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Meningioma with perivascular pseudorosettes: a morphological entity distinct from papillary meningioma?
J Pimentel1, L Albuquerque, L Tavora
1Department of Neurology, Hospital de Santa Maria, Lisboa, Portugal.
Abstract:
Although papillary meningioma is a well known variant of meningiomas, many of the previously reported cases do not seem to contain structures that fulfill the classical microscopic descriptions of a papilla. The case of a 79-year-old man with a meningioma of the convexity is described. This meningioma was totally removed but recurred 36 months after surgery. The main cellular components of the tumor, some of them mimicking astrocytic cells, were arranged preferentially around vessels featuring perivascular pseudorosettes. The survey of the literature stresses a possible morphological misinterpretation of some of the mentioned papillary variants. Although both papillary variants and those with perivascular pseudorosettes seem to display a similar, not always malignant, behavior, strictly from the morphological point of view they should be separated.
Insights
Papillary meningiomas may be misidentified; this case highlights tumors with perivascular pseudorosettes that mimic papillary variants. Morphological distinction is crucial despite similar clinical behavior.
Area of Science:
- Neuropathology
- Oncology
Background:
- Papillary meningioma is a recognized variant of meningioma.
- Previous reports often lack classical papillary structures.
Observation:
- A case of a 79-year-old man with a convexity meningioma is presented.
- The tumor recurred 36 months after complete surgical removal.
- Tumor cells mimicked astrocytic cells and formed perivascular pseudorosettes.
Findings:
- Literature review suggests potential morphological misinterpretation of papillary meningiomas.
- Papillary variants and those with perivascular pseudorosettes share similar, generally non-malignant behavior.
- Strict morphological differentiation between these variants is recommended.
Implications:
- Accurate histopathological classification of meningiomas is essential for understanding tumor behavior.
- Distinguishing between papillary meningioma and tumors with perivascular pseudorosettes may refine prognostication.
- Further research is needed to clarify the distinct biological and clinical characteristics of these variants.