Two cases of nondura‐based clear cell meningioma of the cauda equina

Payano, Maria; Kondo, Yoshiyuki; Kashima, Kenji; Daa, Tsutomu; Yatsuka, Tomoji; Kida, Hirotaka; Nakayama, Iwao; Yokoyama, Shigeo

doi:10.1111/j.1600-0463.2004.apm1120209.x

Cited by 24 publications

(26 citation statements)

References 27 publications

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“…We report a rare case of cauda equina clear cell meningioma without dural attachment, which was successfully treated by gross total resection. nosis is improtant 20) . It is noteworthy that some clear cell meningiomas are not attached to the dura but to the neural sheath, as in the present case.…”

Section: Resultsmentioning

confidence: 99%

“…Its abundant glycogen is what gives the name, "clear cell, " to this particular type of meningioma 20) . Whorl formation is histologic feature in the differentiation of clear cell meningioma from a metastatic deposit of so-called clear cell carcinoma, including renal cell carcinoma, which is negative or very weakly positive for vimentin.…”

Section: Discussionmentioning

confidence: 99%

“…The recurrence rate of clear cell meningioma is reported to be 42-61% in operative cases 3,9,20,25) . Intraspinal clear cell meningioma is associated with a lower rate of recurrence than the intracranial variant 8) .…”

Section: Fig 4 Tumor Cells Staining Positive For Vimentin (×400)mentioning

confidence: 99%

“…Most meningiomas are attached to the dura mater and very seldomly they grow without dural attachment. To the best of our knowledge, only several cases of intraspinal nondura based clear cell meningioma have been reported 2,5,17,19,20) . In this article, we present an unusual case of intraspinal clear cell meningioma characterized by the absence of dural attachment.…”

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Non-Dura Based Intaspinal Clear Cell Meningioma

Choi

Cho

et al. 2011

J Korean Neurosurg Soc

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findings. The motor power of her lower limbs was normal, and rectal examination revealed normal anal tone.Magnetic resonance (MR) imaging showed a well-demarcated 1.5×1.9×2.9 cm sized mass lesion at L2-3. The mass was hypo-intense on T1-and T2-weighted images with homogeneous gadolinium enhancement. There was also a cystic lesion within the spinal cord on the cranial side of the mass at T12-L2. The cyst was isointense to the cerebrospinal fluid and was diagnosed to be tumor associated syrinx (Fig. 1). Myelography of the lumbar spine revealed obstruction of contrast flow due to the intradural mass. Operation was conducted with the presumptive diagnosis of intradural extramedullary meningioma. An L1-3 laminectomy and intradural exposure revealed a yellowish pink, well-encapsulated, elliptical mass of firm consistency. The tumor was found to be draped by and adhered to the nerve roots at its upper pole near the conus medullaris and cauda equina at its lower pole without dural attachment. However, the tumor was successfully dissected from the nerve roots and removed completely. The patient recovered uneventfully after the operation. The postoperative MR imaging showed no residual tumor with marked reduction of the syrinx. All of the patient's preoperative symptoms improved after surgery.The histology of the tumor showed patternless sheets of polygonal cells with clear glycogen-rich cytoplasm and small clusters of cells in a meningothelial pattern with whorl formation (Fig. 2). A Periodic acid-Schiff (PAS) stain showed a positive reaction in the cytoplasm of tumor cells containing glycogen (Fig. 3). Tumor cells were stained positive for vimentin (Fig. 4) and epithelial membrane antigen (EMA). These findings were compatible with the diagnosis of clear cell meningioma. Postoperatively, the patient's symptoms were dramatically alleviated. Ad- INTRODUCTIONClear cell meningioma is a very rare histological type of meningioma that is included in the World Health Organization (WHO) classification as a peculiar variant affecting younger patients 10,14,24,25) . Clear cell meningiomas have been reported in only 0.2% of meningioma cases and have a more aggressive and complicated course due to their histological nature and anatomical locations 25) . Most meningiomas are attached to the dura mater and very seldomly they grow without dural attachment. To the best of our knowledge, only several cases of intraspinal nondura based clear cell meningioma have been reported 2,5,17,19,20) . In this article, we present an unusual case of intraspinal clear cell meningioma characterized by the absence of dural attachment. CASE REPORTA 34-year-old female patient was admitted with complaints of pain in her lower limbs and both hips for 6 months and voiding difficulty for 1 year. She had also experienced numbness in her lower limbs. Her symptoms worsened over time. One year prior to admission, she visited a local obstetrics and gynecology clinics complaining voiding difficulty and was treated conservatively under the diagnosis of cystitis with...

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Fig 4 Tumor Cells Staining Positive For Vimentin (×400)mentioning

confidence: 99%

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Non-Dura Based Intaspinal Clear Cell Meningioma

Choi

Cho

et al. 2011

J Korean Neurosurg Soc

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“…Primary orbital meningiomas arise from the optic nerve sheath and may infiltrate the sphenoid wing producing hyperostosis [1,21]. Clear cell meningioma (CCM) is a peculiar variant of meningioma affecting young patients which typically arises in spinal or cerebellopontine locations and shows high incidence of recurrence [14,[16][17][18]27]. CCM is one of the rarest histologic forms of meningiomas, representing 0.2% of these tumors.…”

Section: Introductionmentioning

confidence: 99%

Primary clear cell meningioma of the orbit mimicking a metastatic carcinoma: usefulness of immunohistochemistry and cytogenetic analysis

et al. 2008

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Clear cell meningiomas (CCM) are rare tumors of the nervous system that usually occur in young patients and display high recurrence rates and potentially aggressive behavior. In this report, we describe a primary CCM of the orbit in an 84-year-old man with a previous history of a clear cell carcinoma of the kidney. Histologically, the tumor demonstrated a sheet-like proliferation of clear polygonal cells. Differential diagnosis includes metastasis of clear cell carcinomas. Immunohistochemistry, by showing that tumor cells expressed vimentin, epithelial membrane antigen, and progesterone antigens, and cytogenetic analysis, by identifying a monosomy 22, confirmed the diagnosis of CCM.

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