Meningeal sarcoma with rhabdomyoblastic differentiation: case report

A case of primary neoplasm of the meninges with unusual histological and clinical features, which occurred in a 61-year-old man is described. Although conventional light microscopy revealed an undifferentiated tumor consisting of small- to medium-sized elements, it did not allow any definitive histogenetic interpretation. Immunohistochemistry showed that the neoplastic cells were positive for actin, desmin, myoglobin, and vimentin, thus leading to the diagnosis of meningeal sarcoma with rhabdomyoblastic differentiation. This interpretation was also supported by electron microscopy, in dewaxed tissue samples, which revealed the presence of abortive Z-lines. It is noteworthy that retrospective microscopic examination of all the slides obtained both at initial presentation and at relapses demonstrated in some fields that the undifferentiated population was associated with typical meningiomatous features, as was also shown by the staining for the epithelial membrane antigen. Clinically, the tumor was characterized by an exceedingly long course (10 years). The histogenesis of the tumor and the diagnostic relevance of immunohistochemical techniques are discussed.