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Short communication: sclerosing meningioma in the deep sylvian fissure
Shintaro Fukushima1, Yoshitaka Narita, Motoki Yonezawa
1Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan, shfukush@ncc.go.jp.
Abstract:
Sclerosing meningioma is a rare type of meningeal tumor with extensive collagen depositions. Deep sylvian meningioma, a tumor that is unattached to the dura mater, is also unusual. The biological activity of both is controversial, as are therapeutic strategies. A heterogeneous contrast-enhanced mass in the right sylvian fissure of a 10-year-old boy with a 3-year history of epilepsy was identified via magnetic resonance imaging. The patient underwent partial surgical resection because the tumor was hard and contained numerous perforators arising from the right middle cerebral artery. The tumor was histologically diagnosed as sclerosing meningioma. Twelve months after surgery, the patient was asymptomatic and did not require any additional therapies. This case is the first report of a sclerosing meningioma arising in the deep sylvian fissure. We discuss the therapeutic dilemma of this case with respect to the current literature.
Insights
This is the first reported case of a sclerosing meningioma in the deep sylvian fissure. The pediatric patient with epilepsy experienced a positive outcome after partial surgical resection, highlighting a potential treatment approach.
Area of Science:
- Neuro-oncology
- Neurosurgery
- Pediatric Neurology
Background:
- Sclerosing meningiomas are rare meningeal tumors characterized by significant collagen deposition.
- Deep sylvian meningiomas, unattached to the dura mater, are also uncommon, with controversial biological activity and therapeutic strategies.
Observation:
- A 10-year-old boy with a 3-year history of epilepsy presented with a heterogeneous, contrast-enhancing mass in the right sylvian fissure, identified via MRI.
- The tumor was surgically resected due to its hardness and proximity to perforators of the right middle cerebral artery.
Findings:
- Histological examination confirmed the diagnosis of sclerosing meningioma.
- Twelve months post-surgery, the patient remained asymptomatic and required no further treatment.
Implications:
- This case represents the first documented instance of a sclerosing meningioma occurring in the deep sylvian fissure.
- The successful partial resection and favorable outcome in this pediatric case offer insights into managing this rare tumor, despite therapeutic controversies.
