Cases reported "Meningeal Neoplasms"

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11/209. granular cell tumor of intracranial meninges.

    BACKGROUND: granular cell tumor (GCT) is a benign neoplasm composed of a proliferation of round or polygonal cells that contain eosinophilic granular cytoplasm. The most common locations are tongue and subcutaneous tissue, but a variety of other sites may be involved including the central nervous system (CNS). Most CNS GCT arise in the pituitary, but rare cases involving brain and leptomeninges have been described. Extracranial GCT are usually S-100-positive, but those of the CNS, as well as the congenital variant of GCT, can be S-100-negative. CASE REPORT: We report an incidental autopsy finding of a 2.5 mm GCT that arose in the intracranial meninges overlying the anterior superior cerebellar vermis. RESULTS: The neoplasm had abundant eosinophilic, granular cytoplasm that was PAS-positive and diastase-resistant. Immunohistochemical studies showed that the neoplasm was positive for CD68 and negative for S-100, GFAP, EMA, and keratin. Thus, the immunophenotype is consistent with non-neural origin. CONCLUSION: Although this lesion in this circumstance was of no clinical significance, knowledge of the occurrence of GCT at this site broadens the differential diagnosis of eosinophilic lesions of the leptomeninges.
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12/209. An isochromosome 6p in a primary meningeal malignant melanoma.

    The rearrangement of chromosome 6, particularly the deletion of 6q, has been observed in human malignant melanoma with or without brain metastases. The isochromosome 6p has also been described. In this study, we report the cytogenetic analysis of a primary malignant melanoma of the central nervous system. Its dominating karyotype was 47,XX, i(6)(p10). fluorescence in situ hybridization (FISH), using a 6p chromosome arm probe, confirmed the structure of the isochromosome. To our knowledge, this is the first report of this type of chromosomal aberration in an uncommon neoplasm of leptomeningeal melanocytic origin.
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13/209. Necrotizing sarcoid granulomatosis mimicking an intracranial neoplasm: clinicopathologic features and review of the literature.

    We present a unique case of biopsy-proven necrotizing sarcoidosis involving the central nervous system (CNS) in a 52-year-old woman. The patient presented with a 3-month history of left-sided headache and sharp, shooting pains on the left side of her face. She also has a previous history of sarcoidosis, histopathologically confirmed on parotid gland biopsy 24 years before. Imaging studies of the present lesion revealed a 1.8 x 1.4-cm mass in the left temporal lobe with signal intensity suggestive of meningioma or low-grade glial neoplasm. Surgical resection was initiated, and intraoperative consultation with frozen sections revealed granulomata. The lesion was biopsied, and surgical intervention was terminated. Permanent sections failed to reveal bacteria, mycobacteria, fungi, or foreign bodies. A diagnosis of necrotizing neurosarcoidosis was rendered. The patient was administered steroid therapy and clinically responded favorably. At the most recent follow-up almost 2 years later, there was no evidence of recurrence or progression. Necrotizing sarcoidosis has been reported most commonly in the lungs and rarely in other organ systems. We report the first histologically proven case involving the CNS as well as a rare example of sarcoidosis and necrotizing sarcoid granulomatosis in the same patient. sarcoidosis and its necrotizing variant should be considered in the differential diagnosis of a granulomatous mass lesion involving the CNS, particularly in the context of a history of systemic disease.
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14/209. Benign melanocytic tumor in infancy: discussion on a rare case and review of the literature.

    Meningeal melanocytoma is an infrequent neoplasm of the central nervous system (CNS), especially in childhood and infancy. It was first described as an entity different from pigmented meningiomas and schwannomas in 1972, and few cases have been published so far. In this article, a 5-month-old male patient with meningeal melanocytoma is presented. This midline lesion was localized in the posterior fossa and manifested by hydrocephalus. The entire dural origin and extradural growing pattern in addition to the destruction of the adjacent occipital bone were the unexpected presentations since these tumors usually tend to locate on leptomeninges and to extend into the adjacent neural compartment rather than the outside. On the other hand, this case is the only one which had identical lesions in both surrenal glands and the left renal capsule, the structures containing neural-crest-derived cells outside the CNS. The prognostic criteria, differential diagnosis and its embryological aspects are discussed with an extensive review of the related existing literature.
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15/209. Metastatic solitary fibrous tumor of the meninges. Case report.

    Solitary fibrous tumor (SFT) is a unique tumor composed of interstitial dendritic cells that was first described in the thorax and subsequently reported in diverse organs. Extrathoracic SFTs are predominantly benign but rare malignant cases have been documented. In the nervous system, SFT has been described as a meningeal lesion although all 14 previously reported cases were benign. The authors report the first case of a meningeal SFT occurring in a 55-year-old woman. The tumor first presented as a meningeal lesion that after three recurrences over a 10-year period metastasized to the soft tissues and lungs. The potentially malignant nature of cranial SFTs, especially those with atypical histological features and high mitotic counts, should be recognized.
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16/209. Papillary meningioma with pleural metastasis: case report and literature review.

    Papillary meningiomas are rare meningeal tumors which are associated with a grim prognosis. These tumors usually recur locally and in some cases they metastasize. The clinical, radiological and histopathological features of a case of a papillary meningioma with a pleural metastasis in a 13-year-old boy are presented. The literature on metastasizing papillary meningiomas is reviewed. Up to now, 131 cases of papillary meningioma have been reported in the literature. Only 8 cases gave rise to metastases outside the central nervous system. The preferential site of metastasis appeared to be the lung. This is the first report of a papillary meningioma giving rise to a metastasis in the pleura.
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17/209. Meningeal involvement in B-cell chronic lymphocytic leukemia: report of two cases.

    Symptomatic central nervous system (CNS) involvement in chronic lymphocytic leukemia (CLL) or its variants is rare. We report two cases of CLL with leptomeningeal involvement. Patient one was an 81-year-old male who had CLL stage C (IV) at diagnosis and developed meningeal disease 29 months later. Patient 2 was a 42-year-old male with a diagnosis of CLL stage A (II) that evolved into mixed-cell CLL/prolymphocytic leukemia (PLL) 1.5 years later, with leptomeningeal infiltration of prolymphocytes developing 26 months after initial diagnosis. Meningeal leukemia was diagnosed by cerebrospinal fluid examination, with flow cytometry showing the same immunophenotypic findings of lambda-light chain restriction as the lymphocytes in bone marrow in one patient, and with morphologic characteristics exhibiting exclusively prolymphocytes in the other patient. The CNS disease of both patients responded effectively to intrathecal chemotherapy and cranial irradiation. However, both patients died of infection, a major cause of morbidity and mortality in patients with CLL. The clinicopathologic features of these two patients indicate that, despite the rarity of CNS involvement in CLL patients, any neurologic manifestation in CLL patients should arouse suspicion of meningeal leukemia and patients should be examined and managed accordingly.
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18/209. Unusual growth within a meningioma (leukemic infiltrate).

    Intracranial meningiomas are generally slow-growing neoplasms. Symptoms depend on their critical intracranial location. The authors describe a case of rapidly enlarging meningioma that became symptomatic as a result of invasion by leukemic cells at the time of a blastic crisis in the context of chronic myeloid leukemia. Infiltration of an intracranial meningioma by cells from extracranial malignant neoplasms is a rare event. Even though central nervous system (CNS) or meningeal involvement is common in some hematologic malignancies, this is, to the best of our knowledge, the first report of invasion of an intracranial meningioma by leukemic cells.
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19/209. Intraspinal clear cell meningioma: diagnosis and management: report of two cases.

    OBJECTIVE AND IMPORTANCE: Intraspinal clear cell meningioma is a rare morphological variant of meningioma. Only 13 case reports are found in the literature; therefore, no management strategy has been defined for this tumor type. This article describes two patients, reviews the literature, and proposes a treatment plan for clear cell meningioma. CLINICAL PRESENTATION: Two female patients, 22 months and 8 years of age, respectively, presented with localized neck and leg pain that limited their ability to walk. magnetic resonance imaging revealed intradural tumors, a cervical intramedullary neoplasm in the younger patient, and a cauda equina tumor in the older child. INTERVENTION: Both patients underwent radical resection of their intradural tumor. Both tumors, however, recurred shortly (5 and 6 mo) after the initial operation. During the second operation, a radical removal was performed on each patient. Both patients received adjuvant radiotherapy. In addition, the younger patient developed posterior fossa metastasis 20 months after intraspinal surgery. CONCLUSION: Intraspinal clear cell meningiomas are very uncommon tumors. The clinical course in our two patients supports the reported 40% recurrence rate within 15 months. These tumors also can disseminate within the central nervous system. We recommend serial imaging studies every 3 months. For recurrent tumors, we recommend localized radiation therapy after reoperation.
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20/209. Primary intracerebral malignant melanoma with leptomeningeal spread, extradural extension and lung metastasis.

    A rare primary intracerebral solitary malignant melanoma with extracranial metastasis is reported. The patient was a 66-year-old man who was revealed to have a tumor in the right temporal lobe by MRI. The tumor was totally resected and the histopathological diagnosis was malignant melanoma. Despite postoperative treatment with chemo-radiotherapy, tumor recurred with multiple subarachnoid dissemination. Complete autopsy showed marked leptomeningeal dissemination of tumor in the cerebro-spinal compartment. In the outside of the central nervous system, a microscopic metastatic nodule was found in the right lung. Metastatic tumor in the spinal cord showed the extradural extension which might have led to hematogenous metastasis to the lung.
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