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Intracranial Myopericytoma: A Rare Benign Tumor at an Extremely Rare Location
Ashish Kumar Shrivastav1, Manish Garg1, Hema Malini Aiyer2
1Department of Neurosurgery and Neurointervention, Dharamshila Narayana Superspeciality Hospital and Research Centre, New Delhi, India.
Abstract:
A 50-year-old female with a history of seizures, headache, nausea, and vomiting. On imaging, parafalcine meningioma with mass effect features was rendered. She underwent right frontal tumor excision and craniotomy. Pathological examination showed a tumor composed of syncytial aggregates of round to plump fusiform cells forming whorls around prominent branching congested vessels. The tumorous cells expressed alpha-smooth muscle actin and heavy chain caldesmon and were negative for epithelial membrane antigen, protein S100, HMB45, CD34, calponin and desmin, thus providing the final diagnosis of intracranial myopericytoma. The rarity of this benign tumor at an extremely location, prompted this study. As preoperative radiological investigations are nonspecific in such cases, hence a detailed and comprehensive pathological examination is mandatory to come to a definitive diagnosis.
Insights
This study reports a rare case of intracranial myopericytoma, a benign brain tumor. Definitive diagnosis requires detailed pathological examination due to non-specific imaging findings.
Area of Science:
- Neuropathology
- Neurosurgery
- Oncology
Background:
- Intracranial myopericytomas are rare, benign neoplasms originating from pericytes.
- Parafalcine meningiomas can present with non-specific symptoms like seizures and headaches.
Observation:
- A 50-year-old female presented with seizures, headache, nausea, and vomiting.
- Imaging revealed a parafalcine mass with mass effect, initially suspected as meningioma.
Findings:
- Surgical excision and histopathological analysis identified the tumor as an intracranial myopericytoma.
- Immunohistochemistry showed tumor cells positive for alpha-smooth muscle actin and heavy chain caldesmon, and negative for EMA, S100, HMB45, CD34, calponin, and desmin.
Implications:
- This case highlights the diagnostic challenge of rare intracranial tumors.
- Comprehensive pathological examination is crucial for accurate diagnosis when radiological findings are ambiguous.
- Understanding the immunophenotype aids in differentiating myopericytomas from other neoplasms.
