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Visual Aura Secondary to Supratentorial Lipomatous Meningioma: A Rare Case Report
Pierfrancesco Lapolla1,2, Placido Bruzzaniti3, Giuseppa Zancana3
1Nuffield Department of Surgical Sciences, University of Oxford, Oxford OX3 9DU, UK.
Background/Aim:
Lipomatous meningioma is a rare type of meningioma that is formed as the result of an accumulation of lipids inside the cell due to metabolic activity dysregulation. It differs from other types of meningiomas in its radiological and immunohistochemical characteristics. We report a rare case of a patient treated in our department for this particular type of meningioma who developed a type of migraine with the aura component as the first clinical symptom.
Case Report:
A 55-year-old woman presented with a migraine and reported having phosphenes in recent years. Head Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) scans were performed; these showed an extensive hypodense and hypointense formation located in the left parieto-occipital region. This formation was implanted in the tentorium region, with a prevailingly adipose-type signal intensity. The patient underwent an occipital craniotomy with the total removal of the lesion. The histological examination indicated a lipomatous metaplastic meningioma.
Conclusion:
We reported the first case of a lipomatous meningioma presenting with a migraine with a visual aura. Seizures and headaches can be included as possible symptoms. According to the current literature, lipomatous meningiomas affect women more commonly than men. The patient of our reported case presented visual disturbances in the form of a visual aura, which occurred 10 years before finding the meningioma, and surgery dramatically improved the symptoms and quality of life.
Insights
This study reports the first case of a lipomatous meningioma presenting with migraine with visual aura. Surgical removal of this rare brain tumor significantly improved the patient's symptoms and quality of life.
Area of Science:
- Neuro-oncology
- Neurosurgery
- Neurology
Background:
- Lipomatous meningioma is a rare tumor characterized by lipid accumulation due to metabolic dysregulation.
- It exhibits distinct radiological and immunohistochemical features compared to other meningiomas.
Observation:
- A 55-year-old woman presented with migraine and visual disturbances (phosphenes).
- Imaging revealed a hypodense/hypointense lesion in the left parieto-occipital region, consistent with a lipomatous meningioma.
- The patient underwent successful surgical resection via occipital craniotomy.
Findings:
- Histological examination confirmed lipomatous metaplastic meningioma.
- This is the first reported case of lipomatous meningioma presenting with migraine and visual aura.
- The patient experienced significant symptom improvement and enhanced quality of life post-surgery.
Implications:
- Migraine with visual aura can be an early clinical symptom of lipomatous meningioma.
- Lipomatous meningiomas predominantly affect women.
- Early diagnosis and surgical intervention can lead to favorable outcomes.
