Mixed microcystic and angiomatous meningioma
Headache and left sided weakness.
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MRI demonstrates a large extraaxial right sided parafalcine mass which is isointense on T1, hyperintense on T2 with areas of attenuation on FLAIR consistent with cystic regions. Bright enhancement of the solid components is noted. No convincing flow voids. The compressed adjacent brain demonstrates extensive edema.
This patient went on to have a craniotomy and resection of the mass.
Microscopic Description: Sections show a moderately cellular neoplasm, attached to dura matter. There are microcystic changes and prominent vascularity, including both thick and thin-walled blood vessels. In some areas, tumor cells with regular oval nuclei and abundant eosinophilic cytoplasm form solid sheets. There are foci of xanthomatous change and occasional cells associated with round eosinophilic globules. Whorl formation is not evident. There are no atypical features and no brain tissue is present to assess invasion.