• Journal of Korean Neurosurgical Society
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• v.49 no.2
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• pp.124-127
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• 2011

A 43-year-old male presenting with headache and dizziness underwent craniotomy and gross total resection of an extraaxial tumor was achieved via left occipital interhemispheric approach. The tumor was diagnosed as papillary meningioma arising from the left falcotentorium with such pathologic characteristics of bronchoalveolar adenocarcinoma. At postoperative day 40, he developed generalized tonic clonic seizure and then progressed to a status epilepticus pattern. Brain magnetic resonance imaging showed irregular leptomeningeal enhancement with a significant peritumoral area. Through a cerebrospinal fluid (CSF) study, we identified the meningioma cells of the papillary type from the CSF. At the postoperative day 60, he fell into semicomatose state, and the computed tomography imaging showed low density on both cerebral hemispheres, except the basal ganglia and cerebellum, with overall brain swelling and an increased intracranial pressure. He died on the following day. We experienced a rare case of a papillary meningioma with leptomeningeal seeding.

• Journal of Korean Neurosurgical Society
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• v.52 no.2
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• pp.98-102
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• 2012

Objective : To study the clinical significance and relevant factors of radiation-induced intratumoral necrosis (RIN) and peritumoral edema (PTE) after Gamma knife radiosurgery (GKRS) for intracranial meningiomas. Methods : We retrospectively analyzed the data of 64 patients who underwent GKRS for intracranial meningioma. The mean lesion volume was 4.9 cc (range, 0.3-20), and the mean prescription dose of 13.4 Gy (range, 11-18) was delivered to the mean 49.9% (range, 45-50) isodose line. RIN was defined as newly developed or enlarged intratumoral necrosis after GKRS. Results : RIN and new development or aggravation of PTE were observed in 21 (32.8%) and 18 (28.1%) cases of meningioma, respectively during the median follow-up duration of $19.9{\pm}1.0$ months. Among various factors, maximum dose (>25 Gy) and target volume (>4.5 cc) were significantly related to RIN, and RIN and maximum dose (>24 Gy) were significantly related to the development or aggravation of PTE. In 21 meningiomas with development of RIN after GKRS, there was no significant change of the tumor volume itself between the times of GKRS and RIN. However, the PTE volume increased significantly compared to that at the time of GKRS (p=0.013). The median interval to RIN after GKRS was $6.5{\pm}0.4$ months and the median interval to new or aggravated PTE was $7.0{\pm}0.7$ months. Conclusion : A close observation is required for meningiomas treated with a maximum dose >24 Gy and showing RIN after GKRS, since following or accompanying PTE may deteriorate neurological conditions especially when the location involves adjacent critical structures.

• Journal of Veterinary Clinics
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• v.29 no.4
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• pp.328-330
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• 2012

A 13-year-old, neutered male, chihuahua was referred to the Veterinary Medical Teaching Hospital of Chungnam National University with a history of a bilateral mandibular mass, intermittent vomiting, cough, and left sided staggering starting ten days prior. Clinical examination along with radiography, neurologic examination and magnetic resonance imaging (MRI) demonstrated a well-circumscribed and solitary mass in the brain stem. The dura mater was thickened with marked linear enhancement after contrast administration. Based on diagnostic image analysis and histopathologic examination, this case was diagnosed as intracranial meningioma. The patient's symptoms were controlled for 18 months by a combination therapy of prednisolone and lomustine (CCNU), and then he died of at home.

• Journal of Korean Neurosurgical Society
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• v.63 no.5
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• pp.657-663
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• 2020

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.

• Journal of Korean Neurosurgical Society
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• v.55 no.2
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• pp.99-102
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• 2014

A previously healthy 52-year-old man presented to the emergency room with acute onset left hemiparesis and dysarthria. Brain computed tomography and magnetic resonance examinations revealed acute cerebral infarction in the right middle cerebral artery territory and a sphenoid ridge meningioma encasing the right carotid artery terminus. Cerebral angiography demonstrated complete occlusion of the right proximal M1 portion. A computed tomography perfusion study showed a wide area of perfusion-diffusion mismatch. Over the ensuing 48 hours, left sided weakness deteriorated despite medical treatment. Emergency extracranial-intracranial bypass was performed using a double-barrel technique, leaving the tumor as it was, and subsequently his neurological function was improved dramatically. We present a rare case of sphenoid ridge meningioma causing acute cerebral infarction as a result of middle cerebral artery compression.

• Journal of Korean Neurosurgical Society
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• v.40 no.4
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• pp.281-284
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• 2006

Cystic Meningiomas are rare tumor. There is a clear prevalance in infants, according for $10{\sim}19%$ of all intracranial meningiomas in this age group, compared with only $2{\sim}4%$ in adults. But, reports of cystic meningioma have been increased in frequency since the introduction of computed tomography[CT] and magnetic resonance image[MRI]. Authors report two cases of cystic meningioma in adults. Radiological finding showed extraaxial mass with cystic component. Authors performed total surgical resection of the tumor mass and of the entire cystic component with cystic wall in both patients. Postoperative histopathological diagnosis of the tumor mass was a transitional meningioma in both patients. Both patients showed favorable prognosis and no recurrence findings in follow up MRI.

• Journal of Korean Neurosurgical Society
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• v.29 no.6
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• pp.800-804
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• 2000

Cerebral paragonimiasis is an important parasitic infestation found in Eastern Asia, West Africa, and Central/South America. It is frequently associated with abscess, granuloma or cystic lesions in chronic stage. Chronic symptoms include seizure, visual disturbance, movement and perception disorders, usually resulting from the spaceoccupying lesions. The authors report a case of chronic cerebral paragonimiasis combined with meningioma. A 69-year-old man presented with generalized seizure and impaired consciousness. CT scan and MR image of the brain revealed two intracranial lesions ; one was cerebral paragonimiasis in the left temporo-occipital lobe, and the other a huge falx meningioma. Two lesions were successfully removed in staged operations and the generalized seizure was controlled after removal of the cerebral paragonimiasis.

• Journal of Korean Neurosurgical Society
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• v.47 no.5
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• pp.385-388
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• 2010

Intracranial granulocytic sarcomas are rare tumors, which are composed of immature granulocytic cells. Although it has been well known that these tumors are associated with acute myeloblastic leukemia (AML), they have been almost always related to bone marrow relapse. However, isolated recurrence of granulocytic sarcoma following complete remission from prior AML is extremely rare, especially in the central nervous system. A 44-year-old male presented with isolated recurrence of granulocytic sarcoma mimicking a falx meningioma two years after complete remission by allogenic peripheral blood stem cell transfusion (PBSCT) in the acute myelomonoblastic leukemia (FAB, M4). Because of depressed mental state and mass effect, total surgical resection was performed. Pathological findings were compatible with the granulocytic sarcoma. There was no evidence of leukemic relapse in the peripheral blood. We suggest that this phenomenon can be explained by the hypothesis that a certain barrier effect such as blood brain barrier might lead to the proliferation of intracranial leukemic cells which metastasized before PBSCT.

• Journal of the Korean Society of Radiology
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• v.83 no.3
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• pp.719-723
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• 2022

Rosai-Dorfman Disease (RDD) is a rare lymphoproliferative disease, and the occurrence of isolated intracranial RDD is extremely rare. Most cases of intracranial RDDs present as dural masses showing homogenous enhancement on MRI, which makes it difficult to differentiate these masses from meningiomas before surgery unless massive cervical lymphadenopathy is observed. We herein report a rare case of isolated intracranial RDD in a 65-year-old male. Brain MRI revealed a well-defined enhancing mass-like lesion involving the right frontal convexity and subtle diffusion restriction. However, only a subtle blush was observed on the preoperative cerebral angiogram. Although instances of isolated intracranial RDD are rare, it should be considered as a potential differential diagnosis when a dural mass with hypovascularity is visualized on the cerebral angiogram.

• Journal of Korean Neurosurgical Society
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• v.42 no.4
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• pp.276-280
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• 2007

Objective : The purpose of this study was to review the characteristics of falcine meningioma retrospectively and to identify the parameters associated with tumor recurrence. Methods : The analysis included; age, sex, extent of resection, and radiologic and pathologic findings. Falcine meningiomas were classified by location as anterior, middle, or posterior as described for parasagittal meningiomas. Results : Of the 795 meningioma patients treated between 1990 and 2004 at the authors' institution, 68 patients with meningiomas arising from the falx underwent craniotomies. There were 22 male and 46 female patients (1:2.1). Mean age was 55 years and ranged from 14 to 77 years. Locations of falcine meningioma were; the anterior third in 33 cases, middle in 20, and posterior in 15. Mean tumor volume was 42 cc and ranged from 4 to 140 cc. In 58 of the 68 patients tumors were totally removed. Additional surgery for recurrence was performed in 6 patients over 15 years. Of these 6 patients, only two patients underwent gross total tumor resection at first operation; the other four underwent subtotal tumor resection. Based on pathologic reports, the largest tumor subtype was transitional. There were four patients with a high grade tumor-three atypical and one anaplastic meningioma. Of the 68 patients, 59 achieved a good outcome (no neurological deficit or recurrence), six had temporary complications, two suffered new permanent postoperative deficits, and the remaining one died due to severe brain swelling despite postoperative intensive care. Extent of surgical resection was found to be significantly related to tumor recurrence. Conclusion : Falcine meningioma accounted for 8.5% of intracranial meningiomas and the transitional meningioma was the most common subtype of falcine meningioma. Gross total resection of tumor was the single most important predictor of an improved surgical outcome.