Psammomatous meningioma

Psammomatous meningioma is a histologic subtype of meningioma usually presented as a heavily calcified intracranial or spinal mass lesion. The meningothelial and psammomatous types are the most common involving the spine. 

Please refer to the articles on meningioma and spinal meningioma for a broad discussion of this entity.

Meningiomas are more common in women, with a ratio of 2:1 intracranially and 4:1 in the spine. This histologic subtype is particularly more common to arise from thoracic spine. 

There is no relevant difference on clinical presentation among the various histologic subtypes of meningioma.  

The common histologic subtypes of ossified meningioma are transitional, psammomatous, and metaplastic 3. This densely calcified tumour is characterised by the presence of numerous psammoma bodies.

This tumour is classified as a benign meningioma (WHO grade one). 

Plain film 

Plain films no longer have a role in the diagnosis or management of meningiomas. This subtype could be seem as a calcification along the neuroaxis.  

CT

Usually presented as an extra-axial calcified mass lesion, although in some instances the mass is hyperdense on CT without overt calcification (more sparse psammoma bodies). 

MRI

Signal characteristics will depend on how calcified the tumour is. If very heavily calcified then the mass will be low on all sequences with little if any visible enhancement (burnt out meningioma). If calcification is less marked then signal characteristics are typically: 

  • T1: hypo or isointense
  • T2: hypo or isointense
  • T1 C+ (Gd): presence of enhancement

Surgical treatment could provide a partial or complete resection of the tumour, and the overall prognosis will depends in large part on the entirety of resection. 

Recurrence rates after a surgery is related also to a young age (<50 years), multiple lesions, calcification extension, and ossification. 

Share article

Article information

rID: 33440
Section: Pathology
Tag: refs
Synonyms or Alternate Spellings:
  • Psammomatous meningiomas

Support Radiopaedia and see fewer ads

Cases and figures

  • Drag
    Case 1
    Drag here to reorder.
  • Drag
    Fig 1: H&amp;E
    Drag here to reorder.
  • Drag
    Case 2: bone window
    Drag here to reorder.
  • Drag
    Case 2: T2
    Drag here to reorder.
  • Drag
    Case 3: T1 C+
    Drag here to reorder.
  • Drag
    Case 4: T2
    Drag here to reorder.
  • Updating… Please wait.
    Loadinganimation

    Alert accept

    Error Unable to process the form. Check for errors and try again.

    Alert accept Thank you for updating your details.