Abstract

Xanthomatous meningioma is a WHO grade I metaplastic meningioma where neoplastic cells contain lipid-filled vacuolated cytoplasm. The origin of xanthomatous meningiomas is believed to be from meningothelial cells but diagnosis remains difficult because of their close resemblance with the histiocytes. Peculiar radiographic features may aid in diagnosis, however, definitive diagnosis requires immunohistochemical staining. We report a case of 43-year-old male with sphenoid wing meningioma revealing xanthomatous changes and received treatment as grade 1 meningioma. Though the exact pathophysiology remains unknown, we believe focal or gross metaplastic changes lead to transformation of tumor cells into the xanthomatous subtype. Authors discuss this interesting a rare histologic variant with discussion of the relevant literature.

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