Deep Sylvian Meningioma without Dural Attachment – A Case Report

Yamagishi, Masayuki; Bohara, Manoj; Komasaku, Soichiro; Yamada, Masahiko; Kawahara, Dan; Sadamura, Yuko; Mori, Masanao; Nishimuta, Yosuke; Ishii, Takeshi; Tokimura, Hiroshi

doi:10.2176/nmccrj.cr.2018-0215

Cited by 3 publications

(2 citation statements)

References 21 publications

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“…However, meningiomas without dura attachment were occasionally reported. Supratentorial meningiomas without dura attachment, regarding their sites, are classified into 5 categories as intraventricular meningiomas,2 pineal region meningiomas,3 deep sylvan meningiomas,4 intraparenchymal or subcortical meningiomas,5,6 and others. Subcortical meningioma, or intraparenchymal meningioma as it is named in some literature, is a type of meningioma without dura attachment and considered to arise from arachnoid cells of the pia mater within brain sulcus 7.…”

Section: Discussionmentioning

confidence: 99%

Benign Meningioma With Rare Radiological and Behavioral Features

Wen

Wang

et al. 2022

Journal of Craniofacial Surgery

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Background: Meningiomas are usually dura-based primary nonmalignant neoplasms of the central nervous system. It is extremely rare that a meningioma is located at the convexity of the brain, but shows no dura attachment and causes osteolysis of the skull. Case Presentation: A 57-year-old woman presented with an incidentally discovered scalp lump on the head. Neurological deficits were not found. Radiological examination revealed a localized osteolytic lesion in the right parietal bone, which was initially diagnosed as a bone tumor and was surgically resected. At surgery, a tumor mass was found located at the brain convexity without dura attachment. It was tightly attached to the brain parenchyma and had no distinct boundary from the brain. The mass was rather small, but resulted in significant osteolysis of the skull and destruction of the dura. Simpson grade I resection of the tumor was performed. Histological and immunohistochemical results indicated a meningothelial meningioma. Conclusions: Both preoperative and intraoperative diagnoses are difficult for this case. Knowledge of this case is crucial for clinicians to be aware of this entity because it can be easily confused with bone tumors. Further research on the relationship between meningioma and bone metabolism is required to investigate the mechanism of osteolysis.

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Section: Discussionmentioning

confidence: 99%

Benign Meningioma With Rare Radiological and Behavioral Features

Wen

Wang

et al. 2022

Journal of Craniofacial Surgery

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“…A case of deep sylvian meningioma without dural attachment is also reported recently. 40) Theories regarding the origin of this tumor include the theory that it has a malignant nature, 13) a secondary tumor attached to the nerve root after loss of dural adhesions, 16) Schwann cells differentiation into spinal fluid histiocytes, 33) and the theory that it occurs from a pia matter 35) ; but, there is no settled opinion. In our case, the tumor was found to have dural attachments, and the tumor was in contact with the roots through the arachnoid.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative Anatomical Findings in Pediatric Clear Cell Meningioma of the Lumbar Spine: Case Report and Literature Review

Ikeda

Isoo

Sakakibara

et al. 2021

NMC Case Report Journal

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Clear cell meningioma (CCM) is a WHO classification Grade II meningioma. It is a very rare disease, of which only 41 cases of spinal cord CCM in children have been reported to date. CCMs sometimes do not have the "dural attachment" that is usually found in meningiomas, and our understanding of the origin of CCMs is therefore controversial. We hereby present a case of pediatric CCM of the lumbar spine, in which we examined intraoperatively, the detailed anatomical location of the tumor. The case is a 10-year-old boy, who presented to our hospital with a 2-month history of lower back and bilateral lower extremity pain upon waking, which gradually worsened. Lumbar spine CT and MRI revealed an intradural extramedullary tumor at the L3 vertebral level, and surgery was performed to remove it. The tumor was in close contact with the dura mater, and also in contact with the cauda equina via the arachnoid. The tumor was likely located primarily between the dura mater and arachnoid. The pathological diagnosis was CCM, with an MIB-1 index of less than 1%. His back pain and bilateral lower extremity pain improved after surgery, and he was discharged from our hospital. Postoperative radiation therapy was not performed. Based on this case, we suggest that intraoperative examination of the anatomical location of these tumors and accumulation of relevant experience are important to elucidate the embryological mechanisms of this rare disease.

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Sylvian Fissure Meningiomas: Case Report and Literature Review

et al. 2020

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Meningiomas are primary intracranial tumors derived from arachnoid cap cells or meningothelial cells and usually display dural attachment. However, a small proportion of meningiomas that arise from the Sylvian fissure do not manifest dural attachment. Sylvian fissure meningiomas are relatively rare and have differential characteristics as compared with typical meningiomas. Herein, we reported a special case of atypical meningioma in the Sylvian fissure, that showed non-enhancement after contract management. The patient was a 30-year-old woman with a 2-year history of seizures. Preoperative computerized tomography and magnetic resonance imaging scans showed a calcific, non-enhancing lesion in the right insula lobe. The lesion was excised surgically for seizure control. Intraoperatively, the tumor was observed to be closely adhered to the middle cerebral artery (MCA), resulting in mild arterial damage. A case of Sylvian fissure meningioma was ultimately diagnosed by histopathological examination of the resected specimens. Sylvian fissure meningiomas are closely associated with the MCA and exhibit unusual imaging characteristics. Preoperative misdiagnosis may have serious adverse consequences and may result in incorrect surgery. To improve awareness of Sylvian fissure meningiomas on the differential diagnosis of Sylvian fissure lesions among clinicians, we present this report and briefly summarize previously reported cases to describe the clinical, pathological, radiological, and surgical features.

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Deep Sylvian Meningioma without Dural Attachment – A Case Report

Cited by 3 publications

References 21 publications

Benign Meningioma With Rare Radiological and Behavioral Features

Benign Meningioma With Rare Radiological and Behavioral Features

Intraoperative Anatomical Findings in Pediatric Clear Cell Meningioma of the Lumbar Spine: Case Report and Literature Review

Sylvian Fissure Meningiomas: Case Report and Literature Review

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