Xanthomatous meningioma

Last revised by Frank Gaillard on 22 Nov 2021

Xanthomatous meningiomas are rare histological variants of metaplastic meningiomas. They are characterized by cells with a lipid-filled vacuolated cytoplasm.

Although reported numbers are too small to confirm that this is definitely the case (less than 10 reported cases 1), they appear to share similar clinical presentation and treatment and prognosis as other meningiomas, and thus these features are not repeated here. 

The number of xanthomatous meningiomas fully documented is still small, no favored age group or gender were identified, with reported cases in children, adults and elderly patients 1,3

Metaplastic meningiomas are characterized by tumor cells sharing the characteristics of tissues from other parts of the body. In the case of xanthomatous meningiomas, they show an extensive xanthomatous change in their cells together with the characteristic features of meningothelial meningiomas 1-3. As these cells are positive for the epithelial membrane antigen (EMA), they can be differentiated from macrophages 1.  

  • differing from the conventional meningiomas, they tend to be hypodense on non-contrast CT images due to the lipid content 4

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