Intraventricular metaplastic meningioma in a child: Case report and review of the literature

Stanford University Medical Center, Stanford, California 94305, USA.
Neuropathology (Impact Factor: 1.65). 04/2009; 29(6):708-12. DOI: 10.1111/j.1440-1789.2009.01008.x
Source: PubMed


Childhood meningiomas are rare and display important differences from adult forms. We report the first case of an intraventricular metaplastic meningioma arising in a child. A 7-year-old female underwent resection of an enhancing tumor arising within the left lateral ventricle. It was composed of monomorphic cells embedded within an abundant myxoid stroma. The cells demonstrated epithelial membrane antigen and vimentin immunoreactivity. Ultrastructural analysis demonstrated intermediate filaments, complex intercellular interdigitations and desmosomes, and a diagnosis of myxoid (metaplastic) meningioma was rendered. This case reflects the higher incidence of intraventricular meningiomas in childhood and greater incidence of intraventricular meningiomas in the left lateral ventricle. Recognition of the grade I myxoid meningioma in this case is paramount since chordoid meningiomas, which share similar histologic features, are of a higher grade and worse prognosis.

8 Reads
  • Source
    • "Case 1 is a metaplastic meningioma, characterized by mesenchymal elements, including osseous, cartilaginous and myxoid tissue, which may lead to calcification or ossification and cystic formation as exhibited in the MRI scans. A previous case report (7) regarding a metaplastic meningioma in a child also revealed similar MRI features; for example, the meningioma was located in the lateral ventricle and cystic changes were observed within the tumor. By contrast, case 2 is of a psammomatous meningioma, which is mainly composed of hyalin and calcifies to form the characteristic concentric calcifications known as psammoma bodies, thus, is shown as a densely calcified mass on MRI and CT scans. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Cystic meningioma is an uncommon meningioma variant that is often difficult to distinguish from other intra-axial tumors, including necrotic gliomas. Cystic meningiomas located in the ventricle are particularly rare and may be misdiagnosed with other brain tumors, including ependymoma, choroid plexus papilloma and neurocytoma, due to its location. The present study discusses two cases of lateral ventricular meningiomas, which exhibited intratumoral or peritumoral cystic changes on magnetic resonance imaging scans. The two patients underwent surgical treatment and histological examination confirmed one case of metaplastic meningioma and the other case of psammomatous meningioma. The two patients were middle-aged females and had been misdiagnosed prior to surgery. Although this clinical entity is rare, the diagnosis of meningioma should be considered, particularly in middle-aged female patients.
    Full-text · Article · May 2014 · Experimental and therapeutic medicine
  • [Show abstract] [Hide abstract]
    ABSTRACT: Optic neuropathy associated with proptosis and ocular motility restrictions is suggestive of a compressive etiology. This raises concern for a mass lesion involving the orbit or orbital apex. Meningiomas, which account for 4% of all intraorbital tumors and 20 to 30% of all intracranial tumors, are capable of compressing critical anatomic structures within the orbit or orbital apex, and thereby impairing both afferent and efferent visual function. The purpose of this case report is to present a case of chordoid meningioma associated with compressive optic neuropathy. A 51-year-old woman presented with clinicopathological features pathognomonic of compressive optic neuropathy and orbital apex syndrome. Radiologic and neuropathologic evaluation revealed a large right anterior temporal atypical meningioma with chordoid features associated with frontal intraparenchymal edema. The therapeutic intervention consisted of orbitozygomatic craniotomy and radiotherapy. Postoperatively, the patient progressed very well with considerable improvement of her visual and oculomotor function. The MIB-1 labeling index of 5 to 7% calls for close observation because of an increased probability of recurrence. This case highlights the importance of prompt diagnosis and treatment, because chordoid meningiomas exhibit a more aggressive biological behavior, with the potential to cause significant morbidity because of mass effect and higher risk of recurrence. To our knowledge, this is the first report of a rare case of a chordoid meningioma in the anterior temporal lobe that presented as a compressive optic neuropathy. The details of this case are presented with a review of relevant literature.
    No preview · Article · Feb 2011 · Optometry and vision science: official publication of the American Academy of Optometry
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Myxoid (metaplastic) meningioma is a rare WHO Grade I meningioma subtype arising from the leptomeninges. It has unique Alcian blue stromal staining and distinctive cellular interdigitations, junctional complexes, and nucleolar pseudoinclusions on ultrastructural pathology that help to distinguish it from other meningioma variants. The authors describe the case of a rare left middle fossa, extraaxial myxoid meningioma in a 50-year-old woman to emphasize the important histological characteristics and observations essential for making a precise diagnosis. To their knowledge this is the seventh reported case of a myxoid meningioma in the literature and the sixth case in an adult; however, it is the first reported instance of myxoid meningioma in a patient presenting with intratumoral hemorrhage.
    Full-text · Article · Jan 2012 · Journal of Neurosurgery
Show more