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Primary Intraparenchymal Meningiomas: A Case Report and a Systematic Review
Vladimir Papic1, Nebojsa Lasica1, Bojan Jelaca1
1Clinic of Neurosurgery, Clinical Center of Vojvodina, Novi Sad, Serbia; Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
Background:
Primary intraparenchymal meningiomas are exceedingly rare and often challenging to diagnose, given their misleading radiologic features. It is hypothesized that they arise from the cap cells of the pia mater that enter the brain via penetrating blood vessels during brain development. We systematically reviewed and analyzed previously reported features of primary intraparenchymal meningiomas in terms of radiography, presenting symptoms, and histopathology.
Methods:
A literature search of the Web of Science and PubMed databases and crossed references was performed in March 2021, per PRISMA guidelines, with no restrictions regarding publication date. Data regarding demographic features, clinical, radiographic, and histopathologic characteristics were extracted.
Results:
A total of 52 patients (including the reported case) were included in this review. The mean age was 21.1 years (range, 0.3-66 years) with a male/female ratio of 1.9:1. The most common localizations of intraparenchymal meningiomas were in the frontal (30.8%) and temporal (21.2%) lobes. Cyst formation was more readily observed and was noted in 51.4% of patients. Histopathology showed a higher incidence of World Health Organization grade II (14/52, 26.9%) and World Health Organization grade III (7/52, 13.5%) of primary intraparenchymal meningiomas.
Conclusions:
We present a comprehensive analysis of every reported primary intraparenchymal meningioma. Because of their rarity and capacity to mimic other more common intra-axial tumors, they represent a diagnostic challenge. This systematic review highlights the importance of paying attention to atypical intra-axial lesions, with a particular reflection on the discrepancy between clinical characteristics and imaging features.
Insights
Primary intraparenchymal meningiomas are rare brain tumors that can mimic other intra-axial lesions. This review analyzes their features to aid in diagnosis.
Area of Science:
- Neuro-oncology
- Neurosurgery
- Radiology
Background:
- Primary intraparenchymal meningiomas are rare tumors arising within the brain parenchyma.
- Their origin is hypothesized to be from pia mater cap cells entering the brain via blood vessels.
- These tumors present diagnostic challenges due to misleading radiologic features.
Observation:
- A systematic review included 52 patients with primary intraparenchymal meningiomas.
- The mean age was 21.1 years, with a male predominance (1.9:1 ratio).
- Frontal and temporal lobes were the most common locations, and cyst formation was observed in 51.4% of cases.
Findings:
- Histopathology revealed a significant incidence of World Health Organization (WHO) grade II (26.9%) and WHO grade III (13.5%) tumors.
- The study analyzed radiography, presenting symptoms, and histopathology of these rare tumors.
- Atypical intra-axial lesions require careful consideration due to potential misdiagnosis.
Implications:
- Accurate diagnosis of intraparenchymal meningiomas is crucial due to their rarity and potential for mimicking common brain tumors.
- Understanding the clinical, radiographic, and histopathologic features aids in differentiating these tumors.
- This review emphasizes the importance of recognizing discrepancies between clinical presentation and imaging findings.
