Summary
Four cases of cystic meningiomas were found among 194 meningiomas diagnosed by computed tomography (CT) and operated on during a 7 year period, an incidence of 2%.
The cysts were in all cases peritumoral. The cyst’s wall was the brain itself, and the ependymal ventricular wall was part of their medial boundary. They contained xanthochromic fluid with a high protein content.
Three meningiomas were parasagittal and one was adjacent to the pteryon and the external part of the sphenoid ridge. The mural nodules were in 2 cases apparent single nodes although in one it was part of multiple distant and regional growths, in another the tumour was built by the aggregation of 2 nodes, the remaining case was an “en plaque” meningioma. All were definitely attached to the dura.
Histological pattern was different in every case. Those parasagittal were: one pure meningotheliomatous, one mixed meningotheliomatous with pseudo psammomatous and lipoblastic sections and one highly vascular angioblastic; the pteryonal case was psammomatous and microcystic.
CT diagnosis is difficult because glial, metastatic and other tumours may look cystic and resemble cystic meningiomas. Nevertheless in 3 cases the correct diagnosis was suspected preoperatively because the solid portion of the tumour showed intense and homogeneous contrast enhancement with a sharp edge and was located adjacent to the dura. On the other hand in the remaining case, the parasagittal solid tumour was not readily apparent on CT (the “en plaque”, case), and the tentative preoperative diagnosis was of an epidermoid tumour.
At operation on the contrary the macroscopic aspect was typical of meningioma and the histological peroperative frozen sections confirmed the diagnosis with ease in all cases.
In the light of the aforesaid findings the authors conclude that every patient with a cystic tumour, no matter the tentative preoperative diagnosis is, should be given the benefit of surgical intervention.
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References
Alguacil-García A, Pettigrew NM, Sima AAF (1986) Secretory meningioma. Am J Surg Pathol 10: 102–111.
Amano K, Miura N, Tajika Y, Matsumori K, Kubo O, Kobayashi N, Kitamura K (1980) Cystic meningioma in a 10-month-old infant. J Neurosurg 52: 829–833.
Becker D, Norman D, Wilson ChB (1979) Computerized tomography and pathological correlation in cystic meningiomas. J Neurosurg 50: 103–105.
Claveria LE, Sutton T, Tress BM (1977) The radiological diagnosis in meningiomas, the impact of EMI scanning. Br J Radiol 50: 15–22.
Cushing H, Eisenhardt L (1938) Meningiomas: Their classification, regional behaviour, life history and surgical end results. Ch C Thomas, Springfield, 111, pp 26, 577-588, 785.
Dell S, Ganti SR, Steinberger A, McMurtry III J (1982) Cystic meningiomas: a clinicoradiological study. J Neurosurg 57: 8–13.
Henry JM, Schwartz FT, Sartawi MA, Fox JL (1974) Cystic meningiomas simulating astrocytomas. J Neurosurg 40: 647–650.
Kepes JJ (1982) Meningiomas: Biology, pathology and differential diagnosis. Masson Publishing USA Inc, New York, pp 108–110.
Kleinman GM, Liszczak T, Tarlov E, Richardson EP (1980) Microcystic variant of meningioma. Am J Surg Pathol 4: 383–389.
Lee SH, Rao KCGV (1983) Primary tumours in adults. In: Lee SH, Rao KCGV (ed) Cranial computed tomography. McGrawHill Book Co, New York, pp 241–293.
Nauta HJV, Tucker WS, Horsey WJ, Bilbao JM, Gonsalves C (1979) Xanthochromic cysts associated with meningioma. J Neurol Neurosurg Psychiatry 42: 529–535.
Pullicino P, Kendall BE, Jakubowski J (1960) Difficulties in diagnosis of intracranial meningiomas by computed tomography. J Neurol Neurosurg Psychiatry 43: 1022 1029.
Quest DO (1978) Meningiomas: an update. Neurosurgery 3:219–225.
Rengachary S, Batnitzky S, Kepes JJ, Morantz RA, O’Boynick P, Watanabe I (1979) Cystic lesions associated with intracranial meningiomas. Neurosurgery 4: 107–114.
Vassilouthis J, Ambrose J (1979) Computed tomography scanning appearances of intracranial meningiomas. J Neurosurg 50:320–327.
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Borovich, B. et al. (1988). Cystic Meningiomas. In: Isamat, F., Jefferson, A., Loew, F., Symon, L. (eds) Proceedings of the 8th European Congress of Neurosurgery Barcelona, September 6–11, 1987. Acta Neurochirurgica Supplementum 42, vol 42. Springer, Vienna. https://doi.org/10.1007/978-3-7091-8975-7_29
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DOI: https://doi.org/10.1007/978-3-7091-8975-7_29
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