1/50. Intracranial Castleman's disease of solitary form. Case report.This 62-year-old woman presented with clumsiness in her right hand. magnetic resonance imaging demonstrated a small lesion mimicking a meningioma, which had arisen from the tentorium and contained notable edema. Full recovery was achieved by total removal of the lesion, which was diagnosed as a lymphoid mass resembling giant lymph node hyperplasia on histological examination. The lack of notable findings on whole-body and laboratory studies was compatible with a rare case of intracranial Castleman's disease of solitary form. The authors document clinical, neuroradiological, and pathological features of this rare disease.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/50. A meningioma-mimicking tumor caused by mycobacterium avium complex in an immunocompromised patient.Intracranial tuberculomas manifesting radiologically as typical dural-based "meningiomas" have been reported, most frequently in immunosuppressed patients. Their incidence is high in developing countries; they are only sporadically observed in Western europe and north america, usually in patients with acquired immunodeficiency syndrome (AIDS). According to published reports, intracranial tuberculomas are always due to infection by mycobacterium tuberculosis. We report a case of a 50-year-old woman with systemic lupus erythematosus (SLE) who presented with a dural based, meningioma-like mass in the right frontal region, resulting from a localized infection by mycobacterium avium complex. Histologically, the mass resembled a meningioma in being composed of spindly cells arranged in a fascicular pattern. Immunohistochemical stains showed this tumor to consist of a large aggregate of AFB-laden histiocytes without caseating necrosis or multinucleated giant cells.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
3/50. Unususpected meningioma in a patient with pituitary gigantism. Case report with autopsy findings.A unique example of a clinically unsuspected large parasellar meningioma is described in a 36-yr-old pituitary giant who had been treated initially with conventional irradiation, subsequently by surgical excision of an acidophil adenoma, and ultimately with medroxyprogesterone acetate (MPA) prior to his demise. The patient died of increased intracranial pressure resulting from a combined mass effect of the meningioma and recurrent tumor. The relationship between radiation and the development of the meningioma is discussed, as well as the fine ultrastructure of a highly functioning acidophil adenoma.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
4/50. Malignant fibrous histiocytoma associated with a meningothelial meningioma.A 72-year-old woman was operated for a left parietal tumor of the meninges. The symptomatology began 22 years earlier with a right hemiparesis. The histological examination of the tumor showed a proliferation of meningothelial cells with whorl formation, associated with a pleomorphic proliferation of a malignant fibrous histiocytoma. The meningothelial meningioma showed a typical aspect, with nuclear inclusions and absence of mitotic activity. The second tumor component showed a storiform architecture with giant multinucleated cells, necrosis and many typical and atypical mitoses. There was also an inflammatory component with infiltrates of lymphocytes. This tumor component at the border with the meningioma appeared to arise from the septa of the meningioma with many prongs merging into one large and pleomorphic histiocytomatous tumor. The dual histological aspect and the case are discussed in the light of what is already known in the literature. The woman has been irradiated after surgery and she is doing well 6 months after operation.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
5/50. Mixed mesenchymal differentiation in meningiomas.Five intracranial meningiomas showing mixed mesenchymal differentiation are described. Three contained cartilage, three contained bone, four contained hyaline fibrous strands or nodules which in two instances were calcified, three contained angiomatous areas, one contained pericytoma-like areas, four contained pleomorphic and sometimes multinucleate giant cells, and one contained a mucoid matrix including spheroidal cells superficially resembling chordoma. The importance of recognising such tumours is emphasised as they can be misdiagnosed as metastatic deposits, particularly in a frozen section.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
6/50. A giant hyperostosing meningioma in a child.A case of 15-year-old boy with a giant hyperostotic meningioma is presented. The patient had a huge prominence at the posterior parietal region. The CT scan showed a giant intracranial tumor in the left parieto-occipital region under the hyperostotic bone. The tumor and hyperostotic bone were totally resected with the involved portion of the sagittal sinus. Histological study revealed a meningioma. The presence of such a huge hyperostosis and some peculiarities of childhood meningiomas are discussed.- - - - - - - - - - ranking = 6keywords = giant (Clic here for more details about this article) |
7/50. Dura and cranial base reconstruction by external oblique fascia and rectus abdominis muscle flap.The rectus abdominis muscle flap, combined with the external oblique fascia, were utilized in cranial-base reconstruction. In a wide defect caused by resection of a giant meningioma, the dura was reconstructed with the external oblique fascia and anterior sheath, and the cranial-base defect was reconstructed with the rectus abdominis muscle flap.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
8/50. Giant aneurysm of the distal anterior cerebral artery: associated with an anterior communicating artery aneurysm and a dural arteriovenous fistula.We describe an unusual case of a giant pericallosal artery aneurysm, producing psychomotor depression from mass effect, associated with a smaller aneurysm of the anterior communicating artery, a dural arteriovenous fistula, and a meningioma. magnetic resonance imaging (MRI) and cerebral angiography demonstrated the giant aneurysm and the meningioma. cerebral angiography provided a detailed appreciation of the cerebral circulation, including both aneurysms, the dural arteriovenous fistula, and the potential collateral supply to the involved anterior cerebral distribution. The anterior communicating artery aneurysm was successfully clipped as was the distal anterior cerebral branch supplying the giant aneurysm before its resection. The patient made a full recovery but with persisting, slight dysphasia. We conclude that computed tomography, cerebral angiography, and MRI are of specific value in the assessment of giant aneurysms, but only angiography can provide detailed characterization of the aneurysm and demonstrate other possible cerebrovascular pathology such as multiple aneurysms and arteriovenous fistulas.- - - - - - - - - - ranking = 4keywords = giant (Clic here for more details about this article) |
9/50. Combined supratentorial and infratentorial approach to large pineal-region meningioma.Our case report is used to describe a combined supratentorial and infratentorial approach to a giant pineal-region meningioma. The procedure involves section of the less dominent transverse sinus and the tentorium. After the cerebellum and the occipital lobe are retracted away from each other, the operative procedure is carried out. The brain stem and the large veins of this region are better exposed with minimal retraction of the cerebellum and occipital lobe. The transverse sinus is resutured at the end of the procedure to reestablish the blood circulation. The operative procedure is ideal for extensive lesions in the pineal region, providing wide and direct exposure.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
10/50. tuberculoma of the cervical spinal canal mimicking en plaque meningioma.A previously healthy, hiv-negative, 40-year-old man presented with a 2-month history of progressive weakness of his left arm. magnetic resonance imaging revealed an intradural, extramedullary plaque-shaped lesion at C6-T1 levels with high contrast enhancement. Based on the patient's clinical and radiologic findings, it was believed that the patient had an en plaque meningioma, and he was operated on. Histologic examination of the mass revealed granulomas with multinucleated and Langhans-type giant cells, typical of a tuberculoma. Intradural extramedullary tuberculomas should be considered in the differential diagnosis of en plaque meningioma as a rare entity.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
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