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Intraparenchymal Angiomatous Meningioma: A Diagnostic Dilemma
Divya Bansal1, Preeti Diwaker2, Priyanka Gogoi3
1Senior Resident, Department of Pathology, University College of Medical Sciences, GTB Hospital , Dilshad Garden, Delhi, India .
Abstract:
Meningioma arises from the arachnoid cap cells of the cerebrum. Intraparenchymal meningiomas or meningiomas without dural attachment are rare. We report a case of 40-year-old male who presented with a history of headache, dizziness and gradual loss of vision since one year. Clinicoradiological diagnosis of a high grade glioma was considered. Tumour was excised and haematoxylin and eosin stained sections revealed a tumour comprised predominantly of variable sized blood vessels showing hyalinization in a background of plump spindle cells with oval vesicular nuclei. In view of these features angiomatous meningioma was suspected. However, to confirm the diagnosis, a panel of immunohistochemical markers including vimentin, EMA and GFAP was done and a final diagnosis of angiomatous meningioma was offered. Angiomatous meningioma is a rare variant of meningioma and even much rarer in the intraparenchymal location. Angiomatous meningioma should be considered in the differential diagnosis of highly vascular intraparenchymal brain tumours.
Insights
This case study highlights a rare intraparenchymal angiomatous meningioma, a brain tumor variant. Early consideration of this diagnosis is crucial for highly vascular brain tumors.
Area of Science:
- Neuropathology
- Neurosurgery
- Oncology
Background:
- Meningiomas typically originate from the arachnoid cap cells of the cerebrum.
- Intraparenchymal meningiomas, lacking dural attachment, represent a rare subset of these tumors.
Observation:
- A 40-year-old male presented with headache, dizziness, and vision loss, initially suspected as a high-grade glioma.
- Histopathological examination revealed a tumor with prominent hyalinized blood vessels and spindle cells.
- Immunohistochemical markers confirmed the diagnosis of angiomatous meningioma.
Findings:
- Angiomatous meningioma, a rare meningioma variant, was diagnosed.
- The tumor's intraparenchymal location further increased its rarity.
Implications:
- Angiomatous meningioma should be included in the differential diagnosis for highly vascular intraparenchymal brain tumors.
- Accurate diagnosis through histopathology and immunohistochemistry is essential for appropriate patient management.
