A Case Report of Meningeal Hemangiopericytoma: A 9-Year Journey from the Brain to the Spine (original) (raw)
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Primary Extracranial Meningiomas: An Analysis of 146 Cases
Head and Neck Pathology, 2009
Primary extracranial meningiomas are rare neoplasms, frequently misdiagnosed, resulting in inappropriate clinical management. To date, a large clinicopathologic study has not been reported. One hundred and forty-six cases diagnosed between 1970 and 1999 were retrieved from the files of the Armed Forces Institute of Pathology. Histologic features were reviewed, immunohistochemistry analysis was performed (n = 85), and patient follow-up was obtained (n = 110). The patients included 74 (50.7%) females and 72 (49.3%) males. Tumors of the skin were much more common in males than females (1.7:1). There was an overall mean age at presentation of 42.4 years, with a range of 0.3-88 years. The overall mean age at presentation was significantly younger for skin primaries (36.2 years) than for ear (50.1 years) and nasal cavity (47.1 years) primaries. Symptoms were in general non-specific and reflected the anatomic site of involvement, affecting the following areas in order of frequency: scalp skin (40.4%), ear and temporal bone (26%), and sinonasal tract (24%). The tumors ranged in size from 0.5 up to 8 cm, with a mean size of 2.3 cm. Histologically, the majority of tumors were meningothelial (77.4%), followed by atypical (7.5%), psammomatous (4.1%) and anaplastic (2.7%). Psammoma bodies were present in 45 tumors (30.8%), and bone invasion in 31 (21.2%) of tumors. The vast majority were WHO Grade I tumors (87.7%), followed by Grade II (9.6%) and Grade III (2.7%) tumors. Immunohistochemically, the tumor cells labeled for EMA (76%; 61/80), S-100 protein (19%; 15/78), CK 7 (22%; 12/55), and while there was ki-67 labeling in 27% (21/78), \3% of cells were positive. The differential diagnosis included a number of mesenchymal and epithelial tumors (paraganglioma, schwannoma, carcinoma, melanoma, neuroendocrine adenoma of the middle ear), depending on the anatomic site of involvement. Treatment and follow-up was available in 110 patients: Biopsy, local excision, or wide excision was employed. Follow-up time ranged from 1 month to 32 years, with an average of 14.5 years. Recurrences were noted in 26 (23.6%) patients, who were further managed by additional surgery. At last follow-up, recurrent disease was persistent in 15 patients (mean, 7.7 years): 13 patients were dead (died with disease) and two were alive; the remaining patients were disease free (alive 60, mean 19.0 years, dead 35, mean 9.6 years). There is no statistically significant difference in 5-year survival rates by site: ear and temporal bone: 83.3%; nasal cavity: 81.8%; scalp skin: 78.5%; other sites: 65.5% (P = 0.155). Meningiomas can present in a wide variety of sites, especially within the head and neck region. They behave as slow-growing neoplasms with a good prognosis, with longest survival associated with younger age, and complete resection. Awareness of this diagnosis in an unexpected location will help to avoid potential difficulties associated with the diagnosis and management of these tumors.
Extracranial primary and secondary meningiomas
International Journal of Oral and Maxillofacial Surgery, 2012
Meningioma is a well-recognized tumour of the central nervous system. However, extracranial non-dural or ectopic meningiomas are rare and in most of the reported cases, meningiomas are diagnosed only after histopathologic examination. Over the last 5 years, the authors have seen three cases. In these case reports, they discuss the salient features of these lesions, which can aid the preoperative diagnosis and management of these patients. One of the cases is a rarity, owing to the extreme extracranial position which allowed the pressure of the tumour abrade the adjacent structures. In one case, reconstruction of the skull bone using polymeric materials (Acrylic matter) was necessary. In the other two cases, titanium plates and screws were used to reconstruct the jaw.
The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses, 2009
Approximately 30% of primary brain tumors are meningiomas; 90% of these are benign. The remaining 10% have aggressive pathological features and significantly higher recurrence rates. Treatments include surgery, radiation therapy, and other medical therapies. Management of these patients involves vigilant neuroradiological imaging, follow-up visits, symptom management, and ongoing patient and family teaching. Even with aggressive treatment modalities, morbidity and mortality rates remain high.
Meningothelioma as the predominant histological subtype of midline skull base and spinal meningioma
Journal of neurosurgery, 2006
Object. This study was undertaken to test a hypothesis that meningiomas of the midline skull base and spine are predominantly of the meningothelial histological subtype. Methods. The cases of 794 consecutive patients who underwent resection for meningioma at the Cleveland Clinic between January 1991 and March 2004 were reviewed retrospectively. The authors analyzed the relationship between the tumors' histological subtypes and sites of origin in the 731 patients from this group who harbored tumors that were determined to be benign histologically (World Health Organization Grade I). Meningothelial meningiomas (MMs) accounted for 63.5% (464/731) of the Grade I tumors. The incidence of MM according to the site of origin was as follows: 84.9% (186/219) in the midline skull base, 58.3% (35/60) in the lateral skull base, 48.5% (183/377) in a non-skull base location, and 80% (60/75) in spinal locations. The incidence of MM in the midline skull base and spinal locations were significantly higher than in non-skull base or lateral skull base locations. Conclusions. Meningiomas of the midline neuraxis are predominantly meningotheliomas. Analysis of the increasingly available data on genetic and topographic characteristics of MMs suggests that they may represent a unique entity, contrary to the prevailing belief that all benign meningiomas are identical tumors.
Vertebral metastases from intracranial meningioma
Acta Radiologica Short Reports, 2014
Meningioma rarely gives rise to metastases outside the brain and meninges. We report here a case of a patient who was treated for anaplastic brain meningioma with surgery and fractionated radiation therapy without any recurrence until 5 years after the operation, when she developed vertebral metastases.
Histological-subtypes and anatomical location correlated in meningeal brain tumors (meningiomas)
Journal of Neurosciences in Rural Practice, 2014
Context: Not enough literature is available to suggest a link between the histological subtypes of intracranial meningeal brain tumors, called 'meningiomas' and their location of origin. Aim: The evidence of correlation between the anatomical location of the intracranial meningiomas and the histopathological grades will facilitate specific diagnosis and accurate treatment. Materials and Methods: The retrospective study was conducted in a single high-patient-inflow Neurosurgical Center, under a standard and uniform medical protocol, over a period of 30 years from December 1982 to December 2012. The records of all the operated 729 meningiomas were analyzed from the patient files in the Medical Records Department. The biodata, x-rays, angiography, computed tomography (CT) scans, imaging, histopathological reports, and mortality were evaluated and results drawn. Results: The uncommon histopathological types of meningiomas (16.88%) had common locations of origin in the sphenoid ridge, posterior parafalcine, jugular foramen, peritorcular and intraventricular regions, cerebellopontine angle, and tentorial and petroclival areas. The histopathological World Health Organization (WHO) Grade I (Benign Type) meningiomas were noted in 89.30%, WHO Grade II (Atypical Type) in 5.90%, and WHO Grade III (Malignant Type) in 4.80% of all meningiomas. Meningiomas of 64.60% were found in females, 47.32% were in the age group of 41-50 years, and 3.43% meningiomas were found in children. An overall mortality of 6.04% was noted. WHO Grade III (malignant meningiomas) carried a high mortality (25.71%) and the most common sites of meningiomas with high mortality were: The cerebellopontine angles, intraventricular region, sphenoid ridge, tuberculum sellae, and the posterior parafalcine areas. Conclusion: The correlation between the histological subtypes and the anatomical location of intracranial meningeal brain tumors, called meningiomas, is evident, but further research is required to establish the link.
Extracranial meningiomas in the head-and-neck region: A 15 years' experience
Nigerian Journal of Clinical Practice, 2018
Meningiomas constitute a large group of tumors of the central nervous system, with the prevalence of 18%–20%. Extracranial localization of meningeomas could appear due to their extracranial origin or due to the spreading of intracranial meningeomas. In this paper, we present our 15 years' experience in the diagnosis and treatment of extra- and intracranial meningiomas invading the head-and-neck region. In the period from 2001 to 2016 at our clinic, there were five patients (three men and two women), with meningiomas of extracranial origin or meningiomas of intracranial origin, spreading into the head-and-neck region. All patients were surgically treated, with the addition of adjuvant radiation therapy in some of the cases. Postoperative and postirradiation complications were described as well.
Primary Extracranial Meningiomas of the Head and Neck
Life, 2021
Meningiomas represent the most common benign histological tumor of the central nervous system. Usually, meningiomas are intracranial, showing a typical dural tail sign on brain MRI with Gadolinium, but occasionally they can infiltrate the skull or be sited extracranially. We present a systematic review of the literature on extracranial meningiomas of the head and neck, along with an emblematic case of primary extracranial meningioma (PEM), which provides further insights into PEM management. A literature search according to the PRISMA statement was conducted from 1979 to June 2021 using PubMed, Web of Science, Google Scholar, and Scopus databases, searching for relevant Mesh terms (primary extracranial meningioma) AND (head OR neck). Data for all patients were recorded when available, including age, sex, localization, histological grading, treatment, possible recurrence, and outcome. A total of 83 published studies were identified through PubMed, Google Scholar, and Scopus databases...
Histopathological Spectrum of Meningioma in a Tertiary Care Hospital
2019
Background: Meningiomas are the commonest benign intracranial neoplasm with a diverse histological pattern. The aim of the study was to evaluate clinical and histopathological spectrum of meningiomas and grade them according to the 2016 WHO classification. Methods: The study included all cases of meningioma received between January 2017August 2018. The clinicoradiological features were noted and histological examination of H&E stained sections was done. Results: 82 cases were included in the study, of these 82.9% were intracranial in location while 17.1% were spinal. Female predominance was seen and commonest age range was 41-50 years(n=24). Histologically the most frequent meningioma intracranially was meningothelial and psammomatous meningioma in the spine. Grade I meningiomas accounted for 92.7% cases, Grade II 6.1% and Grade III 1.2%. Conclusion: Meningioma is a slow growing benign neoplasm in majority of patients with a wide variation in histological appearance. They are predom...
2013
12 À Aim: To report a rare case of a spinal WHO grade I meningioma extending 13 À through intervertebral foramina C7 to D4 with an extensive mediastinal mass and 14 À infiltration of the vertebrae, and to discuss the malignant behavior of a tumor 15 À classified as benign. Methods (Clinical Presentation, Histology, and Imaging): A 16 À 54-year-old man suffered from increasing lower back pain with gait difficulties, 17 À weakness and numbness of the lower extremities, as well as urge incontinence. CT 18 À scan of the thorax and MRI scan of the spine revealed a large prevertebral tumor, 19 À which extended to the spinal canal and caused compression of the spinal cord at 20 À the levels of C7 to D4 leading to myelopathy with hyperintense signal alteration 21 À on T2-weighted MRI images. The signal constellation (T1 with and without 22 À contrast, T2, TIR) was highly suspicious for infiltration of vertebrae C7 to D5.