Collision Tumor Composed of Meningioma and Cavernoma

Abstract

A true collision tumor is a rare entity composed of two histologically distinct neoplasms coinciding in the same organ. This paper reports a unique case of cerebral collision tumor consisting of two benign components. On the first hand, meningioma which is usually a benign lesion arising from the meningothelial cell in the arachnoidal membrane. On the other, cerebral cavernoma which is a well-circumscribed, benign vascular hamartoma within the brain. To our knowledge, there is no previously documented case of cerebral collision tumor consisting of two benign components. A 56-year-old Caucasian male suffered in 2002 from an atypical meningioma WHO II° located in the left lateral ventricle. Three years after the tumor extirpation, the patient suffered from a hematoma in the fourth ventricle due to a recurrently haemorrhaged cavernoma. In 2008, a recurrence of the tumor in the left lateral ventricle was discovered. Additionally, another tumor located in the quadrigeminal lamina was detected. After surgical resection of the tumor in the left lateral ventricle, the pathological examination confirmed the diagnosis of a collision tumor consisting of components of a meningioma WHO II° and a cavernoma. Postoperatively, no adjuvant treatment was needed and no tumor recurrence is discovered up to the present. A possible explanation for the collision of those two different tumors may be migration of tumor cells mediated by the cerebrospinal fluid. After 5-years of follow-up, there is no sign of any tumor recurrence; therefore, surgical tumor removal without adjuvant therapy seems to be the treatment of choice.

Supratentorial dural-based collision of cavernoma and meningioma: a case report

“…Most of them presented cases with collision tumors consisting of malignant astrocytoma (including glioblastoma) and meningioma. There are also reports of collision tumors consisting of two different cerebral metastases [1]. This report presents an unusual case of dural-based tumor mass mimicking CM and including both lesions -CM and meningioma.…”

“…Weigel et al reported the first case of collision tumor consisted of meningioma and cavernoma but ventricular localization [ 1 ]. In the reported case, collision tumor appeared after some surgical resections of a recurrent meningioma of left lateral ventricle and a cavernoma of caudal section of the aqueduct and dorsolateral part of the fourth ventricle.…”

“…The occurrence of these lesions could be coincidental. Weigel et al based on ventricular localization of both tumors hypothesized that a possible explanation of the collision of the two different tumors may be a cerebrospinal fluid mediated migration of tumor cells [ 1 ]. Kilani et al described some hypotheses based on radiation and traumas of head [ 10 ].…”

“…Such tumors consist of components with different histogenesis and tumorogenic pathway representing a mosaic of two concurrent but independent tumors that have "collided" with each other [1]. Our report presents the case of a patient with supratentorial convexity dural-based lesion that have MR findings of cavernous malformation (CM) and composed both of CM and meningioma.…”

“…An intracranial collision tumor represents two coexisting, histologically distinct primary tumors in the same site without histological admixture or an intermediate cell population zone. Such tumors consist of components with different histogenesis and tumorogenic pathway representing a mosaic of two concurrent but independent tumors that have “collided” with each other [ 1 ]. Our report presents the case of a patient with supratentorial convexity dural-based lesion that have MR findings of cavernous malformation (CM) and composed both of CM and meningioma.…”