Cyst formation of meningioma: report of two cases and review of literature

Cystic meningioma is rare and said to account for 1 to 2% of all types of meningioma. Here we report two cases of cystic meningioma. Case 1 is a 25-year-old man. He had suffered from sporadic epileptic seizure for about two years until the first CT was performed. It revealed a large cystic lesion at the right parietal region in touch with the midline structure. A nodular high density area was delineated in the contrast enhanced CT on the medial wall of the cyst. He showed no neurological abnormality at all. Case 2 is a 56-year-old female who had been complaining of memory disturbance, and an episode of sudden dizziness followed by a syncope that lasted for a few minutes. Neurological examination revealed slight right hemiparesis, right homonymous hemianopsia and left papilledema. A large cystic lesion was delineated at the temporal region in the plain CT, and no positively enhanced region could be found in the contrast enhanced CT. After surgical removal of the tumors, both cases were identified as cases of meningioma. They were diagnosed histopathologically as a fibroblastic meningioma and a meningotheliomatous meningioma respectively. The wall of the cyst consisted of the cortical surface per se in both cases. Preoperative diagnosis of such cases and the mechanism by which the cyst is formed were also discussed.     

Lymphoplasmacyte-rich meningioma: a report of three cases and a review of the literature]

We report three patients (a 36-year-old man, a 41-year-old woman, and a 22-year-old man) with lymphoplasmacyte-rich meningioma who manifested characteristics on radiological and blood examinations. Two were hospitalized with gradual deterioration of hemiparesis and one with general convulsive seizure. Radiological examination revealed typical meningiomas of convexity in two and that of falx in one. Two of the patients showed large perifocal edema. Anemia was found in one patient and an elevated level in the zinc sulfate turbidity test was noted in all cases. Abnormal findings in laboratory examination improved quickly, whereas perifocal edema remained for six months after tumor removal. The tumors were histologically confirmed to be meningioma with massive infiltrates of plasma cells and lymphocytes. Seventeen cases of lymphoplasmacyte-rich meningioma that have been reported to date including our three cases were reviewed.     

Cervical extradural meningioma: case report and literature review

BACKGROUND: Extradural lesions are most commonly metastatic neoplasms. Extradural meningioma accounts for 2.7 to 10% of spinal neoplasms and most commonly is found in the thoracic spine. DESIGN: Case report. FINDINGS: A 45-year-old woman presented with posterior cervicothoracic pain for 8 months following a motor vehicle crash. Magnetic resonance imaging of the cervical spine revealed an enhancing epidural mass. Computerized tomography of the chest, abdomen, and pelvis revealed no systemic disease. Due to the lesion's unusual signal characteristics and location, an open surgical biopsy was completed, which revealed a psammomatous meningioma. Surgical decompression of the spinal cord and nerve roots was then performed. The resection was subtotal due to the extension of the tumor around the vertebral artery. CONCLUSION: Meningiomas should be considered in the differential diagnosis of contrast-enhancing lesions in the cervical spine.     

Malignant intraventricular meningioma: literature review and case report

Malignant intraventricular meningiomas (IVMs) are very rare with only a few reported cases. A midline search up to December 2020 selected 40 articles for a total of 65 patients. The inclusion criteria were series and case reports in English language, as well as papers written in other languages, but with abstracts written in English. Malignant IVMs at the first diagnosis (group A, 50 patients) and those with anaplastic transformation from previous WHO grades I and II tumors (group B, 15 patients) were separately analyzed. The unique personal case among 1285 meningiomas (0.078%) is also added. Malignant IVMs mainly occur in women (61%) with a median age of 45 years and are mainly located in the lateral ventricle (93%) and trigonal region (74%), with no cases in the fourth ventricle. Irregular borders (80%), heterogeneous enhancement (83%), and perilesional edema (76%) are the most frequent radiological findings. The histology was mainly pure anaplastic (85%), whereas papillary (7%), rhabdoid (5%), and mixed forms (3%) are very rare. The CSF spread was found in 60% of the cases. The prognosis is very dismal, with an overall median survival of 17.5 months after surgery for the anaplastic forms. Malignant IVMs at initial diagnosis (group A) show better overall survival (25 months) than those occurring from anaplastic transformation of lower grade tumors (group B) (10.1 months).

     

Deep sylvian meningioma: case report and review of the literature

A case of intrasylvian meningioma is presented with some considerations to the clinical, radiological, and pathological features of the tumor. A 34-year-old Japanese woman, who had experienced several episodes of fainting attacks since 19 years old, was admitted to our hospital on March 22, 1983. Her plain skull roentgenogram showed abnormal calcification in her left fronto-temporal region. CT scan demonstrated clear-marginal high density mass in the left sylvian fissure which was homogeneously enhanced after administration of contrast medium. Left carotid angiogram showed intrasylvian mass with small tumor stain in late arterial phase, but external carotid artery had no concern with this tumor. On March 30, left fronto-temporal craniotomy was performed. The tumor was located in the extra-axial space of the sylvian fissure without any attachment to the dura mater or to the choroid plexus of the ventricles. This hard tumor, 70 grams in its weight, was successfully removed. It was histologically diagnosed fibroblastic meningioma. The patient was discharged without any neurological deficits. Twenty-four cases of meningiomas not attached to the dura mater or to choroid plexus could be reviewed from the literature. This type of meningioma is occasionally called "deep sylvian meningioma", but in some reports the tumors developed far from sylvian fissure. And even in the cases in which the tumors were reported to be located in the sylvian fissure, macroscopic space where tumors developed was various. The clinical features, diagnosis, and surgical management of this tumor were also discussed in the report.     

Intramedullary meningioma: case report and review of the literature.

Intramedullary meningioma is a rarely reported clinical entity. As far as we know, only three cases have been reported to date. We describe a further case at the cervical level and review the few published cases.     

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.     

Pseudo-oligodendrogliomatous meningioma. Report of 2 cases and review of the literature]

We report two cases of oligodendroglioma-like meningioma revealed by symptoms of increased intracranial pressure, progressive hemiparesia and partial epileptic seizures. Brain CT-scan or scintigraphy and carotid arteriography were suggestive of a convexity meningioma. One patient had received radiation treatment for scalp tinea capitis 25 years previously. In spite of complete surgical removal, the tumor recurred in both cases respectively 17 years and 18 months later. The two patients were operated again, and one underwent a complementary radiotherapy. Pathologic diagnosis was particularly difficult in the first case where the pattern at conventional histologic technics was that of oligodendroglioma. On the occasion of recurrence, immuno-histochemistry and ultrastructural studies were performed. The tumor was positive for epithelial membrane antigen (E.M.A) and cytokeratin, but was negative for glial fibrillary acidic (G.F.A.) protein, S 100 protein (S 100), neuron-specific enolase (N.S.E.), vimentin, anti-LEU-7 (N.H.K.1), and neurofilaments (N.F.). Electron microscopy showed closely adjacent cells with tonofilaments and numerous desmosomes. These findings permitted to establish the diagnosis of oligodendroglioma-like meningioma instead of oligodendroglioma. In the second case, the histologic pattern was also reminiscent of oligodendroglioma, but presence of few cellular whorls in some part of the tumor permitted the correct diagnosis. The pathogenesis of this atypical form of meningioma, its tendency for recurrence, and usefulness of radiotherapy are discussed and literature is reviewed.     

Cystic meningioma. Case report and literature review

BACKGROUND: Cystic meningioma is a rare variety of meningioma. It represents 1,6 to 10% of intracranial meningiomas, the authors report a case of intracranial cystic meningioma with a review of literature. CASE REPORT: A 46-year-old female presented with left parietooccipital headache followed by right side hemiparesis. CT scan brain showed a left parietal tumor with double solid and cystic components thought to be glioma or metastasis preoperatively. At surgery the extraaxial solid and cystic lesion had a well defined capsule that could be easily separated from the perilesional cortical surface. The tumor was totally removed. The histological study showed a cystic meningioma. CONCLUSION: Cystic meningioma is an uncommon tumor that should be considered in the differential diagnosis of brain tumors with a cystic component.     

椎管内血管周细胞瘤2例报告并文献复习

血管周细胞瘤（ hemangiopericytoma, HPC）,又称血管外皮细胞瘤,是一种起源于血管周细胞的中间型侵袭性肿瘤,主要发生于软组织和骨质,而发生于中枢神经系统者很少见,其中原发于椎管者更为罕见。1942年Stout和Murray^[1]首次将外膜细胞构成的肿瘤命名为血管外皮细胞瘤,即HPC。     

Posttraumatic intracranial meningioma: a case report and review of the literature

A case of posttraumatic meningioma with pathological evidence of intimate association with a nidus of chronic inflammatory reaction is presented. The literature regarding the controversial association of trauma with this neoplasm is critically reviewed. Although meningiomas are not common sequelae of head trauma, it is proposed that they may arise when the injury results in chronic inflammation.     

胡桃夹综合征2例报告并文献复习

目的 探讨胡桃夹综合征的诊断及治疗.方法 回顾性分析本院收治的2例胡桃夹综合征患者的临床资料,检索并复习国内外相关文献,2例患者均行腹腔镜下左肾静脉人造血管外支架置入固定术,术中将直径约1cm长约4～5cm的带外支撑环的e-PTFE人造血管固定于下腔静脉与肾门之间的左肾静脉外,抵抗肠系膜上动脉的压迫,减轻肾静脉受压.结果 2例患者手术顺利,分别于术后12d、13d肉眼血尿消失,术后1个月复查尿常规均提示:潜血(-),尿蛋白(-),术前伴有精索静脉曲张者,术后1个月复查症状明显减轻,随访6个月未复发.结论 尿红细胞形态分析及计数、膀胱镜检查、彩超及CTA对于胡桃夹综合征诊断有重要价值,腹腔镜下左肾静脉血管外支架置入固定术治疗胡桃夹综合征疗效满意、并发症少、恢复快.     

暴发性心肌炎2例报告并文献复习

目的:报道2例暴发性心肌炎(fulminant myocarditis)患儿,以提高对该病的认识.方法:对2007年12月-2008年1月我院收治的暴发性心肌炎2例的临床资料进行回顾性分析.结果:2例均为女性,中位数年龄7.6岁.2例均以腹痛、呕吐起病,1例伴心动过速(12岁心率160次/分),1例心率正常(3.2岁心率110次/分),2例均在入院后数小时出现心源性休克,阿-斯综合征.白细胞计数、心肌酶、C-反应蛋白显著升高,ST-T改变.2例均给与吸氧、卧床休息、1-6二磷酸果糖及大剂量Vitc静滴.2例均死亡.结论:暴发性心肌炎常以心外症状首发,部分患儿以腹痛、呕吐为主诉,病情凶险、进展迅速、病死亡率高.早期诊断、早期应用甲强龙及丙种球蛋白、积极监护尤为重要.     

原发性肾脏淋巴瘤2例报道并文献复习

目的探讨原发性肾脏淋巴瘤的临床特点。方法总结2例原发性肾脏淋巴瘤患者的临床资料,结合文献讨论其发病特点、影像学特征、治疗及预后。结果 2例患者均实施手术加化疗,病理诊断均为非何杰金淋巴瘤,1例死于术后2月,另1例已存活1年,仍在随访中。结论原发性肾脏淋巴瘤是一种罕见的恶性淋巴瘤,影像学征象与肾细胞癌相似,以成人发病为主,易误诊为肾癌,病理类型多为B细胞来源的非何杰金淋巴瘤,综合治疗是延长生存的较好方式。     

Bilateral renal oncocytoma: report of 2 cases and literature review

We report on 2 patients with bilateral renal oncocytoma treated in the last 5 years. One patient underwent bilateral partial nephrectomy for a solitary tumor in each kidney. Both tumors were confirmed to be renal oncocytomas by light and electron microscopic examination. After 4 years this patient had no evidence of local recurrence or distal metastasis. The second patient presented with bilateral multiple renal oncocytomas. Transabdominal bilateral renal exploration revealed 2 tumors in the right kidney and 3 tumors in the left kidney. Right radical nephrectomy and enucleation of the left renal tumors were performed. Examination by light and electron microscopy confirmed that all tumors from both kidneys were oncocytomas. Only 8 cases of bilateral renal oncocytoma have been reported in the literature, including our 2 cases. In 6 of these 8 cases the tumors were multicentric, which may be a characteristic of bilateral renal oncocytoma. Recognizing the coexistence of multicentricity and bilaterality is important because more conservative treatment is required. However, a favorable prognosis may still be anticipated.