The clinical and imaging features of clear cell meningioma in ten cases

Abstract

Objective To investigate the clinical features and imaging findings of intracranial clear cell meningioma. Methods The clinical data were reviewed, including presentation, imaging and prognosis of 10 patients suffered from intracranial clear cell meningioma for 2 months-7 years and underwent surgical treatment. The patients included five males and five females with the age from nine to sixty⁃two years old (mean 35.43). The tumors were located at cerebellopontine angle (CPA) zone (n = 5), parietal lobe (n = 1), tuberculum sella (n = 1), jugular foramen (n = 1), tentorium of cerebellum (n = 1) or lateral cerebral ventricle (n = 1). The initial symptoms included headache (n = 4), gait disturbance (n = 2), hearing loss (n = 2), vision loss (n = 1) and bucking (n = 1) which were associated with the mass locations. Results CT (n = 8) and MRI (n = 10) of 10 patients were retrospectively reviewed. CT findings of the lesions presented with hyperdensity (n = 6), isodensity (n = 1), or isodensity with hyperdensity (n = 1). MRI T1WI showed isointensity (n = 4), hypointensity with isointensity (n = 4) or hyperintensity (n = 2), whereas T2WI isointensity with hyperintensity (n = 7), presented hypointensity (n = 1), isointensity (n = 1), or hyperintensity (n = 1). On gadolinium⁃enhanced T1WI, moderate enhancement was seen in 8 lesions and marked enhancement was seen in 2 lesions. In initial CT scanning peritumoral edema was found in 7 cases, dural tail sign in 5 cases, cysts in 7 cases, calcification in 3 cases, periosteal proliferation in 1 case and bone destruction in 5 cases. Seven patients underwent complete resection and 3 underwent subtotal resection. Follow⁃up period was 11-120 months. Recurrence occurred in 5 patients. The mean recurrence time was 55.62 months. Conclusion Clear cell meningioma is a rare meningioma and often occurs in young persons without significant difference in sex. The CPA zone is the most affected area. The prognosis is closely related to the extent of resection. Clear cell meningioma tends to present marked enhancement, peritumoral edema, cystic components, and bone involvement in imaging findings． DOI：10.3969/j.issn.1672⁃6731.2012.05.019