resection); (iii) the recurrence rate in patients where the number of involved segments ≥3 levels was significantly higher than that in patients where the number of involved segments was 1–2 levels. For children with CCM, complete surgical resection might be an important characteristic for predicting the risk of the recurrence of CCM.
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Affiliation(s)
- Zheng Hao
- Department of Neurosurgery, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China.,Department of Emergency Trauma Centre, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China
| | - Si Hu
- Department of Neurosurgery, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China
| | - Nian-Zu Yu
- Department of Neurosurgery, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China
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5
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Zhang H, Ma L, Shu C, Dong LQ, Ma YQ, Zhou Y. Spinal Clear Cell Meningiomas: Clinical Features and Factors Predicting Recurrence. World Neurosurg 2019; 134:e1062-e1076. [PMID: 31765868 DOI: 10.1016/j.wneu.2019.11.093] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 11/14/2019] [Accepted: 11/15/2019] [Indexed: 01/29/2023]
Abstract
OBJECTIVE As a World Health Organization grade II tumor of the nervous system, clear cell meningioma (CCM) is an uncommon histologic variant of meningioma. Spinal CCMs are even rarer, with <100 spinal CCMs reported in the English literature. We present this study to characterize clinical manifestations of spinal CCMs and determine the factors predicting recurrence. METHODS A literature search was performed for relevant case reports and series in PubMed and Embase until September 1, 2019. These articles were reviewed to identify clinical features, treatment modalities, and prognosis of patients with spinal CCMs. RESULTS Eighty-four spinal CCMs were analyzed. Of these patients, 36 (42.9%) were young (age ≤18 years), and the mean age at resection was 24 years. Fifty-three patients (63.1%) were female and 31 (36.9%) were male. Most of the tumors (56/84, 66.7%) were located in the lumbar region. In 31 patients (36.9%) >2 segments in the craniocaudal direction were involved (number of involved segments ≥3 levels). Gross tumor resection was performed in 77 patients (91.7%). Twenty patients (23.8%) showed radiographic evidence of recurrence during follow-up. Recurrence-free survival at 1, 5, and 10 years after resection of spinal CCM was 87%, 71%, and 47%, respectively. Multivariate analysis showed that age ≤18 years (hazard ratio [HR], 3.64; P = 0.024), subtotal resection (HR, 3.43; P = 0.031), and segments involving ≥3 levels (HR, 5.66; P = 0.002) were associated with increased recurrence. CONCLUSIONS Spinal CCMs have their own unique clinical features compared with conventional spinal meningiomas and intracranial CCMs. Spinal CCMs have a predilection to affect younger patients, are prone to appear in the lumbar region, and have a high recurrence rate. Age ≤18 years, subtotal resection, and involvement of long segments (≥3 levels) are positive predictors of recurrence.
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Affiliation(s)
- Hui Zhang
- Department of Neurosurgery, Air Force Medical Center of the Chinese PLA, Beijing, China
| | - Li Ma
- Department of Anesthesiology, 7th Medical Center of the Chinese PLA General Hospital, Beijing, China
| | - Cheng Shu
- Department of Neurosurgery, Air Force Medical Center of the Chinese PLA, Beijing, China
| | - Lian-Qiang Dong
- Department of Neurosurgery, Air Force Medical Center of the Chinese PLA, Beijing, China
| | - Ya-Qun Ma
- Department of Anesthesiology, 7th Medical Center of the Chinese PLA General Hospital, Beijing, China.
| | - Yan Zhou
- Department of Neurosurgery, Air Force Medical Center of the Chinese PLA, Beijing, China
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Li J, Zhang S, Wang Q, Cheng J, Deng X, Wang Y, Hui X. Spinal Clear Cell Meningioma: Clinical Study with Long-Term Follow-Up in 12 Patients. World Neurosurg 2018; 122:e415-e426. [PMID: 30342264 DOI: 10.1016/j.wneu.2018.10.064] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 10/06/2018] [Accepted: 10/08/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND Clear cell meningioma (CCM) is a rare histologic subtype of meningioma. The features of CCMs have commonly been based on intracranial cases. However, CCMs in the spinal cord are even rarer, and their natural history, management, and prognosis remain ill-defined. METHODS From January 2006 to January 2018, 12 patients with spinal CCM were treated in our hospital. The clinical features, radiologic findings, diagnosis, treatment, and outcome of these patients were analyzed retrospectively. Additionally, we performed a review of the reported data on spinal CCMs. RESULTS CCMs accounted for 2.8% of all the spinal meningiomas treated in our hospital. The most common localization of this disease was the lumbar region (7 of 12). The mean age at diagnosis was significantly younger than that of patients with spinal meningiomas (28.8 ± 13.4 years vs. 54.0 ± 14.4 years). During the follow-up period, 5 patients (41.7%) experienced tumor recurrence. Kaplan-Meier analysis showed that younger patients had a significantly shorter progression-free survival time than older patients. The review of the reported data showed that 55 cases of spinal CCMs had been reported. Nineteen patients (38.0%) had developed local recurrence, with a 5-year progression-free survival rate of 33.3%. CONCLUSIONS Spinal CCMs are extremely rare tumors with a predilection to affect younger patients and have a high recurrence rate. Although gross total resection is considered to be the optimal treatment, radiotherapy could be considered for patients who had undergone subtotal resection or for younger patients, regardless of the extent of removal. Close follow-up of the entire neuraxis for years is crucial.
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Affiliation(s)
- Jiuhong Li
- Department of Neurosurgery, West China Hospital of Sichuan University, Sichuan, China
| | - Si Zhang
- Department of Neurosurgery, West China Hospital of Sichuan University, Sichuan, China
| | - Qiguang Wang
- Department of Neurosurgery, West China Hospital of Sichuan University, Sichuan, China
| | - Jian Cheng
- Department of Neurosurgery, West China Hospital of Sichuan University, Sichuan, China
| | - Xueyun Deng
- Department of Neurosurgery, Nanchong Central Hospital, The Second Clinical Medical College of North Sichuan Medical College, Nanchong, China
| | - Yanchao Wang
- Department of Neurosurgery, West China Hospital of Sichuan University, Sichuan, China
| | - Xuhui Hui
- Department of Neurosurgery, West China Hospital of Sichuan University, Sichuan, China.
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Kawasaki Y, Uchida S, Onishi K, Okanari K, Fujiki M. Pediatric nondura-based clear cell meningioma of the cauda equina: case report and review of literature. Br J Neurosurg 2018; 34:215-218. [PMID: 29363346 DOI: 10.1080/02688697.2018.1429565] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Although spinal meningiomas are uncommon in children, clear cell meningioma has been described as the most common variant of spinal meningiomas in the pediatric age group. 24 cases of pediatric spinal clear call meningioma have been reported in the literature. We report one case and review the literature regarding pediatric spinal clear cell meningioma.
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Affiliation(s)
- Yukari Kawasaki
- Department of Neurosurgery, Graduate School of Medicine, Oita University, Oita, Japan
| | - Susumu Uchida
- Department of Neurosurgery, Graduate School of Medicine, Oita University, Oita, Japan
| | - Kouhei Onishi
- Department of Neurosurgery, Graduate School of Medicine, Oita University, Oita, Japan
| | - Kazuo Okanari
- Department of Pediatrics, Graduate School of Medicine, Oita University, Oita, Japan
| | - Minoru Fujiki
- Department of Neurosurgery, Graduate School of Medicine, Oita University, Oita, Japan
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8
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Intracranial Clear Cell Meningiomas: Study on Clinical Features and Predictors of Recurrence. World Neurosurg 2017; 97:693-700.e11. [DOI: 10.1016/j.wneu.2016.10.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 09/29/2016] [Accepted: 10/01/2016] [Indexed: 11/20/2022]
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9
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Balogun JA, Halliday W, Bouffet E, Kulkarni AV. Spinal clear cell meningioma in a 3-year-old: a case report. Pediatr Neurosurg 2013; 49:311-5. [PMID: 25377168 DOI: 10.1159/000366452] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Accepted: 07/29/2014] [Indexed: 11/19/2022]
Abstract
Clear cell meningioma (CCM) is an aggressive meningioma variant with a tendency to early recurrence posing a challenge to its treatment. Although spinal meningiomas are uncommon in children, this rare entity has been described as the most common variant of spinal meningiomas in the pediatric age group. We present the case of a 3-year-old with a confirmed lumbar spine CCM and discuss the problems encountered in the management of this disease.
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Affiliation(s)
- James A Balogun
- Division of Neurosurgery, The Hospital for Sick Children, Toronto, Ont., Canada
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10
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Wang XQ, Zeng XW, Zhang BY, Dou YF, Wu JS, Jiang CC, Zhong P, Chen H. Spinal meningioma in childhood: clinical features and treatment. Childs Nerv Syst 2012; 28:129-36. [PMID: 21947034 DOI: 10.1007/s00381-011-1570-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2011] [Accepted: 08/11/2011] [Indexed: 01/31/2023]
Abstract
OBJECT The purpose of this retrospective study is to determine the clinical characteristics and the prognosis of the spinal meningioma in childhood (under 18 years of age) based on the treatment at our institution. METHODS Ten spinal meningioma cases in children were treated during the last 9 years. The clinical data was retrospectively analyzed and the results were compared with those in the literature. RESULTS The series included eight males and two females and the mean age was 13.2 years. The most common initial symptoms were pain (6/10) and the common signs were limb weakness (4/10) and gait disturbance (2/10) and distal paresthesia (1/10) and bladder disturbance (1/10). Four patients had other clinical signs of neurofibromatosis type II (NF-2) such as tumors elsewhere. All the tumors were located in cervical and thoracic vertebrae. Resection according to Simpson Grade I (6/10), II (2/10), III (1/10), and IV (1/10) were performed. Grade II meningiomas accounted for 3/10 in this series. All patients were followed up with mean follow-up period of 43 months. Seven patients had recurrence of the tumor in that period and one had died. CONCLUSIONS Spinal meningioma is an uncommon pediatric neoplasm and has a poor prognosis. It has a male predominance and is inclined to be associated with NF-2, and those that are associated with higher pathologic subtypes and NF-2 have more unfavorable outcome. Every effort should be made to achieve total removal which may decrease the incidence of recurrence.
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Affiliation(s)
- Xiao-Qiang Wang
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai 200040, China
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Ko JK, Choi BK, Cho WH, Choi CH. Non-dura based intaspinal clear cell meningioma. J Korean Neurosurg Soc 2011; 49:71-4. [PMID: 21494369 DOI: 10.3340/jkns.2011.49.1.71] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2010] [Revised: 04/20/2010] [Accepted: 01/13/2011] [Indexed: 11/27/2022] Open
Abstract
A 34-year-old female patient was presented with leg and hip pain for 6 months as well as voiding difficulty for 1 year. Magnetic resonance imaging revealed a well-demarcated mass lesion at L2-3. The mass was hypo-intense on T1- and T2-weighted images with homogeneous gadolinium enhancement. Surgery was performed with the presumptive diagnosis of intradural extramedullary meningioma. Complete tumor removal was possible due to lack of dural adhesion of the tumor. Histologic diagnosis was clear cell meningioma, a rare and newly included World Health Organization classification of meningioma usually affecting younger patients. During postoperative 2 years, the patient has shown no evidence of recurrence. We report a rare case of cauda equina clear cell meningioma without any dural attachment.
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Affiliation(s)
- Jun Kyeung Ko
- Department of Neurosurgery, School of Medicine, Pusan National University, Busan, Korea
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12
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Abstract
Abstract
BACKGROUND AND IMPORTANCE
Intracranial clear cell meningioma is very rare. We present 3 cases of intracranial clear cell meningiomas genetically characterized by comparative genomic hybridization with a review of the literature.
CLINICAL PRESENTATION
Patient 1 is a 38-year-old woman with a petroclival tumor. Patient 2 is a 60-year-old man with a tumor at the foramen magnum. Patient 3 is a 60-year-old man with a tumor at the posterior clinoid process. Gross total resection was performed in patients 1 and 2. Patient 1 has been free from recurrence for 10 years. Patient 2 had a tumor recurrence at 14 months after the operation. After partial resection, conventional radiotherapy was given, and there was no tumor regrowth at 2 years after radiotherapy. Subtotal resection was performed in patient 3, and no regrowth was detected for 3 months. Histologically, all tumors were composed of cells with clear cytoplasm reactive for periodic acid–Schiff and diagnosed as clear cell meningioma. The MIB-1 and p53 staining indexes were 1.8, 1.7, and 5.6 and 1.1, 1.0, and 5.5, respectively. Comparative genomic hybridization revealed no chromosomal number aberrations in patient 1, numerous losses and gains including loss of chromosome 1 in patient 2, and loss of only 22q in patient 3. Because staining indexes of MIB-1 and p53 were equivalent in 2 patient (patients 1 and 2) with a long follow-up period, the contrary clinical courses are likely associated with genetic characteristics.
CONCLUSION
To the best of our knowledge, this is the first report that suggests association between tumor behavior and genetic characteristics in clear cell meningiomas.
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Affiliation(s)
- Shigeo Ohba
- Department of Neurosurgery, Keio University School of Medicine, Tokyo, Japan
| | - Hikaru Sasaki
- Department of Neurosurgery, Keio University School of Medicine, Tokyo, Japan
| | - Tokuhiro Kimura
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan
| | - Eiji Ikeda
- Department of Pathology, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
| | - Takeshi Kawase
- Department of Neurosurgery, Keio University School of Medicine, Tokyo, Japan
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Shen Y, Nunes F, Stemmer-Rachamimov A, James M, Mohapatra G, Plotkin S, Betensky RA, Engler DA, Roy J, Ramesh V, Gusella JF. Genomic profiling distinguishes familial multiple and sporadic multiple meningiomas. BMC Med Genomics 2009; 2:42. [PMID: 19589153 PMCID: PMC2716362 DOI: 10.1186/1755-8794-2-42] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2009] [Accepted: 07/09/2009] [Indexed: 11/27/2022] Open
Abstract
Background Meningiomas may occur either as familial tumors in two distinct disorders, familial multiple meningioma and neurofibromatosis 2 (NF2), or sporadically, as either single or multiple tumors in individuals with no family history. Meningiomas in NF2 and approximately 60% of sporadic meningiomas involve inactivation of the NF2 locus, encoding the tumor suppressor merlin on chromosome 22q. This study was undertaken to establish whether genomic profiling could distinguish familial multiple meningiomas from sporadic solitary and sporadic multiple meningiomas. Methods We compared 73 meningiomas presenting as sporadic solitary (64), sporadic multiple (5) and familial multiple (4) tumors using genomic profiling by array comparative genomic hybridization (array CGH). Results Sporadic solitary meningiomas revealed genomic rearrangements consistent with at least two mechanisms of tumor initiation, as unsupervised cluster analysis readily distinguished tumors with chromosome 22 deletion (associated with loss of the NF2 tumor suppressor) from those without chromosome 22 deletion. Whereas sporadic meningiomas without chromosome 22 loss exhibited fewer chromosomal imbalance events overall, tumors with chromosome 22 deletion further clustered into two major groups that largely, though not perfectly, matched with their benign (WHO Grade I) or advanced (WHO Grades II and III) histological grade, with the latter exhibiting a significantly greater degree of genomic imbalance (P < 0.001). Sporadic multiple meningiomas showed a frequency of genomic imbalance events comparable to the atypical grade solitary tumors. By contrast, familial multiple meningiomas displayed no imbalances, supporting a distinct mechanism for the origin for these tumors. Conclusion Genomic profiling can provide an unbiased adjunct to traditional meningioma classification and provides a basis for exploring the different genetic underpinnings of tumor initiation and progression. Most importantly, the striking difference observed between sporadic and familial multiple meningiomas indicates that genomic profiling can provide valuable information for differential diagnosis of subjects with multiple meningiomas and for considering the risk for tumor occurrence in their family members.
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Affiliation(s)
- Yiping Shen
- Molecular Neurogenetics Unit, Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA, 02114, USA.
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14
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Colen CB, Rayes M, McClendon J, Rabah R, Ham SD. Pediatric spinal clear cell meningioma. Case report. J Neurosurg Pediatr 2009; 3:57-60. [PMID: 19119906 DOI: 10.3171/2008.10.17668] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
In this report the authors describe a unique case of spinal clear cell meningioma in a 13-year-old girl. Clear cell meningiomas (CCMs) are not uncommon. To the authors' knowledge, 14 cases of pediatric CCM occurring in the spinal canal have been reported. Factors lending resistance to meningioma initiation and invasion are analyzed. This 13-year-old girl presented with pain radiating down her left leg. Admission MR imaging showed an inhomogeneous enhancing intradural-extramedullary mass at the L4-5 level. Resection revealed a CCM, and radiotherapy was subsequently administered. Postoperatively there has been no recurrence in > 2 years. In this paper the authors report a case of CCM and provide a comprehensive literature review on this disease. Current recommendations for its management are still debatable, especially in the pediatric population, and the authors propose an algorithm for its treatment and surveillance.
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Affiliation(s)
- Chaim B Colen
- Department of Neurological Surgery, Wayne State University School of Medicine, Detroit, Michigan 48225, USA.
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Abstract
Meningeal derived tumors of the first 2 decades of life are often diagnostically challenging due to the wide morphologic spectrum encountered and the rarity of most individual entities. The 2 most common patterns include the dural/leptomeningeal-based mass and neoplastic meningitis. Both primary and secondary meningeal presentations may occur, either early or late in the course of various meningothelial, mesenchymal, embryonal, glial, hematopoietic, histiocytic, melanocytic, and inflammatory tumors. As in other areas of pediatric pathology, there are significant differences between this patient cohort and adults, differences which will be emphasized in this review.
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Affiliation(s)
- Arie Perry
- Division of Neuropathology, Washington University School of Medicine, St. Louis, Mo 63110-1093, USA.
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Park SH, Hwang SK, Park YM. Intramedullary clear cell meningioma. Acta Neurochir (Wien) 2006; 148:463-6. [PMID: 16341630 DOI: 10.1007/s00701-005-0695-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2005] [Accepted: 10/18/2005] [Indexed: 10/25/2022]
Abstract
Intramedullary clear cell meningioma (CCM), which is more aggressive than other meningioma variants, is extremely rare. To date, only one case of such a spinal tumour has been documented. We report the first case of an intramedullary CCM originating in the thoracic region of the spinal cord.
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Affiliation(s)
- S-H Park
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
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Abstract
Meningiomas are common central nervous system tumors that originate from the meningeal coverings of the brain and the spinal cord. Most meningiomas are slowly growing benign tumors that histologically correspond to World Health Organization (WHO) grade I. However, certain rare histological variants (clear cell, chordoid, papillary, and rhabdoid), as well as atypical (WHO grade II) and anaplastic (WHO grade III) meningiomas show a more aggressive biological behavior and are clinically associated with a high risk of local recurrence and a less favorable prognosis. This review summarizes the most important features of meningioma pathology and provides an up-to-date overview about the molecular mechanisms involved in meningioma initiation and progression. Current data indicate that meningioma initiation is closely linked to the inactivation of one or more members of the highly conserved protein 4.1 superfamily, including the neurofibromatosis type 2 gene product merlin/schwannomin, protein 4.IB (DAL-1) and protein 4.1R. The genetic alterations in atypical meningiomas are complex and involve losses on 1p, 6q, 10, 14q and 18q, as well as gains on multiple chromosomes. The relevant genes are still unknown. Anaplastic meningiomas show even more complex genetic alterations, including frequent alteration of the CDKN2A, p14ARF, and CDKN2B tumor suppressor genes at 9p21, as well as gene amplification on 17q23. A better understanding of the molecular mechanisms involved in meningioma pathogenesis may not only lead to the identification of novel diagnostic and prognostic marker but will also facilitate the development of new pathogenesis-based therapeutic strategies.
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Affiliation(s)
- Arie Perry
- Division of Neuropathology, Washington University School of Medicine, St Louis, MO 63110-1093, USA.
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18
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Boet R, Ng HK, Kumta S, Chan LC, Chiu KW, Poon WS. Lumbosacral clear-cell meningioma treated with subtotal resection and radiotherapy. J Clin Neurosci 2004; 11:432-6. [PMID: 15080967 DOI: 10.1016/j.jocn.2003.10.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2003] [Accepted: 10/10/2003] [Indexed: 10/26/2022]
Abstract
We wish to report a rare case of clear-cell meningioma in the lumbosacral region in a 34-year-old male patient who presented to us with lower back pain and leg pain. The management of the patient will be reported and histological appearance discussed. This rare tumour in a difficult anatomical position presents a challenge that requires management in a multidisciplinary fashion.
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Affiliation(s)
- Ronald Boet
- Division of Neurosurgery, Department of Surgery, Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China
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19
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Payano M, Kondo Y, Kashima K, Daa T, Yatsuka T, Kida H, Nakayama I, Yokoyama S. Two cases of nondura-based clear cell meningioma of the cauda equina. APMIS 2004; 112:141-7. [PMID: 15056231 DOI: 10.1111/j.1600-0463.2004.apm1120209.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Clear cell meningioma is a rare disorder. We report two cases of nondura-based clear cell meningioma of the cauda equina, one in a 24-year-old male and the other in a 19-year-old female. Both patients had complained of numbness and spontaneous pain in the lower back and limbs for several months. Magnetic resonance imaging and computed tomography scanning revealed an intradural tumor in the cauda equina in each case. At surgery, a neurilemoma was suspected, because each of the tumors had displaced nerve roots and had attached to one of the nerve roots without any adherence to the dura. Light microscopy revealed that both tumors were well-demarcated with a thin capsule and consisted mainly of clear, glycogen-rich, polygonal cells with vague whorl formations, and of copious deposits of hyalinized blocky collagen in the stroma and perivascular areas. The neoplastic cells were immunopositive for vimentin and epithelial membrane antigen, but immunonegative for S-100 protein and chromogranin A. Positive nuclei for MIB-1 were very few in both cases, and PCNA-labeling indices were 12.1% and 24.7%, respectively. No local recurrence has been seen for 61 months and for 52 months, respectively.
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Affiliation(s)
- Maria Payano
- Department of Pathology, Oita University Faculty of Medicine, Oita, Japan
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20
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Kuzeyli K, Cakir E, Usul H, Karaarslan G, Kadir Reis A, Temiz C, Baykal S. Clear cell meningioma: case report and literature review. J Clin Neurosci 2003; 10:264-6. [PMID: 12637070 DOI: 10.1016/s0967-5868(02)00287-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The clear cell meningioma is rare and a recently described histologic variant of meningioma. The most interesting aspect of clear cell meningioma is the high recurrence rate and agressiveness. Until now 17 intracranial clear cell meningioma cases had been reported in the English language literature. We present 2 new cases of clear cell meningioma which is discussed with the relevant literature.
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Affiliation(s)
- Kayhan Kuzeyli
- Department of Neurosurgery, Karadeni;z Technical University, School of Medicine, 61080 Trabzon, Turkey.
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