• Journal of Korean Neurosurgical Society
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• 제49권1호
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• pp.71-74
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• 2011

A 34-year-old female patient was presented with leg and hip pain for 6 months as well as voiding difficulty for 1 year. Magnetic resonance imaging revealed a well-demarcated mass lesion at L2-3. The mass was hypo-intense on T1- and T2-weighted images with homogeneous gadolinium enhancement. Surgery was performed with the presumptive diagnosis of intradural extramedullary meningioma. Complete tumor removal was possible due to lack of dural adhesion of the tumor. Histologic diagnosis was clear cell meningioma, a rare and newly included World Health Organization classification of meningioma usually affecting younger patients. During postoperative 2 years, the patient has shown no evidence of recurrence. We report a rare case of cauda equina clear cell meningioma without any dural attachment.

• Journal of Korean Neurosurgical Society
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• 제39권5호
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• pp.389-392
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• 2006

Intramedullary clear cell meningioma[CCM]. which is more aggressive than other variants of meningioma, is extremely rare. To date, only one case has been documented in spinal tumors. We report the first case of an intramedullary CCM originating in the spinal cord at the thoracic region.

• Journal of Korean Neurosurgical Society
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• 제38권1호
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• pp.54-60
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• 2005

The clear cell meningioma[CCM] is a rare and recently described as a histologic variant of meningioma. It has been identified and included in new World Health Organization[WHO] classification of the Central Nervous System[CNS] tumors recently. The CCMs are histologically characterized by sheets of spindled to polygonal cells with clear cytoplasm, which is the expression of high glycogen concentration. The CCMs occur in younger patients and usually are located in the spinal canal and posterior fossa. The most interesting aspect of CCM is the high recurrence rate and aggressiveness. Poor outcome has been shown in intracranial and spinal tumor location, but the indicators that predict outcome have not been established. Until now 22 intracranial CCM cases had been reported in English literature and 3 cases in Korean. The authors report two cases of CCM located at cerebral convexity and one at cavernous sinus those were totally removed [Simpson Grade $I{\sim}II$] by subfrontal, frontal and orbitocranial approaches. The clinical, radiological, histopathological, and neurosurgical features of these cases are discussed with the relevant literatures.

• 대한세포병리학회지
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• 제15권1호
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• pp.52-55
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• 2004

Secretory meningioma is a distinct subtype of meningioma. We describe the cytologic features of a secretory meningioma on squash preparations, in comparision with other cytologic mimickers. A 54-year-old woman presented with hearing loss, vertigo, tinnitus, and headache for seven years. A brain MRI study revealed a 4.5cm sized mass in the cerebellopontine angle, which showed homogenous signal intensity in T2-weighted image. The intraoperative squash smear showed some well-defined, thin rimmed intracytoplasmic inclusions, containing a finely granular eosinophilic core among less cohesive meningiomatous cells. Histologic sections revealed a meningothelial meningioma with scattered inclusions, with periodic acid-Schiff, carcinoembryonic antigen, and cytokeratin positivity. Identification of characteristic intracytoplasmic inclusions is helpful for diagnosing secretory meningiomas. On squash preparations, differential diagnoses included tumors with inclusions or cytoplasmic vacuolizations, such as metastatic mammary infiltrating ductal carcinoma, gastric adenocarcinoma, hepatocellular carcinoma, and clear cell ependymoma, oligodendroglioma, hemangioblastoma, chordoma, and other variants of meningiomas (clear cell, xanthomatous, microcytic, and chordoid variants). In addition, the possibilities of glioma with eosinophilic granular body, and metastatic tumors from mammary infiltrating ductal carcinoma, gastric adenocarcinoma, and hepatocellular carcinoma in meningioma should be considered.

• Journal of Korean Neurosurgical Society
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• 제56권1호
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• pp.58-60
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• 2014

Spinal meningiomas typically adhere to the dura matter. Non-dural based spinal meningiomas are rare and most are clear cell meningiomas. We report here the first case of a fibrous meningioma with non-dural attachment. The patient was a 49-year-old female, who complained of numbness in the legs and a gait disturbance. Magnetic resonance imaging revealed a $1.7{\times}1.4-cm$ mass in the C7-T1 intra-dural extramedullary space, showing peripheral gadolinium enhancement without a "dural tail sign". A complete microsurgical resection was performed. The mass was covered with a white membrane but was not adhered to the dura, and its appearance was consistent with a neurilemmoma. The histopathological diagnosis was fibrous-type meningioma. The recovery of the patient was uneventful. No surgical complications and no recurrence of the tumor had occurred at the 6-month follow-up.

• Investigative Magnetic Resonance Imaging
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• 제12권2호
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• pp.188-196
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• 2008

목적: 이 연구의 목적은 소아 수막종의 임상적, 영상의학적, 그리고 병리학적 특징을 기술함에 있다. 대상 및 방법: 병리학적으로 진단된 수막종을 가진 16예의 소아환자를 대상으로 임상기록과 자기공명영상을 후향적으로 분석하였다. 평균연령은 14세 (3-18세)였다. 자기공명영상은 병변의 크기, 신호강도, 경계부의 특징, 내부 구조, 조영증강, 그리고 경막과 뇌실질의 변화를 검토하였고 다른 영상 방법 및 병리소견을 함께 분석하였다. 결과: 종양의 평균 크기는 5.24 cm (1.3-18.1 cm)였으며 12예는 천막상부에 4예는 천막하부에 위치하였다. T2 강조 영상에서 높은 신호강도를 보이는 종양이 9예 있었고 4예에서 동신호강도를, 3예에서 낮은 신호강도를 보였다. T1 강조 영상에서는 낮은 신호강도 11예, 동신호강도 4예, 그리고 높은 신호강도 1예가 있었다. 모든 종양의 경계가 좋았고 조영증강을 보였다. 5예에서 종양은 균질한 양상을 보였으며 나머지에는 낭종이나 괴사에 의해 비균질한 양상을 보였다. 경막 부착 소견이 11예에서, 뇌실질 부종이 10예에서 동반되었다. 컴퓨터 단층촬영 소견은 6예에서 밝은 음영을 보였으며 5예에서 석회화를 동반하였다. 혈관 조영술 상 3예는 내경동맥에서, 4예는 외경동맥으로부터 혈액 공급이 이루어졌다. 병리검사결과 종양의 아형은 이행성 (4예), 수막세포성 (4예), 척삭성 (2예), 섬유성 (2예), 투명세포성 (1예), 유리질화성 (1예), 횡문근양 유두모양 (1예), 그리고 비정형(1예) 수막종으로 진단되었다. 결론: 소아의 수막종은 주로 10대에 발생하며 다양한 병리학적 아형을 보일뿐만 아니라 비정형적인 영상 소견으로 인해 축내 종양으로 오인될 수 있다.