Meningioma with Intra- and Peritumoral Abscess

Abstract

The association of meningioma with intra- and peritumoral brain abscess is rare. All cases reported in literature had some focus of infection in the body. We report a 56-year-old man with well-controlled diabetes mellitus found to have a space-occupying lesion upon evaluation for headache, vomiting, and clumsiness of right upper limb. Perioperatively, pus was found intra- and perilesionally around a thick, capsulated, dural-based, vascular lesion. Histopathology was suggestive of meningioma, and Escherichia coli was isolated upon culture.

Intratumoral abscess complicating a postradiation-induced World Health Organization grade II meningioma: illustrative case

“…Observations According to the literature, there are 18 reported cases of abscesses associated with cerebral meningioma (either peri-or intratumoral) and 15 cases of intrameningioma abcess [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] (Table 1). Typically, these abscessed tumors are close to avenues of entry into the cranial vault-that is, near the skull base, sellar region, or sinuses.…”

“…Brain meningiomas and abscesses are common independently, but intrameningioma abscesses are rare, with only 15 cases previously described in the literature. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] In all but one of these cases, either a known source of infection or a likely cause of infection was identified. 20 One prior case describes a "sterile" abscess within a meningioma, or an abscess without microbial growth from its samples.…”

Meningioma-associated abscess: an unusual case report and review of the literature

“…One of these cases described a ‘sterile’ abscess formation thought related to androgen treatment in the context of prostate carcinoma [ 17 ]. The immunocompromised nature of the patient, recent steroid treatment and presumed urinary/dental infections were cited as potential sources/contributing factors to the remaining cases without a clear cause [ 7 , 11 , 13–16 ].…”

“…The organisms cultured were also consistent with a majority abdominopelvic origin. Of the fifteen cases with a confirmed organism, ten were consistent with abdominopelvic microbiota with E. coli being the most common organism seen in five cases [ 3 , 9 , 13 , 18 ]. The clinical/biochemical inflammatory response seen to infection demonstrated a variable level of severity, from asymptomatic to occult sepsis and also a varied temporal relationship between infection and tumour identification.…”