Coextensive Meningioma and Cholesterol Granuloma in the Forebrain of a Cat

Abstract

A 9-year-old, female, spayed, domestic longhaired cat presented to The Ohio State University Veterinary Medical Center Oncology Service with a 6-month history of changes in behavior and weight loss. The owner reported that the cat had become abnormally unfriendly and would growl or hiss when touched. The cat also had gait changes, manifested by left hind limb weakness, difficulty walking up stairs, and occasionally losing balance and falling down stairs. The cat was examined by its regular veterinarian and had abdominal radiographs, CBC, and biochemistry profile performed, which did not detect any abnormalities. On physical examination, the cat was underweight with an estimated body condition score (BCS) of 1/5. Neurologic examination revealed a very dull mentation, severe generalized muscle atrophy, and a slow, reluctant, and crouched gait. Cranial nerve examination revealed no abnormalities. There was absence of conscious proprioception in all limbs. A forebrain lesion was suspected. The cat was examined 8 days later because of progressive signs of neurologic disease. The cat was obtunded and had a right head turn with a mild right head tilt. The gait showed proprioceptive/right vestibular ataxia with knuckling of both thoracic limbs on ambulation, a crouched posture, and a splaying outward of the left thoracic limb. There was a decreased menace response bilaterally that was worse on the left and decreased nasal sensation bilaterally. Spinal reflexes were normal in all limbs. Neurolocalization was to the right-forebrain with possible brainstem involvement. An abdominal ultrasound was then performed at the owner’s request to investigate the gastrointestinal tract as a possible explanation for the weight loss, but no abnormalities were identified.

Xanthomatous meningioma: A metaplastic or degenerative phenomenon?

“…xanthoma cells associated with tumor necrosis and hemorrhage. 13 Intriguingly, cholesterol crystal depositions or cholesterol clefts that are frequently present in other animals' meningiomas 14 have not been reported in humans. Here, we describe the first case of xanthomatous meningioma with the presence of cholesterol crystal depositions in a human.…”

Cholesteatoma and hydrocephalus associated to a third ventricle meningioma in a cat

“…Although meningiomas are the most frequent primary tumors in the central nervous system of domestic animals (HIGGINS et al, 2017), often involving the third ventricle in cats (TROXEL et al, 2003), the simultaneous occurrence of meningioma and cholesteatoma within the choroid plexus is uncommon (ONDREKA et al, 2013). Cholesteatomas are rare in cats, both as primary condition (FLUEHMANN et al, 2006) or in association to other neoplasms (CHAWLA et al, 2015;ODRENKA et al, 2013). Etiology and pathogenesis of these tumor-like nodules are still unknown, with two mechanisms postulated: i) general dysfunction of lipid metabolism (FLUEHMANN et al, 2006); ii) chronic or intermittent congestion and edema along with congestive hemorrhage in the choroid plexus (CANTILE & YOUSSEF, 2016).…”

“…Conversely, cholesteatomas, or cholesterol granulomas are nonneoplastic nodular lesions resulting from chronic or intermittent hemorrhage in the choroid plexus. These are mainly observed within the ventricular system of senile horses, while in cats it is a rare condition (CANTILE & YOUSSEF, 2016;CHAWLA et al, 2015;FLUEHMANN et al, 2006). This study aimed to describe the pathological and immunohistochemical features of a case of a cholesteatoma and noncommunicating hydrocephalus associated to a third ventricle meningioma in a cat.…”

Xanthogranuloma and Hepatic Lipidosis in a Mexican Moccasin Snake (Agkistrodon bilineatus) with Hypercholesterolemia: A Case Report

“…This lesion is mainly located in the choroid plexus, lateral ventricles and the fourth ventricle [1,3,7,8]. Xanthogranuloma has been reported in humans, birds, reptiles, amphibians, dogs, cats and more frequently in horses, where it is mainly associated with aging and is usually a finding at necropsy [1,3,4,[6][7][8]. In humans and birds it is commonly a cutaneous disease, [8] in dogs and cats it has been described in middle ear (aural cholesteatoma) [4] and in reptiles it has been anecdotically reported (mostly described in lizards).…”

“…could result in cholesterol crystal deposition and CG formation [4]. In reptiles, hepatic lipidosis may be due to an increase in food consumption, to drug intoxication and in some species it occurs physiologically during hibernation.…”