Meningioma of the fourth ventricle presenting with intermittent behaviour disorders: a case report and review of the literature

Chaskis, Cristo; Buisseret, T; Michotte, Alex; D’Haens, Jean

doi:10.1054/jocn.2001.0879

Cited by 17 publications

(14 citation statements)

References 27 publications

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“…Arachnoid cap cells and trabecular arachnoid cells are supposed to originate microcystic meningioma in human beings [10] and small whorls of meningothelial (arachnoid) cells (forming the tela choroidea), which are normally present in the choroid plexus, could originate the intraventricular meningiomas [3,7]. In our case, the tumor clearly originated from the choroid plexus of the 4th ventricle.…”

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confidence: 65%

Microcystic Meningioma of the Fourth Ventricle in a Dog

et al. 2011

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ABSTRACT. A 5-year-old female cross-breed dog was presented with a 1-month history of progressive changes in the posture of the head and in the gait. At neurological examination the dog showed a central vestibular syndrome lateralized to the left. MRI showed a space occupying lesion within the fourth ventricle, characterized by iso-to hypointensity in T1 and hyperintensity in T2 with a heterogeneous contrast uptake. Histologically, a neoplasia composed of meningothelial cells forming compact whorls with slight atypia, and stellate cells delimitating microcysts containing eosinophilic fluid was observed. Neoplastic cells were positive for vimentin and negative for GFAP and FVIII. A diagnosis of intraventricular microcystic meningioma was achieved. Intraventricular meningiomas in dogs are rarely encountered and reports of meningiomas within the fourth ventricle have not yet been described. Although choroid plexus tumor is the most frequent neoplasia localized in the fourth ventricle, intraventricular meningioma should be included in the differential diagnoses.KEY WORDS: canine, central nervous system tumors, intraventricular meningioma, microcystic meningioma.J. Vet. Med. Sci. 73(3): 367-370, 2011 Meningiomas are the most common canine intracranial tumors and differently from human neuro-oncology are frequently classified as atypical meningioma (grade II) with a poorer therapeutic response [14]. Meningiomas involve most commonly the anterior half of the dorsal surface of the brain near the falx [11]. Other common locations are tentorium cerebelli, ventral or lateral aspect of the brainstem, mainly at hypothalamus and optic chiasm level, and other external surfaces of the brain with a typical extra-axial growth pattern [9,11]. Although the intraventricular location involving the tela choroidea of the third ventricle represents a common site for meningiomas in cats [15], it is rare in dogs and the presence of meningiomas in the fourth ventricle has not yet been described in the literature. A secondary involvement of the fourth ventricle by a meningioma consequent to local extension has been described in a dog [6]. In human beings, intraventricular meningiomas are rare and meningiomas of the fourth ventricle are exceptional [4].Histologically, meningiomas in animals are classified as meningothelial, fibroblastic, transitional, psammomatous, angiomatous, papillary, granular cell, myxoid and anaplastic [5]. Rare reports of cystic and microcystic meningiomas are also described [1,8,12,14].To our knowledge, no cases of microcystic meningiomas involving the fourth ventricle in dogs have been described so far. This report describes the clinical, neuroradiological and neuropathological findings of a dog with a primary meningioma of the fourth ventricle with histological features suggestive of microcystic subtype.A 5-year-old female cross-breed dog was presented with a 1-month history of progressive changes in the head posture, frequent fallings, circling to the left side and excessive anxiety. Neurological evaluation rev...

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Microcystic Meningioma of the Fourth Ventricle in a Dog

et al. 2011

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“…The cells of origin are believed to be arachnoid cap cells confined to the choroid plexus. 3 CT scans reveal a sharply demarcated lobular mass with hyperattenuation and periventricular oedema. On MRI, the lesion can appear as isointense to hypointense compared to gray matter on T1-weighted MRI and isointense to hypointense on T2weighted MRI, with intense enhancement of the mass.…”

Section: Discussionmentioning

confidence: 99%

“…The low signal intensity on T2-weighted MRI is one of the key features of meningioma, greatly aiding in the correct imaging assessment. 1,3 The tumour was surgically removed via an occipital interhemispheric approach. The histopathological diagnosis was a transitional type intraventricular meningioma, with psammoma bodies.…”

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A solid mass with a cystic component arising in the occipital horn of the lateral ventricle in an elderly woman

Pepa

Altavilla

Sabatino

et al. 2010

Journal of Clinical Neuroscience

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AnswerB. Intraventricular meningioma. DiscussionIntraventricular lesions are unusual and represent less than 10% of all intracranial neoplasms. Tumours that primarily or exclusively involve the ventricular system constitute a heterogeneous group. Certain histologic tumour types predominantly occur in children, whereas others are more common in adults. It is important to differentiate between a true intraventricular lesion and an intraparenchymal tumour invaginating into the ventricle. The presence of a liquoral cap around the lesion can be suggestive of an intraventricular neoplasm. In addition, the surrounding brain parenchyma may be less affected by an intraventicular neoplasm, and any areas of altered MRI signal at imaging may be more suggestive of a local irritative effect than local infiltration. Nevertheless, on MRI, low-grade parenchymal tumours often look indistinguishable from intraventricular meningiomas. 1 The epidemiology of ependymoma shows a clear preference for younger age groups, although the occurrence of supratentorial ependymomas in adults has been described. Ependymomas appear as a well-circumscribed mass that arises from the ventricle walls and occupies ventricular space. MRI appearances of ependymoma are comparable to those of intraventricular meningiomas. In addition, cystic areas are common in these lesions. 2 Therefore the reported lesion could be an ependymoma based on the neuroimaging. However, ependymomas often tend to be inhomogeneous on T1-weighted MRI, and show variable enhancement with contrast administration. Ependymoma would be rare in a patient of this age.Choroid plexus tumours are intraventricular papillary lesions that are observed usually in childhood. However, there are reports of patients with choroid plexus papillomas with specific chromosomal aberrations that occur equally in adult and paediatric patients. On non-enhanced CT the tumour appears as a smooth or lobulated mass, hyperdense in relation to surrounding brain parenchyma. With intravenous contrast, there is marked, homogeneous enhancement. With MRI these tumours show an isointensity on T1-weighted MRI and iso-hypointensity on T2-weighted MRI, with marked enhancement after gadolinium. On CT scans and MRI, the mass may appear similar to an intraventricular meningioma except for a variable hyperintense signal on T2-weighted MRI and flow voids. 1 Thus, the reported lesion could be a choroid plexus papilloma, however the well demarcated round border of the neoplasm, plus the patient age, made this unlikely.In adults, atrial intraventricular meningiomas are among the most common tumours in the lateral ventricle. Although rare, accounting for only 0.7% of all meningiomas, they occur in the left lateral ventricle of middle-aged or older women. The cells of origin are believed to be arachnoid cap cells confined to the choroid plexus. 3 CT scans reveal a sharply demarcated lobular mass with hyperattenuation and periventricular oedema. On MRI, the lesion can appear as isointense to hypointense compared to gray matter on T1-w...

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“…6) Most intraventricular meningiomas are located in the trigone of the lateral ventricle or the third ventricle. 18) Meningioma in the fourth ventricle is extremely rare, with only 25 reported cases.…”

Section: Introductionmentioning

confidence: 99%

“…18) Meningioma in the fourth ventricle is extremely rare, with only 25 reported cases. 1,5,6,[8][9][10]12,13,15,20,21) Accurate preoperative diagnosis can be difficult. Fourth ventricle tumors are uncommon, and represent only 1.4% of all brain tumors.…”

Section: Introductionmentioning

confidence: 99%

Usefulness of Thallium-201 Chloride Single Photon Emission Computed Tomography for the Preoperative Diagnosis of Fourth Ventricle Meningioma-Case Report-

Ooigawa

Miyazawa

Otani

et al. 2004

Neurol. Med. Chir.(Tokyo)

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A 51-year-old woman presented with a fourth ventricle meningioma manifesting as a 2-week history of dizziness and vomiting. Computed tomography (CT) and magnetic resonance (MR) imaging revealed a round mass lesion in the fourth ventricle. Thallium-201 chloride single photon emission computed tomography ( 201 TlCl SPECT) showed high and rapid uptake on the early image and rapid washout on the delayed image. The preoperative diagnosis of meningioma could be established based on these findings. Total removal of the tumor was successfully performed. 201 TlCl SPECT is useful for the preoperative diagnosis of fourth ventricle meningioma combined with CT, MR imaging, and angiography.

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Meningioma of the fourth ventricle presenting with intermittent behaviour disorders: a case report and review of the literature

Cited by 17 publications

References 27 publications

Microcystic Meningioma of the Fourth Ventricle in a Dog

Microcystic Meningioma of the Fourth Ventricle in a Dog

A solid mass with a cystic component arising in the occipital horn of the lateral ventricle in an elderly woman

Usefulness of Thallium-201 Chloride Single Photon Emission Computed Tomography for the Preoperative Diagnosis of Fourth Ventricle Meningioma-Case Report-

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