Presentation
Seizure.
Patient Data
There is a 42 x 51 x 63 mm large extra-axial dural based high convexity frontal mass with multiple cystic components in the right side.
Areas of marked restriction on DWI images (solid component) are seen.
Marked vasogenic edematous changes and mass effect on the ipsilateral frontal horn are also noted.
No evidence of obvious midline shift and subfalcine herniation is depicted.
Case Discussion
Pathology proved a case of cystic meningioma.
Microscopic: sections show the neoplastic cells arranged in a whorled or lobulated architecture and collagenous fibrous background (syncytial and fibrous pattern) with round to oval nuclei, dispersed chromatin, inconspicuous nucleoli, occasional pseudoinclusions, and eosinophilic cytoplasm. Scattered psammoma bodies, focal nuclear pleomorphism, and rare mitotic figures are noted.
Diagnosis: Meningioma with a mixture of syncytial and fibrous pattern (transitional variant), WHO grade 1.
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