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Isolated parenchymal cysts associated with a secretory meningioma: illustrative case
Brett T Simmons1, Chun-Chieh Lin2, Nathan E Simmons1
1Division of Neurosurgery, Dartmouth Hitchcock Medical Center, Lebanon.
Background:
Meningiomas represent one of the most common intracranial tumors found in adults. Uncommonly, these tumors can be associated with an adjacent cyst, which is in direct contact with the tumor. Tumor location and source have previously been categorized into five subtypes.
Observations:
This report details the novel findings of a secretory meningioma with associated cysts separated from the tumor by brain parenchyma. Histopathological analysis of the cyst wall showed no evidence of neoplasia, suggesting the etiology to be from the parenchymal edema.
Lessons:
The authors suggest that the presence of isolated cysts in conjunction with a meningioma (in this case a secretory meningioma) represents a new type VI cyst. These cysts are nonneoplastic and do not require direct operative access for control but can be managed, if needed, with simple aspiration. https://thejns.org/doi/10.3171/CASE25964.
Insights
A new classification for meningioma-associated cysts is proposed. These non-neoplastic cysts, distinct from the tumor, may represent a new type VI cyst and can be managed with aspiration.
Area of Science:
- Neurology
- Neurosurgery
- Pathology
Background:
- Meningiomas are common adult intracranial tumors.
- Occasionally, meningiomas present with adjacent cysts in direct contact.
- Previous classifications identify five subtypes of tumor-associated cysts.
Purpose of the Study:
- To report novel findings of a secretory meningioma with associated cysts separated by brain parenchyma.
- To propose a new classification for meningioma-associated cysts.
Main Methods:
- Detailed case report of a secretory meningioma.
- Histopathological analysis of the cyst wall.
- Radiological assessment of tumor and cyst relationship.
Main Results:
- A secretory meningioma was identified with associated cysts separated from the tumor by brain parenchyma.
- Histopathology revealed no neoplastic cells in the cyst wall, suggesting parenchymal edema as the etiology.
- This presentation suggests a new classification category for meningioma-associated cysts.
Conclusions:
- The findings suggest a new type VI cyst associated with meningiomas.
- These type VI cysts are nonneoplastic.
- Management may involve simple aspiration if necessary, without requiring direct operative access to the tumor.
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