Cases reported "Meningioma"

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1/16. Primary pulmonary malignant meningioma.

    Fewer than 20 cases of primary pulmonary meningioma have been reported. Most of these cases have been histologically and clinically benign. We report an unusual case of primary pulmonary malignant meningioma with atypical histologic features and malignant behavior. A computed tomography scan of the head did not show evidence of tumor. The right upper lobe mass was resected and showed features of an atypical meningioma with loss of architectural pattern, mild nuclear pleomorphism, increased mitotic counts (up to 15 mitotic figures per 10 high power fields), and focally prominent nucleoli. Focally, cells with rhabdoid features were identified. The tumor's immunohistochemical and ultrastructural profiles were consistent with a meningioma. The tumor stained negative for estrogen and focally positive for progesterone receptors and had a MIB-1 labeling index (marker of cell proliferation) of 9.2%. Approximately 5 months after the initial resection, the patient experienced a tumor recurrence with multiple lymph node metastases, spread to the middle and lower lobes of the right lung, and metastasis to the diaphragm. Rarely, primary pulmonary meningiomas may present as high-grade malignant lesions.
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ranking = 1
keywords = rhabdoid
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2/16. Malignant meningioma with rhabdoid transformation.

    We report a rare case of recurrent meningioma with malignant change and rhabdoid transformation in a 54-year-old woman who presented with severe headache and progressive weakness of the right extremities. The patient had a history of atypical meningioma and had undergone a craniotomy to remove a tumor nine years earlier. We discuss the distinctive morphologic, immunohistochemical staining and ultrastructural features of a recurrent malignant meningioma. A meningioma with rhabdoid transformation may indicate aggressive biologic and clinical behavior of the tumor.
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ranking = 6
keywords = rhabdoid
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3/16. meningioma with rhabdoid transformation.

    A 29-year-old man was operated on for an intracranial tumour with the gross features of a meningioma. histology showed features of a rhabdoid tumour. The tumour recurred in 1997, 17 months after the first operation, and was re-excised and showed identical histology. Meningiomas with rhabdoid change are very rare. The clinicopathologic features are presented and the differential diagnoses discussed.
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ranking = 6.1361992841997
keywords = rhabdoid, rhabdoid tumour
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4/16. Rhabdoid papillary meningioma.

    We have studied an uncommon case of rhabdoid papillary meningioma in a 15-year-old boy with a dura-based mass arising in the left posterior fossa. The patient exhibited prominent extracranial extension during the past 6 years, consisting of a mixture of both perivascular pseudopapillary growth and rhabdoid cytologic features of neoplastic meningothelial cells. The meningothelial features were evidenced by the focal whorl formation of tumor cells, coexpression of epithelial membrane antigen and vimentin, and ultrastructural findings of interdigitated cytoplasmic process and intercellular junction. However, the regional and histologic resemblances to ependymoma were further complicated by unexpected focal expression of glial fibrillary acidic protein, neurofilament, and alpha-smooth muscle actin of the tumor cells. The rhabdoid morphology was characterized by sheets of tumor cells with eccentric nuclei and abundant eosinophilic cytoplasm with often recognizable intracytoplasmic hyaline inclusions. These inclusions revealed ultrastructural paranuclear whorls of intermediate filaments, ruling out the other forms of intracytoplasmic eosinophilic inclusions resembling rhabdoid morphology. diagnosis of an unusual rhabdoid papillary meningioma with aggressive behavior is resoluble by immunohistochemical and ultrastructural analyses.
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ranking = 5
keywords = rhabdoid
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5/16. April 2001: a 70 year old woman with recurrent meningioma.

    The April Case of the Month (COM). The contributors report a case of a 70 year-old woman with recurrent meningiomas, one of which showed rhabdoid and lipomatous differentiation. Histopathological study of the first and second previous resections showed only typical meningothelial meningioma. On the third craniotomy, a new tumor specimen showed an admixture of classic meningothelial meningioma with lipomatous and rhabdoid foci. Immunohistochemical studies showed diffuse reactivity for epithelial membrane antigen and vimentin, as well as focal positivity for desmin and smooth muscle actin in the areas with rhabdoid features and S100 protein in the lipomatous foci. The presence of these three different and concomitant histological patterns only in the third surgical resection might support a metaplastic origin and, also, corroborates the concept that rhabdoid features are suggestive of an aggressive behavior.
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ranking = 4
keywords = rhabdoid
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6/16. Evidence of recurrent atypical meningioma with rhabdoid transformation and expression of pyrogenic cytokines in a child presenting with a marked acute-phase response: case report and review of the literature.

    Children presenting with acute systemic illnesses that lack specific clinical or serological defining features may be diagnosed as having a chronic infection, an atypical systemic vasculitis or a connective tissue disease, but often turn out to have occult neoplasias. cytokines have been implicated in causing many of the systemic effects in such cases. In this study, we describe the case of a 9-year-old boy presenting at an interval of 18 months with a marked acute-phase response due to a recurrent atypical meningioma with rhabdoid transformation of the tentorium cerebelli. Resection of the recurrent tumor was curative. We evaluated in detail the local and systemic production of cytokines released by the primary and the recurrent tumor. blood and CSF samples were taken pre-, intra-, and postoperatively, and the production of IL-6, IL-1beta, and TNF-alpha was measured by enzyme-linked immunosorbent assays (ELISA). The level of IL-6 in CSF was about 150-fold increased before tumor resection, normalizing postoperatively. On the contrary, the levels of IL-1beta and TNF-alpha in CSF and of IL-6, IL-1beta, and TNF-alpha in serum were pre-, intra-, and postoperatively within normal limits. Cytokine production was also evaluated immunohistochemically, and confirmed strong IL-6 and TNF-alpha expression in the primary and the recurrent tumor, while expression of IL-1beta was lacking. The scattered MHC class II- and leukocyte common antigen (LCA)-expressing inflammatory cells, which were infiltrating exclusively the tumoral stroma, had no detectable cytokine immunoreactivity. We conclude that chronic IL-6 and TNF-alpha production by the tumor cells in this patient was responsible for the severe systemic illness with which he presented.
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ranking = 5
keywords = rhabdoid
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7/16. Malignant rhabdoid meningioma arising in the setting of preexisting ganglioglioma: a diagnosis supported by fluorescence in situ hybridization. Case report.

    A highly malignant brain neoplasm with rhabdoid morphological features emerged in the bed of a subtotally resected ganglioglioma in a 54-year-old retired nuclear submarine officer. A combined application of neuroimaging, immunohistochemical studies, electron microscopy, and fluorescence in situ hybridization (FISH) was used to establish the morphological identity of the tumor. The rhabdoid appearance of the tumor cells indicated either an especially malignant variant of rhabdoid meningioma or an atypical teratoid/rhabdoid tumor with an unusually late onset. Whereas immunohistochemical studies and electron microscopy could only be used to narrow down the differential diagnosis, FISH revealed loss of one copy of NF2 with preservation of the INI1 region on 22q, thus establishing the identity of the tumor.
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ranking = 8
keywords = rhabdoid
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8/16. Rhabdoid meningioma: intraoperative diagnosis using smear preparation.

    Tumors with rhabdoid morphology were first described by Beckwith and Palmer in 1978 as aggressive renal tumors in very young children. Subsequently, rhabdoid tumors and tumors with rhabdoid features have been described in many other organ systems and all tend to have a poor outcome no matter what the histogenesis of the original tumor. Rhabdoid cells are plump, with abundant eosinophilic fibrillary to hyaline cytoplasm and peripheral, vesicular, variably pleomorphic nuclei. Nucleoli are invariably present. While their morphology is well recognized in processed biopsy material, their presence on a smear preparation can be quite startling. A case is presented to highlight the appearance of rhabdoid cells on an intraoperative smear preparation of a rhabdoid meningioma. An accompanying secretory component added to the complex picture.
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ranking = 5
keywords = rhabdoid
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9/16. Rhabdoid meningioma: cytopathologic findings in cerebrospinal fluid.

    Rhabdoid meningioma is a recently described, rare, WHO Grade III intracranial tumor with an aggressive growth pattern and increased risk of recurrence. We describe the cytopathologic findings on cerebrospinal fluid of one such case in a 26-yr-old female who underwent resection of a left temporo-parietal mass. cerebrospinal fluid contained abundant malignant cells with a prominent "rhabdoid" phenotype, i.e., large cells, eccentric nuclei, single prominent nucleoli, and dense eosinophilic cytoplasm. Although rhabdoid meningioma has a characteristic cytomorphology, the differential diagnosis of this tumor would involve metastatic adenocarcinoma, metastatic malignant melanoma, and other tumors with "rhabdoid" features (such as an atypical teratoid/rhabdoid tumor).
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ranking = 4
keywords = rhabdoid
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10/16. "Rhabdoid meningioma" lacking malignant features. Report of two cases.

    We report 2 cases of meningiomas with rhabdoid morphology but lacking histological features of malignancy. Both occurred in adult women, one arising from the superior surface of the tentorium and the other in the Sylvian fissure. The tumors showed light microscopic, immunohistochemical and ultrastructural evidence of meningothelial differentiation together with diffuse or focal areas exhibiting rhabdoid morphology. The rhabdoid areas were characterized by cells with large cytoplasmic eosinophilic inclusions and large eccentric nuclei. Both cases showed areas with sheet-like growth and one had macronucleoli and brain invasion. The same case showed areas of necrosis that most likely related to pre-operative arterial embolization. Unlike most cases reported in the literature, these "rhabdoid meningiomas" lacked significant mitotic activity or other atypical features. The diagnostic and prognostic significance of this tumor entity is discussed along with a review of the literature.
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ranking = 4
keywords = rhabdoid
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