Primary mediastinal malignant meningioma
Department of Thoracic Surgery, The Northern Hospital, Shenyang, Liaoning, China.European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery (Impact Factor: 3.3). 05/2009; 36(1):217-8. DOI: 10.1016/j.ejcts.2009.03.040
Primary ectopic meningiomas are extremely rare tumors of controversial origin and they are usually limited to the head and neck region. Its occurrence at the mediastinum is even rarer. There has not been any official report regarding primary mediastinal malignant meningioma until today. Because of its rarity and potential value, we report here a case of primary mediastinal malignant meningioma, which turns out to be the first reported case of this type of meningioma. The clinical features, treatment plans, pathological findings, as well as prognosis of a case of primary mediastinal malignant meningioma were carefully analyzed and the literature on ectopic meningioma was reviewed. The diagnosis of ectopic meningioma can only be established based on microscopic and immunohistochemical findings. Surgery is the treatment of choice for ectopic meningioma and postoperative radiotherapy should be managed for patients with suspected invasive meningioma.
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ABSTRACT: Follicular dendritic cell (FDC) sarcoma is a rare low-to-intermediate grade malignant dendritic cell neoplasm that often has an indolent clinical course. FDC sarcomas are often misdiagnosed on aspiration cytology. A 26-year-old woman presented with a solid, slowly growing, painless mass in her right neck for 3 months. Computed tomography revealed a 3.6-cm, well-defined homogenous solid mass located posterior to the mandible and submandibular glands. Fine needle aspiration cytology revealed many large, spindle to ovoid epithelioid cells in singles, small clusters, and syncytial sheets with moderate to abundant cytoplasm, indistinct cell borders, irregular nuclear membrane, fine to vesicular chromatin, and conspicuous nucleoli. The background contained many small mature lymphocytes intimately mixed with large epithelioid tumor cells. Tumor cells were strongly positive for CD21, CD35, CD23, and fascin. Diagnosis of FDC sarcoma was rendered; follow-up surgical resection and ultrastructural study confirmed the diagnosis. The cytogenetic study showed a normal female karyotype 46,XX. Although the cytomorphology of FDC sarcoma is characteristic, a preoperative diagnosis of FDC sarcoma based on fine needle aspiration cytology is very challenging, if not impossible. Immunohistochemistry is always necessary for rendering and/or confirming the diagnosis, and ultrastructural studies are helpful.Acta cytologica 01/2010; 54(5 Suppl):759-63. · 1.56 Impact Factor
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ABSTRACT: Primary extradural meningiomas (PEMs) represent about 2% of all meningiomas and are often encountered by non-neurosurgeons. These lesions typically present as enlarging, painless, benign masses that can be surgically cured. Imaging is critical for defining involvement of adjacent structures; however, diagnosis depends on classic histologic patterns. Treatment for benign PEMs (WHO I) consists of resection with wide margins, whereas adjuvant therapy after resection of atypical (WHO II) or malignant (WHO III) PEMs should be considered. By using the collective experience from our comprehensive cancer center, including neuro-oncologists, neuroradiologists, and neurosurgeons, in addition to a complete literature review, the authors have established treatment guidelines not previously reported. This manuscript describes key features of these challenging tumors to aid in diagnosis, presents the largest published review of all reported PEMs (n = 163), and provides salient treatment guidelines to surgeons unfamiliar with these challenging tumors.Cancer 01/2011; 117(1):24-38. DOI:10.1002/cncr.25384 · 4.89 Impact Factor
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