651/2332. Jugular foramen papillary meningioma: a case report. Jugular foramen meningioma is very rare. Papillary meningioma, the histological aspects and clinical behavior of which are highly malignant, is also very rare. Only 55 cases of jugular foramen meningioma have been reported in the literature. To our knowledge, this is the first report of a jugular foramen papillary meningioma. A 25-year-old woman presented with hoarseness and right hearing disturbance. Neurological examination showed deficits of the right hypoglossal and vagus nerves with palsy. magnetic resonance imaging (MRI) revealed a mass on the right jugular foramen extending intracranially and extracranially, with weak contrast enhancement. The intracranial tumor was removed via the right lateral suboccipital approach. Histopathological examination confirmed the diagnosis of papillary meningioma. We report here the first case of jugular foramen papillary meningioma. No completely effective treatment for papillary meningiomas exists at present, with the exception of surgery. ( info) |
652/2332. Primary chordoid meningioma of lung. Primary meningiomas of the lung are rare. Most pulmonary meningiomas are typical syncytial or transitional meningiomas with smaller numbers of fibrous-type tumors. Herein, we report an unusual pulmonary tumor with the microscopic, immunohistochemical, and ultrastructural characteristics of a chordoid meningioma. The tumor was composed of cords and fascicles of small- to medium-sized spindle and epithelioid cells with eosinophilic cytoplasm and round nuclei with finely dispersed chromatin. The tumor cells were surrounded by an abundant mucoid, vacuolated stroma. The periphery of the tumor was enveloped by a significant lymphoplasmacytic infiltrate. The neoplastic cells were positive for vimentin and epithelial membrane antigen only. The unusual morphology of the tumor caused significant diagnostic difficulties. The differential diagnosis included inflammatory myofibroblastic tumor, spindle cell myoepithelioma, and extraskeletal myxoid chondrosarcoma. To the best of our knowledge, this is possibly the first description of an extracranial or intrapulmonary chordoid meningioma. ( info) |
| We observed three neoplasms with completely different histologies: malignant fibrous histiocytoma (MFH), atypical meningioma (AM), and glioblastoma (GB), developing in a patient with li-fraumeni syndrome. By using a combined molecular approach we performed molecular characterization of all three tumours. Data obtained showed an interesting molecular background of the AM and GB. AM showed TP53mutations and a 22q loss of heterozygosity (LOH). GB showed epidermal growth factor receptor (EGFR) amplification and TP53 mutations, whereas P16, PTEN, Rbwere intact in terms of LOH and/or multiplex PCR (polymerase chain reaction) analysis. Additionally, GB has a 1q LOH, which is an extremely rare alteration in glioblastomas. Identical 1q LOH was also observed in MFH. ( info) |
654/2332. Congenital supratentorial meningeal arteriovenous malformation with hemangioma and massive arachnoid cell hyperplasia. CASE REPORT: We describe the clinical, radiological and pathological findings of concurrent, congenital leptomeningeal arteriovenous malformation with hemangioma diagnosed in a newborn by prenatal and immediately postnatal magnetic resonance imaging. Vascular abnormalities were accompanied by massive arachnoidal cell hyperplasia reminiscent of meningioma. CONCLUSION: To the best of our knowledge, this is the first case of such a lesion reported in the literature. ( info) |
655/2332. Acute posttraumatic paraplegia associated with asymptomatic thoracic meningioma. A case of a patient with acute paraparesis after compression fracture of the twelfth vertebra with progressive neurological deterioration is reported. The occurrence of clinical asymptomatic thoracic meningioma and coincidence with posttraumatic compression fracture of the vertebra at the same level resulting in acute paraparesis is extremely rare. ( info) |
656/2332. Metastatic meningioma to the lungs. meningioma with extracranial metastases is a rare occurrence. However, the lungs are the most common site of extracranial metastases. We describe a case of a patient with recurrent intracranial meningioma and intrapulmonary metastases. ( info) |
657/2332. Cervical spine meningioma presenting as otalgia: case report. OBJECTIVE AND IMPORTANCE: Cervical spine meningiomas have not been reported to present as otalgia. It is important to include otalgia in the differential diagnosis and workup, especially when more common causes of ear pain have been excluded. CLINICAL PRESENTATION: A 66-year-old woman presented to her primary care physician with severe ear pain. She underwent routine diagnostic testing and eventually was referred to a neurologist. After conservative management failed, the patient underwent cervical spine magnetic resonance imaging, which revealed a large meningioma encompassing C2-C3. INTERVENTION: The patient underwent a cervical laminectomy with complete resection of the tumor. She experienced immediate postoperative resolution of her symptoms. CONCLUSION: This case illustrates the importance of aggressive evaluation of otalgia when routine diagnostic studies are inconclusive. Cervical meningiomas are associated with significant potential morbidity and should be excluded early in the diagnostic process. ( info) |
658/2332. Intraspinal clear-cell meningioma: case report and review of literature. BACKGROUND: Intraspinal clear-cell meningioma (CCM) is a rare morphological variant of meningioma with only 16 documented cases. We report one case and review the literature regarding intraspinal CCM. CASE PRESENTATION: A 2-year-old boy and a 2-month-old male infant presented with knee pain and leg weakness. magnetic resonance imaging revealed an intradural extramedullary neoplasm at T10-L1. The patient underwent radical resection of the tumor. pathology and immunohistochemical study demonstrated a CCM. Unfortunately, the patient had a recurrence 5 years after the operation. CONCLUSION: Intraspinal CCMs are very uncommon tumors. They usually show aggressive behavior with local recurrence observed in slightly more than half of all patients. We recommend serial imaging studies every 3 to 6 months during the first several years, after which an annual imaging study should be performed for follow-up. ( info) |
659/2332. The anterior approach to anterior cervical meningiomas: review illustrated by a case. Anterior cervical meningiomas have traditionally been operated on by a posterior approach. However, several reports of an anterior approach to anterior cervical meningiomas and other anterior cervical intradural lesions have documented important advantages: large bony window of access, extradural coagulation of anterior blood supply to meningiomas, visualization of the intradural pathology in front of the spinal cord, and absence of manipulation of the spinal cord during resection of the lesion.In this study, the literature about anterior approaches to anterior cervical meningiomas is systematically reviewed and the advantages and disadvantages of the technique are discussed. Furthermore, a case of complete resection of a large anterior cervical intradural extramedullary meningioma from C5-7 by a three-level corpectomy with progressive postoperative neurological recovery is illustrated, confirming the advantages of the anterior approach. ( info) |
660/2332. Cervical spine chordoid meningioma. Case report. Chordoid meningiomas are a rare but increasingly recognized subtype of meningioma. Although some cases have been associated with systemic symptoms, in many instances the clinical features are indistinguishable from those associated with other subtypes of meningioma. Given the prognostic significance of the diagnosis of chordoid meningioma, careful consideration should be given to the diagnosis during histological assessment. The authors describe a rare case of chordoid meningioma in the cervical spinal region. ( info) |