Abstract
IntroductionA primary intraparenchymal meningioma located in the subcortical region of the brain without a dural attachment is extremely rare. To the best of our knowledge, this is the first report showing that meningioma can mimic cavernous malformations.Case presentationWe present the case of a 42-year-old German man who presented to our institution with seizure. Both computed tomography and magnetic resonance imaging scans showed characters of an intra-axial subcortical lesion with a ‘popcorn’ appearance and hemosiderin deposits in the right parietal lobe. The initial diagnosis was cavernous malformation. Intraoperatively, the lesion presented as a subcortical mass that had no connection to the dura or the ventricle. The histological diagnosis showed a WHO Grade 1 ‘raddled’ psammomatous meningioma with extensive metaplastic ossification. A literature review of 29 cases of intraparenchymal meningiomas regarding their clinical presentations, location and management was performed.ConclusionsMeningiomas can be found in any region of the brain with and without dural attachment. Intraparenchymal meningiomas can have multiple entities mimicking their presentation. Caution must be used regarding the preoperative differential diagnosis.
Highlights
A primary intraparenchymal meningioma located in the subcortical region of the brain without a dural attachment is extremely rare
Meningiomas can be found in any region of the brain with and without dural attachment
We present a rare case of primary intraparenchymal meningioma that, preoperatively, was not typical for meningioma and showed characteristics of cavernous malformation
Summary
The meningioma in our patient had two unusual features: the subcortical location and the radiological appearance mimicking cavernous malformation. This case report highlights the fact that the typical radiological appearance of one lesion may sometimes be misleading. Authors’ contributions SJ carried out the design of the study and drafted the manuscript. TAP conceived of the study, participated in its design and coordination, and helped to draft the manuscript. AEE conceived of the study, participated in its design and coordination, helped to draft the manuscript, and carried out the literature review and discussion section. Author details 1Department of Neurosurgery, University of Kiel, Arnold-Heller-Str., Haus 41, 24105 Kiel, Germany. 2Department of Clinical Neuropathology, Evangelic Hospital Bethel, Remterweg 2, 33617 Bielefeld, Germany. 3Department of Neuroradiology, University of Essen, Hufelandstraße 55, 45147 Essen, Germany. 4Department of Neurosurgery, Evangelic Hospital Bethel, Burgsteig 13, 33617 Bielefeld, Germany
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