Whorling-sclerosing meningioma. A review on the histological features of a rare tumor including an illustrative case

Elmacı, İlhan; Altinöz, Meriç A.; Sav, Aydın; Bölükbaşı, Fatih Han; Önöz, Mustafa; Başkan, Özdil; Sarı, Ramazan

doi:10.1016/j.clineuro.2017.09.009

Cited by 7 publications

(21 citation statements)

References 12 publications

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“…Whorling-sclerosing variant of meningioma is a rare variant of meningioma, which is characterized by onion-skin-like layers of sclerosing structures formed by typical paucicellular associated with or cell-free collagen whorls. 24–26 So far in the relevant spinal tumor articles, this is the first reported tanycytic ependymoma case encountering large areas of whorling and sclerosing zones. Although ependymomas might harbor cartilage, osseous and epithelial islands, so far there is no reported case documenting sclerotic islands amidst nebula-like patterns (whorling) within tumor tissue.…”

Section: Discussionmentioning

confidence: 86%

Whorling Sclerosing Ependymoma of the Cervical Spinal Cord Presenting Tanycytic Histopathologic Features: A Rare Case Report

et al. 2022

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Tanycytic ependymoma is a neuroectodermal tumor that arises from ependymoglial cells or tanycytes. It is highly uncommon. We reported a 34-year-old man who was diagnosed with intradural-intramedullary tanycytic ependymoma, located at the level of C4-5 who had a 9-months history of neck pain and left arm pain, and numbness on fingers. One month prior to presentation, his left arm numbness and paresthesia deteriorated. The lesion was removed totally by C4, C5 hemilaminoplasty. The histologic pattern of this lesion was consisted of fascicles forming nebula-like whorling structures. Because of these structures, tanycytic ependymoma should be taken into consideration in the differential diagnosis of a whorling-sclerosing variant of meningiomas.

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Section: Discussionmentioning

confidence: 86%

Whorling Sclerosing Ependymoma of the Cervical Spinal Cord Presenting Tanycytic Histopathologic Features: A Rare Case Report

et al. 2022

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“…Wild type p53 protein exists in benign cells, but due to its very relatively half-life, p53 is present in diminutive amounts, even undetectable by immunohistochemistry (IHC), whereas accumulated mutant p53 protein are detectable by IHC. Therefore, positivity of p53 expression is associated with p53 mutations [9]. It was shown that non-invasive and invasive adenomas and pituitary carcinomas exerted expression of p53 in 0, 15.2, and 100 % of cases, respectively, which correlated with invasion in a recent study [7].…”

Section: Are the Invasive Prolactinomas Aggressive Prolactinomas Malignant Prolactinomas And Pituitary Carcinomas Different Entities? Anamentioning

confidence: 94%

“…The tumor suppressor TP53 gene encodes the transcription factor p53, which is a genomic "gate keeper" that initially blocks cell cycle and succeedingly induces DNA repair following genomic damage. However, when the DNA injury is irreversible, it induces apoptosis of the cells, thereby eliminating the spread of mutations into the cell progeny [9]. Wild type p53 protein exists in benign cells, but due to its very relatively half-life, p53 is present in diminutive amounts, even undetectable by immunohistochemistry (IHC), whereas accumulated mutant p53 protein are detectable by IHC.…”

Section: Are the Invasive Prolactinomas Aggressive Prolactinomas Malignant Prolactinomas And Pituitary Carcinomas Different Entities? Anamentioning

confidence: 99%

Treatment Strategies for Dopamine Agonist-Resistant and Aggressive Prolactinomas: A Comprehensive Analysis of the Literature

et al. 2021

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Despite most of the prolactinomas can be treated with endocrine therapy and/or surgery, a significant percentage of these tumors can be resistant to endocrine treatments and/or recur with prominent invasion into the surrounding anatomical structures. Hence, clinical, pathological, and molecular definitions of aggressive prolactinomas are important to guide for classical and novel treatment modalities. In this review, we aimed to define molecular endocrinological features of dopamine agonist-resistant and aggressive prolactinomas for designing future multimodality treatments. Besides surgery, temozolomide chemotherapy and radiotherapy, peptide receptor radionuclide therapy, estrogen pathway modulators, progesterone antagonists or agonists, mTOR/akt inhibitors, pasireotide, gefitinib/lapatinib, everolimus, and metformin are tested in preclinical models, anecdotal cases, and in small case series. Moreover, chorionic gonadotropin, gonadotropin releasing hormone, TGFβ and PRDM2 may seem like possible future targets for managing aggressive prolactinomas. Lastly, we discussed our management of a unique prolactinoma case by asking which tumors’ proliferative index (Ki67) increased from 5–6% to 26% in two subsequent surgeries performed in a 2-year period, exerted massive invasive growth, and secreted huge levels of prolactin leading up to levels of 1 605 671 ng/dl in blood.

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“…In the English medical literature, only 31 cases are documented: 28 intracranial and three intraspinal 1,3,8,9 . In general, most intracranial WSMs showed a good prognosis, although brain invasion was seen in five reported cases 2,3 …”

Section: Introductionmentioning

confidence: 99%

Whorling‐sclerosing meningioma invading skull bone and subcutaneous tissue with an incidental toxoplasmosis: A case report

et al. 2022

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Whorling-sclerosing meningioma (WSM) is a rare type of meningothelial tumor. Worldwide, only 31 cases have been reported. The diagnosis of this rare meningioma subtype is based principally on microscopic findings, wherein up to 70% of the tumor tissue should be formed by thick whorls of collagen. Notably, there is still disagreement about whether to consider this entity a benign meningioma (grade 1) or a meningioma with higher malignant potential (grade 2 or even grade 3). In fact, the paucity of reported WSM cases and, consequently, the lack of information about their follow up make their diagnosis and treatment challenging. Herein, we document the first case of WSM in Syria in a 75-year-old woman with an incidental finding of Toxoplasma gondii. Although WSM has not been mentioned in the recent World Health Organization classification of central nervous system tumors, it should be recognized to avoid incorrect diagnosis and spare the patients unnecessary radiotherapy and chemotherapy.

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Whorling-sclerosing meningioma. A review on the histological features of a rare tumor including an illustrative case

Cited by 7 publications

References 12 publications

Whorling Sclerosing Ependymoma of the Cervical Spinal Cord Presenting Tanycytic Histopathologic Features: A Rare Case Report

Whorling Sclerosing Ependymoma of the Cervical Spinal Cord Presenting Tanycytic Histopathologic Features: A Rare Case Report

Treatment Strategies for Dopamine Agonist-Resistant and Aggressive Prolactinomas: A Comprehensive Analysis of the Literature

Whorling‐sclerosing meningioma invading skull bone and subcutaneous tissue with an incidental toxoplasmosis: A case report

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