A case of meningioma with frequent relapses and a hyperhaploid stemline.
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A meningioma of the meningotheliomatous type showed frequent relapses after surgery. Cytogenetic analysis of a tumor biopsy after the last relapse showed a highly aberrant hyperhaploid stemline.Cite
TUMORS of the foramen magnum and the upper part of the cervical spinal cord are often initially seen with confusing clinical syndromes that are frequently ascribed to a conversion hysteria or fibromyositis. In a major review of such tumors, Dodge et al1stated, "Unless the physician obtains an accurate history and attributes sufficient significance to the patient's often bizarre and at times seemingly functional complaints, he is likely to deny the patient his ultimate opportunity for cure." Despite this warning, it seems that scant attention has been given to the role of the patient's history in the early diagnosis of such tumors, and diagnostic studies are only undertaken when signs of spinal cord compression are apparent. The following case report describes a patient in whom the history of recumbent neck pain and electromyographic abnormalities suggested the diagnosis of a meningioma in the upper part of the cervical spinal cord
Foramen magnum
Neck pain
Spinal cord compression
Spinal Cord Neoplasm
Medical History
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TUMORS of the foramen magnum and the upper part of the cervical spinal cord are often initially seen with confusing clinical syndromes that are frequently ascribed to a conversion hysteria or fibromyositis. In a major review of such tumors, Dodge et al1stated, "Unless the physician obtains an accurate history and attributes sufficient significance to the patient's often bizarre and at times seemingly functional complaints, he is likely to deny the patient his ultimate opportunity for cure." Despite this warning, it seems that scant attention has been given to the role of the patient's history in the early diagnosis of such tumors, and diagnostic studies are only undertaken when signs of spinal cord compression are apparent. The following case report describes a patient in whom the history of recumbent neck pain and electromyographic abnormalities suggested the diagnosis of a meningioma in the upper part of the cervical spinal cord
Foramen magnum
Neck pain
Spinal cord compression
Spinal Cord Neoplasm
Medical History
Clinical history
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Immunostaining
Ki-67
Malignant meningioma
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Meningioma with extensive histiocytic changes is rare. We describe a case of histiocytic meningioma which occurred in a 55-year-old woman. The patient had a progressive headache and a decline in fine motor coordination and memory for the past four years. Magnetic resonance imaging demonstrated a well-demarcated, dura-based and contrast-enhancing mass lesion in the right superior frontoparietal region. Histopathologically, the tumor showed neoplastic meningothelial proliferation with extensive and multifocal histiocytic infiltration. The histiocytic component constituted approximately half of the entire tumor. Immunohistochemically, both meningothelial and histiocytic cells showed immunoreactivity for epithelial membrane antigen (EMA), while the histiocytic cells were also positive for CD4 and CD68. In addition, there were scattered S100-positive histiocytes throughout the tumor. Proliferative index highlighted by Ki67 immunostain was 1.6%. There were no high-grade changes such as frequent mitoses, necrosis, or brain parenchymal invasion in the specimen. With review of the literature, we propose that this type of meningioma should be considered as a separate subtype of meningioma. The biological basis and differential diagnosis are discussed.
CD68
Infiltration (HVAC)
Histiocytic sarcoma
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The aim of the study was to investigate the association between meningioma volume and the occurrence of clinic-radiologic signs of tumor aggressiveness. For volumetric approximation, the authors evaluated the method of semiautomatic image segmentation at hand of high-resolution MRI-image sequences.ITK-SNAP was utilized for semiautomatic image segmentation of 58 gadolinium-contrast enhanced T1-weighted thin-slice MRI datasets for volumetric analysis. Furthermore, multimodal imaging datasets (including T2, FLAIR, T1) were evaluated for radiological biomarkers of aggressiveness and growth potential. Thereby generated data was checked for association with retrospectively collected data points.Location (P = 0.001), clinical disease manifestation (P = 0.033), peritumoral edema (P = 0.038), tumor intrinsic cystic degeneration (P = 0.007), three-dimensional complexity (P = 0.022), and the presence of meningioma mass effect (P = 0.001) were statistically associated with higher tumor volumes. There was no association between higher tumor volumes and histopathological tumor grade.The size of a meningioma does not seem to reliably predict tumor grade. Growth potential seems to be influenced by tumor location. Higher tumor volumes were significantly associated with the occurrence of clinical symptoms.
Fluid-attenuated inversion recovery
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