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Suprasellar Clear Cell Meningioma in an Infant
Charles C Anunobi1, Olufemi Bankole2, Nzechukwu Z Ikeri3
1Department of Anatomic & Molecular Pathology, College of Medicine, University of Lagos, Lagos, Nigeria;
Insights
This report details a rare infant clear cell meningioma case in Nigeria. The supratentorial tumor presented with neurological symptoms, leading to surgical intervention and histological confirmation.
Area of Science:
- Neuropathology
- Pediatric Oncology
- Neurosurgery
Background:
- Clear cell meningiomas are rare, particularly in infants.
- Meningiomas are tumors arising from the meninges, the membranes surrounding the brain and spinal cord.
- Infantile meningiomas are exceptionally uncommon, with clear cell subtypes being even rarer.
Purpose of the Study:
- To report an unusual case of clear cell meningioma in an 8-month-old infant.
- To highlight the challenges in diagnosing and managing pediatric meningiomas.
- To discuss the rarity and supratentorial location of this specific tumor type in infancy.
Main Methods:
- Case report of an 8-month-old male infant presenting with non-specific symptoms.
- Diagnostic imaging including computed tomography (CT) of the brain.
- Surgical tumor excision (bifrontal craniotomy with subtotal excision).
- Histopathological examination with immunohistochemical staining (epithelial membrane antigen, S100 protein, vimentin).
Main Results:
- A large (6x5x4 cm) suprasellar clear cell meningioma was identified.
- The tumor caused significant mass effect, occluding the third ventricle.
- Histology confirmed clear cell meningioma with positive immunoreactivity for EMA, S100, and vimentin.
- The infant experienced a fatal cardiac arrest postoperatively.
Conclusions:
- Clear cell meningioma is an exceedingly rare diagnosis in infancy.
- The supratentorial location and early presentation in this case are highly unusual.
- This case underscores the importance of considering rare tumors in pediatric differential diagnoses, despite poor outcomes.
Abstract:
Clear cell meningiomas are an uncommon subtype of meningioma rarely seen in infancy. We report a case of clear cell meningioma in an 8-month-old male infant. He presented at the Lagos University Teaching Hospital, Lagos, Nigeria, in 2015 with persistent vomiting, poor feeding and failure to thrive over a four month period. Generalised hypertonia and hyperreflexia were noted on examination. Computed tomography of the brain revealed a huge largely isodense suprasellar mass with a hypodense core. The tumour, which measured 6 × 5 × 4 cm, enhanced non-uniformly with contrast injection and extended to occlude the third ventricle. The patient underwent a bifrontal craniotomy with subtotal tumour excision. Six hours postoperatively, he went into cardiac arrest and could not be resuscitated. A histological diagnosis of clear cell meningioma was made as the tumour cells were immunoreactive to epithelial membrane antigen, S100 protein and vimentin. This case of clear cell meningioma was unusual due to its early occurrence and supratentorial location.
