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Diagnostic and Therapeutic Challenges of Rare Concurrent Intracranial Meningioma and Oligodendroglioma
Ali Shoushtari1, Lorraina Robinson2, Qinwen Mao2
1Monash University School of Medicine, Melbourne, VIC, Australia.
Introduction:
Concurrent primary brain tumors are rare clinical entities, with a prevalence ranging from 0.1 to 0.5% of all diagnosed brain tumors. The co-occurrence of meningioma and oligodendroglioma is particularly uncommon, posing unique diagnostic and therapeutic challenges. We describe the case of a patient diagnosed with concurrent meningioma and oligodendroglioma and review the existing literature on this rare phenomenon.
Case Presentation:
A 55-year-old female patient with a history of seizures presented to the emergency department with worsening headaches, nausea, and vomiting. She had a known right frontoparietal intracranial mass but had previously declined surgery. Magnetic resonance imaging revealed extensive fluid-attenuated inversion recovery /T2 hyperintensity around the lesion, which had slowly increased over 5 years; the growth of the lesion was producing a mass effect with a significant midline shift. The patient underwent urgent hemicraniectomy with subsequent resection. Clinical evaluation, imaging studies, and histopathological examination were conducted to confirm the diagnosis. Genetic and molecular analyses were also performed to explore potential underlying mechanisms. Histopathological findings confirmed a diagnosis of an isocitrate dehydrogenase-mutated World Health Organization Grade II oligodendroglioma with 1p/19q codeletion, along with a Grade I meningioma.
Conclusion:
The coexistence of meningioma and oligodendroglioma represents a rare clinical event. Surgical management remains the cornerstone of treatment. Further investigation into the genetic and environmental factors that contribute to the co-occurrence of such tumors could pave the way for more targeted therapeutic strategies.
Insights
Concurrent primary brain tumors, specifically meningioma and oligodendroglioma, are rare. This case highlights the diagnostic and therapeutic challenges of these co-occurring brain tumors and emphasizes surgical management.
Area of Science:
- Neuro-oncology
- Pathology
- Neurosurgery
Background:
- Concurrent primary brain tumors are rare, affecting 0.1-0.5% of all brain tumors.
- The co-occurrence of meningioma and oligodendroglioma is exceptionally uncommon.
- This presentation poses significant diagnostic and therapeutic challenges.
Observation:
- A 55-year-old female with a history of seizures presented with worsening headaches and neurological symptoms.
- Imaging revealed a growing intracranial mass, leading to urgent surgical resection.
- Histopathology confirmed a coexisting World Health Organization (WHO) Grade II oligodendroglioma (IDH-mutated, 1p/19q codeleted) and WHO Grade I meningioma.
Findings:
- The patient was diagnosed with concurrent primary brain tumors: an oligodendroglioma and a meningioma.
- Genetic and molecular analyses were performed to investigate potential underlying mechanisms for this rare co-occurrence.
Implications:
- Surgical management is the primary treatment for coexisting meningioma and oligodendroglioma.
- Further research into genetic and environmental factors is crucial for developing targeted therapies for rare brain tumor combinations.
