Atypical Growth Pattern of an Intraparenchymal Meningioma.

Zhen Zeng,Tijiang Zhang,Xiaoxi Chen,Yihua Zhou

doi:10.1155/2016/7985402

Abstract

Meningiomas are the most common primary nonneuroglial extra-axial neoplasms, which commonly present as spherical or oval masses with a dural attachment. Meningiomas without dural attachment are rare and, according to their locations, are classified into 5 varieties, including intraventricular, deep Sylvain fissure, pineal region, intraparenchymal, or subcortical meningiomas. To the best of our knowledge, intraparenchymal meningioma with cerebriform pattern has never been reported. In this paper, we report a 34-year-old Chinese male patient who presented with paroxysmal headaches and progressive loss of vision for 10 months and blindness for 2 weeks. A thorough physical examination revealed loss of bilateral direct and indirect light reflex. No other relevant medical history and neurologic deficits were noted. Computed tomography and magnetic resonance imaging scans showed an irregular mass with a unique cerebriform pattern and extensive peritumoral edema in the parietal-occipital-temporal region of the right cerebral hemisphere. The initial diagnosis was lymphoma. Intraoperatively, the tumor was completely buried in a sulcus in the parietal-occipital-temporal region without connecting to the dura. The histological diagnosis was intracranial meningioma based on pathological examination. Therefore, when an unusual cerebriform growth pattern of a tumor is encountered, an intraparenchymal meningioma should be considered as a differential diagnosis.

Highlights

Meningiomas are the most common primary extra-axial neoplasms in adults, accounting for up to 30% [1] of all primary intracranial tumors and as high as 35.5% in Asian and African people [2]
We present a rare case of primary intraparenchymal meningioma with a cerebriform pattern, which was preoperatively misdiagnosed as lymphoma based on conventional CT and MR imaging features
We presented a case of a large intraparenchymal meningioma that likely developed in a long period of time

Summary

Introduction

Meningiomas are the most common primary extra-axial neoplasms in adults, accounting for up to 30% [1] of all primary intracranial tumors and as high as 35.5% in Asian and African people [2]. Meningiomas without dural attachment are rare and are more likely to occur in young males and are most commonly seen in the intraventricular and pineal regions and the Sylvain fissure [3,4,5]. Intraparenchymal meningioma is extremely rare with only few reported cases [6,7,8]. To the best of our knowledge, an intraparenchymal meningioma with a cerebriform pattern has never been reported. We present a rare case of primary intraparenchymal meningioma with a cerebriform pattern, which was preoperatively misdiagnosed as lymphoma based on conventional CT and MR imaging features

Case Presentation

Findings

Discussion