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[A case of convexity meningioma en plaque]
T Matsushige1, H Yoshioka, S Okita
1Department of Neurosurgery, Hiroshima University.
Abstract:
We present a case of convexity meningioma en plaque (MEP). A 51-year-old male occasionally suffering from right parietalgia and numbness of left upper limb. An intracranial abnormal mass was pointed out incidentally by the brain check up. Computed tomographic (CT) scans demonstrated a hyperostosis and an enhanced abnormal mass at the right front-parietal region. Magnetic resonant images (MRI) revealed a carpet like tumor extended along the dura mater. Cerebral angiography disclosed feedings from parietal branches of right middle meningeal artery and superficial temporal artery. The tumor was removed subtotally with adjacent dura mater, leaving the portion of close adhesion to the brain parenchyma. Histologic diagnosis was transitional meningioma. Immunohistological stainings showed a high staining index (6.9%) of MIB-1 (Ki-69 antigen) and high expression of metalloproteinase-9 (MMP-9), especially along the dura mater. Convexity MEP is so rare that we review previous reported cases of convexity MEP, and discuss the clinicopathologic features on that.
Insights
This study reports a rare case of convexity meningioma en plaque (MEP) in a 51-year-old male. The transitional meningioma showed high MIB-1 and MMP-9 expression, highlighting its aggressive potential.
Area of Science:
- Neurology
- Neurosurgery
- Pathology
Background:
- Meningioma en plaque (MEP) is a rare subtype of meningioma characterized by a flattened, plaque-like growth pattern along the dura mater.
- Convexity MEP, specifically occurring on the surface of the cerebral hemispheres, is exceptionally uncommon.
Observation:
- A 51-year-old male presented with right parietalgia and left upper limb numbness, leading to the incidental discovery of an intracranial mass.
- CT scans revealed hyperostosis and an enhanced mass in the right fronto-parietal region; MRI showed a carpet-like tumor along the dura mater.
- Cerebral angiography identified feeding arteries including the parietal branches of the right middle meningeal artery and superficial temporal artery.
Findings:
- Subtotal tumor resection was performed, preserving the portion adherent to the brain parenchyma.
- Histopathological diagnosis confirmed transitional meningioma.
- Immunohistochemical analysis revealed a high MIB-1 (Ki-69 antigen) staining index (6.9%) and significant metalloproteinase-9 (MMP-9) expression, particularly along the dura mater.
Implications:
- The high MIB-1 and MMP-9 expression suggests an aggressive biological behavior for this convexity MEP.
- This case underscores the importance of thorough clinicopathologic evaluation for rare meningioma subtypes.
- Further research into the specific characteristics and treatment strategies for convexity MEP is warranted.