Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
권호 표지
DOI QR코드

DOI QR Code

Intracranial Metaplastic Meningioma : Clinical and Radio-logical Characteristics of 11 Cases

  • Kim, Taehoon (Department of Neurosurgery, Seoul National University Hospital) ;
  • Kim, Jin Wook (Department of Neurosurgery, Seoul National University Hospital) ;
  • Ji, So Young (Department of Neurosurgery, Seoul National University Hospital) ;
  • Kang, Ho (Department of Neurosurgery, Seoul National University Hospital) ;
  • Kim, Kyung-Min (Department of Neurosurgery, Seoul National University Hospital) ;
  • Kim, Yong Hwy (Department of Neurosurgery, Seoul National University Hospital) ;
  • Park, Chul-Kee (Department of Neurosurgery, Seoul National University Hospital) ;
  • Choi, Seung Hong (Department of Radiology, Seoul National University Hospital) ;
  • Park, Sung-Hye (Department of Pathology, Seoul National University Hospital)
  • Received : 2020.05.27
  • Accepted : 2020.07.08
  • Published : 2020.09.01
Download PDF
⟨ Previous Next ⟩

Abstract

Objective : Metaplastic meningioma is an extremely rare subtype of World Health Organization (WHO) grade I meningioma. It has distinctive histological subtypes according to its own mesenchymal components. Owing to its scarcity, clinical or radiological features of a metaplastic meningioma are poorly described. Methods : Between 2004 and 2018, we analyzed total 1814 cases surgically proven meningioma for 15 years. Among them, metaplastic meningioma was diagnosed in 11 cases. Magnetic resonance images were taken for all patients, and computed tomography scan was taken for 10 patients. Results : WHO grade I meningiomas were 1376 cases (75.9%), 354 cases (19.5%) in WHO grade II, and 84 cases (4.6%) in WHO grade III meningiomas. Metaplastic meningioma was 11 cases as 0.8% of WHO grade I meningioma and 0.6% of entire meningiomas for 15 years. Among the entire 11 metaplastic meningiomas, five tumors (45%) were diagnosed as a lipomatous subtype with rich fat components, four (36%) as an osseous subtype with extensive bone formation and two (18%) as a xanthomatous subtype. There was no cartilaginous subtype metaplastic meningioma in our study. Lipomatous and osseous metaplastic meningioma have peculiar radiological characteristics according to mesenchymal components. Conclusion : We investigated a rare metaplastic meningioma subtype based on our 15-year surgical experience with meningiomas. Further investigation will be necessary for the clear clarification of tumor nature of this rare tumor.

Keywords

References

  1. Barresi V, Caffo M, Ieni A, Alafaci C, Tuccari G : Osteoblastic meningiomas: clinico-pathological and immunohistochemical features of an uncommon variant. J Neurooncol 105 : 225-232, 2011 https://doi.org/10.1007/s11060-011-0588-3
  2. Choi YH, Choi CY, Lee CH, Koo HW, Chang SH : Metaplastic meningioma overspreading the cerebral convexity. Brain Tumor Res Treat 6 : 97-100, 2018 https://doi.org/10.14791/btrt.2018.6.e17
  3. Colnat-Coulbois S, Kremer S, Weinbreck N, Pinelli C, Auque J : Lipomatous meningioma: report of 2 cases and review of the literature. Surg Neurol 69 : 398-402; discussion 402, 2008 https://doi.org/10.1016/j.surneu.2006.11.072
  4. Danisman MC, Kelesoglu KS, Sivri M, Koplay M, Paksoy Y : Microcystic meningioma: difficulties in diagnosis and magnetic resonance imaging findings. Acta Neurol Belg 117 : 745-747, 2017 https://doi.org/10.1007/s13760-017-0760-4
  5. Ersoz S, Yilmaz ZS, Eyuboglu I, Yazar U : Xanthomatous meningioma: a case report. Turk Neurosurg 29 : 141-144, 2019
  6. Gasparinho MG, Ferreira M, Lavrador JP, Livraghi S : Revisiting lipomatous meningioma: a case report and review of an unusual entity. Int J Surg Pathol 23 : 399-403, 2015 https://doi.org/10.1177/1066896915583695
  7. Ikota H, Nakazato Y : A case of metaplastic meningioma with extensive xanthomatous change. Neuropathology 28 : 422-426, 2008 https://doi.org/10.1111/j.1440-1789.2008.00865.x
  8. Indiran V : Intracranial ossified metaplastic meningioma: unusual cause of headache. J Neurosci Rural Pract 8 : 653, 2017 https://doi.org/10.4103/jnrp.jnrp_277_17
  9. Ishida M, Fukami T, Nitta N, Iwai M, Yoshida K, Kagotani A, et al. : Xanthomatous meningioma: a case report with review of the literature. Int J Clin Exp Pathol 6 : 2242-2246, 2013
  10. Kang H, Kim JW, Se YB, Dho YS, Choi SH, Park SH : Sclerosing meningioma : radiological and clinical characteristics of 21 cases. J Korean Neurosurg Soc 59 : 584-589, 2016 https://doi.org/10.3340/jkns.2016.59.6.584
  11. Kim NR, Yee GT, Cho HY : Crush cytology of secretory meningioma: a case report. Brain Tumor Res Treat 3 : 147-150, 2015 https://doi.org/10.14791/btrt.2015.3.2.147
  12. Krisht KM, Altay T, Couldwell WT : Myxoid meningioma: a rare metaplastic meningioma variant in a patient presenting with intratumoral hemorrhage. J Neurosurg 116 : 861-865, 2012 https://doi.org/10.3171/2011.12.JNS111020
  13. Kunimatsu A, Kunimatsu N, Kamiya K, Katsura M, Mori H, Ohtomo K : Variants of meningiomas: a review of imaging findings and clinical features. Jpn J Radiol 34 : 459-469, 2016 https://doi.org/10.1007/s11604-016-0550-6
  14. Mannoji C, Koda M, Murakami M, Kubosawa H, Yamazaki M, Okawa A, et al. : Osseous metaplastic meningioma in the thoracic spine mimicking osteosarcoma: a case report. Spine (Phila Pa 1976) 38 : E632-E634, 2013 https://doi.org/10.1097/BRS.0b013e31828a34e3
  15. Murakami T, Tanishima S, Takeda C, Kato S, Nagashima H : Ossified metaplastic spinal meningioma without psammomatous calcification: a case report. Yonago Acta Med 62 : 232-235, 2019 https://doi.org/10.33160/yam.2019.06.008
  16. Paek SH, Kim SH, Chang KH, Park CK, Kim JE, Kim DG, et al. : Microcystic meningiomas: radiological characteristics of 16 cases. Acta Neurochir (Wien) 147 : 965-972; discussion 972, 2005 https://doi.org/10.1007/s00701-005-0578-3
  17. Salunke P, Aggarwal A, Futane S, Nada R, Gochhait D : Osteoblastic meningioma with turtle shell: different entity from calcified meningioma. Asian J Neurosurg 11 : 450, 2016
  18. Somerset HL, Kleinschmidt-DeMasters BK, Rubinstein D, Breeze RE : Osteochondroma of the convexity: pathologic-neuroimaging correlates of a lesion that mimics high-grade meningioma. J Neurooncol 98 : 421-426, 2010 https://doi.org/10.1007/s11060-009-0089-9
  19. Tang H, Sun H, Chen H, Gong Y, Mao Y, Xie Q, et al. : Clinicopathological analysis of metaplastic meningioma: report of 15 cases in Huashan Hospital. Chin J Cancer Res 25 : 112-118, 2013
  20. Wang DJ, Xie Q, Gong Y, Mao Y, Wang Y, Cheng HX, et al. : Histopathological classification and location of consecutively operated meningiomas at a single institution in China from 2001 to 2010. Chin Med J (Engl) 126 : 488-493, 2013 https://doi.org/10.3760/cma.j.issn.0366-6999.20122874
  21. Yuksel MO, Gurbuz MS, Tanriverdi O, Ozmen SA : Lipomatous meningioma: a rare subtype of benign metaplastic meningiomas. J Neurosci Rural Pract 8 : 140-142, 2017 https://doi.org/10.4103/0976-3147.193539
  22. Zouaoui S, Darlix A, Rigau V, Mathieu-Daude H, Bauchet F, Bessaoud F, et al. : Descriptive epidemiology of 13,038 newly diagnosed and histologically confirmed meningiomas in France: 2006-2010. Neurochirurgie 64 : 15-21, 2018 https://doi.org/10.1016/j.neuchi.2014.11.013