Xanthomatous meningiomas are rare histological variants of metaplastic meningiomas. They are characterised 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.
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Epidemiology
The number of xanthomatous meningiomas fully documented is still small, no favoured age group or gender were identified, with reported cases in children, adults and elderly patients 1,3.
Pathology
Metaplastic meningiomas are characterised by tumour 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.
Radiographic features
CT
- 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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