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Abstract
Background/Aim: Lipomatous meningioma is a rare type of meningioma that is formed as the result of an accumulation of lipids inside the cell due to metabolic activity dysregulation. It differs from other types of meningiomas in its radiological and immunohistochemical characteristics. We report a rare case of a patient treated in our department for this particular type of meningioma who developed a type of migraine with the aura component as the first clinical symptom. Case Report: A 55-year-old woman presented with a migraine and reported having phosphenes in recent years. Head Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) scans were performed; these showed an extensive hypodense and hypointense formation located in the left parieto-occipital region. This formation was implanted in the tentorium region, with a prevailingly adipose-type signal intensity. The patient underwent an occipital craniotomy with the total removal of the lesion. The histological examination indicated a lipomatous metaplastic meningioma. Conclusion: We reported the first case of a lipomatous meningioma presenting with a migraine with a visual aura. Seizures and headaches can be included as possible symptoms. According to the current literature, lipomatous meningiomas affect women more commonly than men. The patient of our reported case presented visual disturbances in the form of a visual aura, which occurred 10 years before finding the meningioma, and surgery dramatically improved the symptoms and quality of life.
Highlights
Meningiomas constitute approximately 36.4% of all CNS neoplasms; these are benign lesions that more frequently involve the female sex
The tumour cells were positive for epithelial membrane antigen (EMA) and Progesterone Receptor (PgR)
Lipomatous meningioma differs from other meningiomas due to its peculiar clinical, radiological and immunohistochemical characteristics
Summary
Meningiomas constitute approximately 36.4% of all CNS neoplasms; these are benign lesions that more frequently involve the female sex. They are classified according to their histological characteristics into different subtypes; lipomatous meningiomas fall within the subtype of metaplastic meningiomas due to the accumulation of adipose tissue within the cells. They have radiological and immunohistochemical characteristics that allow for a specific diagnosis. Headaches and epileptic seizures are the predominant clinical manifestations; this case report presents the first case of a lipomatous meningioma presenting with a migraine with a visual aura
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