A SILENT CASE OF LARGE CYSTIC MENINGIOMA

Meningiomas are the most common extra-axial neoplasms. Meningiomas, in general may be benign or malignant. Cystic meningiomas are one of the subtypes of meningioma, mimicking an intra-axial lesion radiologically and clinically. The common clinical manifestations may include but not limit to headache, vomiting, seizures & focal neurological decits. The cystic component is an uncommon nding that makes it difcult to distinguish between a meningioma and a glial neoplasm radiologically. Here, we discuss a 54-year-old female patient who presented with subacute onset of transient memory disturbances and a sudden neurological deterioration who was found to have a cystic meningioma.

Cystic Meningiomas: A Radiological and Histological Study and Pre Operative Diagnostic Errors

INTRODUCTION: Meningiomas are solid neoplasms, cysts are extremely rare, diagnostically elusive, and behave differently. Therefore, a study was initiated comparing our cases with various series. This is the second largest series so far reported. We tried to hypothesize how to eliminate diagnostic errors in this study, while few interesting points were discovered. MATERIAL AND METHODS: All meningiomas operated in the last seventeen years were reviewed. It was a retrospective study. Diagnostic errors, clinical behaviour and histopathology were reviewed. Planning of surgery and prognostication demands that the diagnosis be established pre-operatively and since these tumours may mimic other brain tumour types on radiology , factors that may lead to better diagnostic accuracy were tried to be established. Categorization of the tumours with different cyst types according to various classifications was done. The follow up period was two months to ten years. RESULTS: Out of 530 meningiomas, we found 20 with cystic changes.. There mean age was 47.5 years. The commonest symptoms were raised intra cranial pressure, hemiparesis, memory loss, behavioral changes, vision loss, papilloedem and cranial nerve palsies. The most common histological variety was meningothelial meningioma. The incidence of high grade or malignant tumors was 30 %. Based on radiology, the highest diagnostic accuracy was achieved in 62.5% cases only. CONCLUSION: Cystic meningiomas continue to pose diagnostic challenges. Multi-planar contrast magnetic resonance imaging (MRI) will help in establishing accurate diagnosis, it reveals cysts missed on computed tomography (CT) scans. This would lead to accurate prognostication and better surgical planning with the aim of preventing recurrences.

Cystic Meningiomas: Report of Four Cases

Although intra cranial meningiomas are usually solid tumors, some are associated with confusing cysts. So, computed tomography scan and conventional magnetic resonance imaging may not easily differentiate these lesions from other tumors frequently associated with cystic or necrotic component as gliomas or metastasis. We report four cases of cystic meningioma in which the diagnosis was not suspected preoperatively because of short clinical history and rapid neurological deterioration. However, a cystic component on imaging studies confused the diagnosis of meningioma with other cyst lesions. Although some authors report that hemorrhage is rare in meningioma, one of our cases was associated with hemorrhage and was histologically grade I meningioma. Total removal of cystic meningioma was our goal and histopathological examination was important to establish the diagnosis after surgery

Differential Diagnosis and Surgical Management of Cerebellopontine Angle Cystic Lesions

Cerebellopontine angle (CPA) tumors in adults are mainly benign and extra-axial. Although the most common CPA lesion (vestibular schwannoma) is familiar to most neurosurgeons, cystic lesions of the CPA do pose an important diagnostic challenge demanding a careful consideration of a wide range of differential diagnosis including: epidermoid cysts, arachnoid cysts, cystic schwannomas, cystic meningiomas as well as other rare entities such as vascular and malignant tumoral lesions. The authors present a critical review of the current literature on cystic CPA lesions, providing an overview about possible differentials as well as guidelines for preoperative imaging evaluation of a cystic CPA lesion.

Cystic meningioma: unusual entity with review of literature

Cystic meningioma is a relatively rare condition, radiological appearance of the cystic-solid components of the mass may create a diagnostic dilemma. The presence of a cyst is not a common imaging feature and this makes it difficult to differentiate it from hemangioblastoma, craniopharyngioma, metastasis and gliomas. Cystic meningiomas are present more commonly in children. We present a 60 year old male who presented with seizures and frontal lobe signs. The lesion was suspected as glioma however, postoperative histopathological examination demonstrated as meningioma. Patient showed remarkable recovery after surgery. Complete cyst resection should be considered if it is technically feasible and safe.