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A meningioma with peripheral rim enhancement on MRI

Yu-qing Yuan1, Min Hou, Hong Wu

  • 1Department of Neurosurgery, The Third Hospital of Chengdu,82 Qinglong Street, Chengdu 610031, Sichuan, China. holder6619@sina.com

Brain Tumor Pathology
|February 4, 2012
PubMed

Insights

This case report details an unusual meningioma with a distinct MRI appearance but indistinct surgical margins. Histopathology revealed specific vascular proliferation, challenging typical meningioma classifications.

Area of Science:

  • Neurosurgery
  • Neuropathology
  • Radiology

Background:

  • Meningiomas are common intracranial tumors, typically benign and well-demarcated.
  • A subset of meningiomas present with indistinct boundaries, posing diagnostic and surgical challenges.
  • Preoperative imaging and intraoperative findings are crucial for surgical planning.

Observation:

  • A 53-year-old male presented with an unusual meningioma.
  • Preoperative MRI showed an irregular lesion with clear boundaries and peripheral rim enhancement.
  • Intraoperative findings revealed no apparent cleavage plane, contradicting the MRI appearance.

Findings:

  • Histological examination showed increased fibroconnective tissue and dilated peripheral vessels.
  • Immunohistochemistry was positive for EMA and CD34, negative for CEA, Ki67, and GFAP.
  • Proliferating peripheral vessels stained positive for CD34, suggesting a 'capsule' structure.

Implications:

  • This case highlights the variability in meningioma presentation and surgical planes.
  • Understanding such unusual presentations is vital for accurate preoperative assessment.
  • Further research into the 'capsule' structure in meningiomas may improve surgical outcomes.

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