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Published on: May 23, 2025
Lipomatous meningioma
Shigeo Ohba1, Kazunari Yoshida, Takekazu Akiyama
1Department of Neurosurgery, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo 160-8582, Japan. di045009@sc.itc.keio.ac.jp
Abstract:
We present a case of intracranial lipomatous meningioma in the parietal convexity in a 64-year-old woman. The mass showed low density on computed tomography, was hyper-intense on T1-weighted magnetic resonance images, and had decreased intensity upon imaging with fat-suppressed sequences. Gross total removal of the tumor was performed. Histopathologically, the tumor was a meningioma with mixed transitional and lipomatous patterns. Immunohistochemically, the meningothelial foci were positive for epithelial membrane antigen (EMA) and vimentin, and negative for S-100 protein. The lipomatous foci were positive for EMA, vimentin, and S-100 protein. The Ki-67 index values of the meningothelial and lipomatous foci were 1.0% and 1.8%, respectively. We review previous reports of lipomatous meningioma and discuss its clinical presentations and pathology.
Insights
This study reports a rare intracranial lipomatous meningioma case. Surgical removal was successful, with detailed histopathological and immunohistochemical analysis of this unique brain tumor.
Area of Science:
- Neuro-oncology
- Neurosurgery
- Pathology
Background:
- Meningiomas are common primary intracranial tumors.
- Lipomatous meningiomas are a rare subtype, characterized by adipose tissue infiltration.
- Understanding their distinct features is crucial for diagnosis and management.
Observation:
- A 64-year-old woman presented with an intracranial lipomatous meningioma in the parietal convexity.
- Imaging revealed characteristic features: low density on CT, T1 hyperintensity, and fat-suppressed signal loss on MRI.
- Gross total tumor removal was achieved.
Findings:
- Histopathology confirmed a mixed meningioma with transitional and lipomatous components.
- Immunohistochemistry showed differential expression of EMA, vimentin, and S-100 protein between meningothelial and lipomatous areas.
- Low Ki-67 indices (1.0% and 1.8%) indicated low proliferative activity in both components.
Implications:
- This case highlights the importance of recognizing the imaging and pathological characteristics of lipomatous meningiomas.
- Accurate diagnosis impacts surgical planning and prognosis.
- Further research into this rare meningioma subtype may refine treatment strategies.
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