Rhabdoid meningioma occurring in an unrelated resection cavity with leptomeningeal carcinomatosis

Abstract

Rhabdoid meningioma (RM) is a recently described, aggressive variant of meningioma. The authors report a case of RM occurring in the resection cavity of an unrelated neurosurgical procedure, temporal lobectomy for intractable seizures. The patient presented with intractable headache 10 years after the temporal lobectomy. Imaging revealed a dura-based, uniformly enhancing lesion within the resection cavity. She underwent gross-total resection and the findings of the surgical pathological report were consistent with an RM, with a dramatically elevated MIB-1 index of approximately 50%. The patient's clinical course was complicated by severe pain and communicating hydrocephalus secondary to rapid dissemination of malignant cells throughout the CSF pathways. Despite aggressive measures, including tumor resection, ventriculoperitoneal shunt placement, and the initiation of conventional radiation therapy, the ensuing leptomeningeal carcinomatosis proved to be rapidly fatal.

Aggressive rhabdoid meningioma with osseous, papillary and chordoma‐like appearance

“…The ratio of male‐to‐female incidence is 40:35, and the age distribution ranges from 2 to 84 years in previous reports with detailed data. To date 110 cases of RM in 40 articles have been reported . The most common locations were convexity (25 of 74), anterior or middle cranial fossa (10 of 74), posterior cranial fossa (13 of 74) and falx or parasagittal sinus (16 of 74).…”

“…In pure RMs, the differential diagnosis included AT/RT, pleomorphic xanthoastrocytoma (PXA), malignant glioma and metastatic tumors with rhabdoid features. At pathologic diagnosis, the combination of cytological features and immunohistochemical staining results helped in the diagnosis of RM …”

“…In 2000, RM was adopted as an aggressive variant of meningioma, designated as WHO grade III malignancy . The clinical course of RM is determined by local recurrences, invasion of adjacent brain and/or dura, widespread leptomeningeal dissemination, remote metastases and fatal clinical outcome . We report a rare case of RM with metaplastic, papillary and chordoid features.…”

Rhabdoid Meningioma: Clinical Features and MR Imaging Findings in 15 Patients

“…This is similar to other previously reported cases of RM in the literature where the mean age at presentation was 46.1 years (range, 9 -84), also with a female predominance (female-to-male ratio, 24:16). [8][9][10][12][13][14][15] Atypical and malignant meningioma usually present earlier than benign meningioma. 4 However, in our study, the age population of the RM was not significantly different from benign meningiomas.…”

Clinicopathologic analysis of rhabdoid meningioma

“…To the best of our knowledge, 50 cases of RM, including three case series, have been published in the English-language literature. 2,3,[8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] Rhabdoid features usually emerge as a focal change, in either benign or malignant meningiomas of other histological subtypes. 2,3 Pure variants of such tumors are very uncommon, but rhabdoid components tend to be more prominent in recurrent tumors.…”