Meningioma

Case contributed by A.Prof Frank Gaillard

Presentation

Headache

Patient Data

Age: 75 years
Gender: Male

MRI brain

Modality: MRI

Multiplanar sequences. Large left frontal convexity extra-axial dural based tumour measuring 4.8 x 4.2 x 3.4 cm in size associated with dural reaction along the anterior 50% of the cerebral convexity. Small cerebral invasion. This demonstrates prominence surface vessels and strong enhancement with no area of necrosis identified. There is considerable mass-effect on the underlying brain with the adjacent frontal gyrus appearing thickened, likely due to mass effect rather than a primary gyral abnormality. There is minor midline shift, moderately extensive white matter disease, likely of ischaemic nature. Old superior right cerebellar infarct. No acute haemorrhage detected. This lesion appears solitary.

No skull marrow lesion seen.

CONCLUSION

Large left frontal lobe convexity lesion likely to be a meningioma, less likely a haemangiopericytoma or dural metastasis.

Case Discussion

The patient went on to have a craniotomy and excision of the mass. 

Histology

MACROSCOPIC DESCRIPTION:

A flattened ovoid soft dull yellow grey and haemorrhagic tumour 53x52x27mm with a sheet of fibrous tissue on one broad aspect 45x42mm and up to 2mm thick. 

MICROSCOPIC DESCRIPTION:

The sections show a moderately hypercellular meningioma. This has a well developed syncytial architecture. Occasional calcified psammoma bodies are also noted. Tumour cells show mild nuclear pleomorphism. A very occasional mitotic figure is identified. No areas of necrosis are seen and there is no evidence of brain invasion. Broad attachment to dural is noted. The dural margins are clear of tumour.

DIAGNOSIS: Meningioma (WHO Grade I).

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Case Information

rID: 30745
Case created: 1st Sep 2014
Last edited: 15th Feb 2016
Inclusion in quiz mode: Included

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