Enhancing gliotic cyst wall with microvascular proliferation adjacent to a meningioma.
Cystic meningiomas are uncommon. Contrast enhancement of the cyst wall of peritumoral cysts on radiological imaging is generally thought to indicate that the wall contains tumor cells. The authors present a patient with a peritumoral cyst that enhanced despite the absence of tumor cells. Histological analysis demonstrated a gliotic cyst wall with numerous microvascular proliferations (MVPs) adjacent to a mixed transitional and angiomatous/microcystic meningioma. Immunoreactivity for vascular endothelial growth factor (VEGF) and its receptor, flt-1, was observed in the endothelial cells of both intratumoral vessels and cyst wall MVPs. Immunoreactivity for tenascin-C was strongly observed within and around the vascular wall of MVPs and in gliotic tissue adjacent to the meningioma. These changes are unusual in the peritumoral brain parenchyma of a slow-growing convexity meningioma and the MVPs may account for the atypical contrast enhancement of the cyst wall despite the absence of tumor cells.
Arai
Masayuki
M
Department of Neurosurgery, Fukui Prefectural Hospital, Yotsui 2-8-1, Fukui City, 910-8526, Japan. myarai@yahoo.co.jp
Kashihara
Kengo
K
Kaizaki
Yasuharu
Y
D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008577:Meningeal Neoplasms / Q000473:pathology* / Q000503:physiopathology; D008579:Meningioma / Q000473:pathology* / Q000503:physiopathology; D009389:Neovascularization, Pathologic; D013194:Staining and Labeling / Q000379:methods; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism
D014408:Biomarkers, Tumor; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A