Angiomatous meningioma

Case contributed by A.Prof Frank Gaillard

Presentation

Headache.

Patient Data

Age: 70 years
Gender: Male
Modality: MRI

A mildly T2 hyperintense, vividly enhancing, extraaxial mass arises from a broad dural base along the anterior wall and floor of right anterior cranial fossa, with mass effect on the right frontal pole and orbital gyri. A small enhancing dural tail extends medially. 

Numerous FLAIR hyperintense foci involve the supratentorial white matter, and there is patchy signal abnormality of the brainstem. Appearances are consistent with moderately severe for age microvascular ischaemia.

Multiple foci of susceptibility artefact is likely to be secondary to amyloid angiopathy. Ventricles and sulci are within limits for age.

Conclusion: 

Features are those of a meningioma. 

Case Discussion

The patient went on to have surgery.

Histology

MICROSCOPIC DESCRIPTION: The sections show a moderately cellular meningioma. The tumour forms whorls and fascicles. The tumour cells have ovoid nuclei with no nuclear pleomorphism. The background shows many blood vessels of varying sizes. They have marked intimal hyperplasia. Mitotic figures are inconspicuous. Necrosis is absent. There is no brain parenchyma included in the biopsy. No evidence of atypical or malignant change is identified.

 

FINAL DIAGNOSIS: Angiomatous meningioma (WHO grade I).

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Case Information

rID: 42303
Case created: 15th Jan 2016
Last edited: 17th Apr 2016
Inclusion in quiz mode: Included

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