Primary intra-fourth ventricular meningioma: Report two cases

Area of Science:

• Neuro-oncology
• Neurosurgery
• Pathology

Background:

• Intraventricular meningiomas are uncommon, with those in the fourth ventricle being exceptionally rare.
• Rarity leads to infrequent consideration in differential diagnoses across all age groups.
• Clinical presentation and imaging findings are often non-specific, mimicking other fourth ventricular tumors.

Observation:

• Presents two cases of primary fourth ventricular meningioma, World Health Organization (WHO) Grade II.
• Both tumors were successfully and totally surgically excised.
• Tumor consistency (firm to soft) facilitated excision without requiring cerebellar vermian splitting.

Findings:

• Successful total resection of Grade II fourth ventricular meningiomas was achieved in both cases.
• The absence of the need for vermian splitting suggests favorable tumor characteristics for surgical removal.
• Preoperative radiological assessment is crucial for accurate diagnosis.

Implications:

• Highlights the importance of including fourth ventricular meningiomas in the differential diagnosis despite their rarity.
• Emphasizes the role of detailed clinical and radiological evaluation in differentiating these tumors from more common lesions.
• Successful surgical outcomes underscore the feasibility of complete tumor removal for these rare neoplasms.