Abstract
Meningiomas are common, typically benign intracranial neoplasms with well-demarcated borders. Meningiomas with indistinct boundaries have been reported. These can invade surrounding structures, and present surgical and diagnostic challenges. We present the case of an unusual meningioma in a 53-year-old male in which preoperative magnetic resonance imaging (MRI) revealed an irregular lesion with clear boundaries and peripheral rim enhancement. Intraoperatively, however, no cleavage plane was apparent. Histological examination showed an increase of fibroconnective tissue with proliferation of dilated vessels in the periphery of the tumor concordant with the rim. Immunohistochemical staining of the tumor was positive for EMA and CD34, but negative for CEA, Ki67, and GFAP. Immunohistochemical staining of proliferating vessels in the periphery of the tumor was positive for CD34. A so-called ‘capsule’ structure was suggested according to MRI findings and pathological examination. The tumor was diagnosed as a mixed type meningioma, WHO grade I.
Similar content being viewed by others
References
Campbell BA, Jhamb A, Maguire JA, Toyota B, Ma R (2009) Meningiomas in 2009: controversies and future challenges. Am J Clin Oncol 32:73–85
Louis DN, Ohgaki H, Wiestler OD, Cavenee WK (eds) (2007) WHO classification of tumours of the central nervous system, 4th edn. IARC Press, Lyon
Marosi C, Hassler M, Roessler K, Reni M, Sant M, Mazza E, Vecht C (2008) Meningioma. Crit Rev Oncol Hematol 67:153–171
Nakasu S, Fukami T, Jito J, Matsuda M (2005) Microscopic anatomy of the brain–meningioma interface. Brain Tumor Pathol 22:53–57
Nakasu S, Nakasu Y, Matsumura K, Matsuda M, Handa J (1990) Interface between the meningioma and the brain on magnetic resonance imaging. Surg Neurol 33:105–116
Perry A (2004) Unmasking the secrets of meningioma: a slow but rewarding journey. Surg Neurol 61:171–173
Perry A, Kurtkaya-Yapicier O, Scheithauer BW, Robinson S, Prayson RA, Kleinschmidt-DeMasters BK, Stemmer-Rachamimov AO, Gutmann DH (2005) Insights into meningioangiomatosis with and without meningioma: a clinicopathologic and genetic series of 24 cases with review of the literature. Brain Pathol 15:55–65
Rajaram V, Brat DJ, Perry A (2004) Anaplastic meningioma versus meningeal hemangiopericytoma: immunohistochemical and genetic markers. Hum Pathol 35:1413–1418
Riemenschneider MJ, Perry A, Reifenberger G (2006) Histological classification and molecular genetics of meningiomas. Lancet Neurol 5:1045–1054
Takeguchi T, Miki H, Shimizu T, Kikuchi K, Mochizuki T, Ohue S, Ohnishi T (2003) Evaluation of the tumor–brain interface of intracranial meningiomas on MR imaging including FLAIR images. Magn Reson Med Sci 2:165–169
Conflict of interest
The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Yuan, Yq., Hou, M., Wu, H. et al. A meningioma with peripheral rim enhancement on MRI. Brain Tumor Pathol 29, 235–239 (2012). https://doi.org/10.1007/s10014-012-0082-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10014-012-0082-4