Multiple meningiomas consisting of fibrous meningioma and anaplastic meningioma.
A 61-year-old woman presented with progressive dementia over a period of 4 months. Computed tomographic (CT) scans and magnetic resonance (MR) imaging showed 2 meningiomas located at the left parasagittal region and the left sphenoid ridge. These tumors had distinct MRI findings; the left parasagittal tumour showed a clear peritumoral CSF space without brain oedema, but the sphenoid ridge tumour was large with marked peritumoral oedema. Total excision of these 2 tumours was attempted with favourable clinical improvement and histological studies revealed meningiomas of different histological types. The left parasagittal tumour was a fibrous meningioma and the left sphenoid ridge tumour was an anaplastic meningioma with typical brain invasion. These tumours showed a MIB-1 staining index of 1% and 30%, respectively. There was also a difference in the immunohistochemical findings for neurofibromin (NF1 product) expression; the left parasagittal tumour expressed neurofibromin but the left sphenoid ridge tumour lacked neurofibromin expression, suggesting an NF1-gene mutation. This case may be a rare example of the simultaneous occurrence of meningiomas with distinct genotypes.
Tomita
Takahiro
T
Department of Neurosurgery, Toyama Medical and Pharmaceutical University, 2630 Sugitani, 930-0194, Toyama, Japan.
Kurimoto
Masanori
M
Yamatani
Kazumasa
K
Nagai
Shoichi
S
Kuwayama
Naoya
N
Hirashima
Yutaka
Y
Endo
Shunro
S
D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008577:Meningeal Neoplasms / Q000000981:diagnostic imaging / Q000235:genetics / Q000473:pathology* / Q000601:surgery*; D008579:Meningioma / Q000000981:diagnostic imaging / Q000235:genetics / Q000473:pathology* / Q000601:surgery*; D008875:Middle Aged; D025542:Neurofibromin 1 / Q000032:analysis / Q000235:genetics; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D025542:Neurofibromin 1