Primary mediastinal malignant meningioma
ABSTRACT 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: 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 · 4.90 Impact Factor