Xanthomatous meningioma; a rare histological variant

Abstract

Introduction: Meningiomas are tumors of the central nervous system originating from the meningothelial tissues, the arachnoid cap cells of the cranium and spinal cord. According to the WHO classification system, grade 1 meningiomas are of nine subtypes. Xanthomatous meningioma is a rare histological variant of meningioma belong to the subtype "Metaplastic meningioma". The Meningioma with a predominantly xanthomatous cellular changes with lipid-laden vacuolated cytoplasm is classified as ''xanthomatous meningioma'' Case report: A 61 year old patient presented with headache, disorientation and hemiparesis. Magnetic resonance imaging (MRI) shows large right parietal enhancing dural based convexity meningioma. The tumor resected enblock and the histological examination revealed features of classical meningioma with predominant areas of xanthomatous changes. Immunostaining for epithelial membrane antigen and vimentin wase positive in both xanthomatous foamy cells and meningothelial areas. GFAP was negative. CD 68 was positive in few scattered cells in the xanthomatous areas. Ki-67 index was 1% in the highly cellular area. The final histopathological diagnosis was xanthomatous meningioma, WHO grade I. Conclusion: Xanthomatous meningioma is a rare variant of meningioma belongs to the subtype metaplastic meningioma. We present the case because it is an extremely rare worldwide.