Clear cell meningioma: Experience at a medical center

Clear cell meningiomas (CCMs) are a rare variant, represent approximately 1% of all craniospinal meningiomas reported worldwide, and typically appear in young and adult individuals, more frequently in women. Although they are classified by the World Health Organization as grade 2, they are meningiomas that often behave aggressively and have a high recurrence rate.

337 records of patients with a histopathological diagnosis of intracranial meningiomas were retrospectively analyzed between January 2017 and December 2022. Three CCM cases are presented as examples. From the 337 records analyzed, 10 were CCM-related (2.96%). This paper describes three cases of meningiomas operated on at La Raza National Medical Center Specialty Hospital (HECMNR) (HECMNR, in Spanish), which belongs to the Mexican Institute of Social Security. The first case was operated with a Simpson grade I resection of the lesion and then developed other two recurrence events, which required another two interventions with Simpson II and III resections, respectively, despite oncological therapy. The second instance utilized a Simpson III resection and was promptly subjected to radiotherapy and currently developed tumoral recurrence that will soon require resection. The third case used a Simpson V resection, since the severe cerebral edema prevented a higher degree of resection.

CCMs have a high risk of recurrence, making reintervention necessary, and therefore, cranial deformity and severe functional and neurological complications may follow, which explains the difficulty in managing this pathology.