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Intracerebral rhabdoid and papillary meningioma with
leptomeningeal spread and rapid clinical progression
Al-Habib A, Lach B, Al Khani A
Department of Pathology and Laboratory Medicine, King Faisal Specialist
Hospital and Research Centre, Riyadh, KSA.
Objective and Importance. Rhabdoid meningioma (RM) is a relatively new,
Grade III tumor entity according to the latest WHO classification.
We report
rhabdoid and partly papillary, highly anaplastic, intracerebral meningioma
with diffuse leptomeningeal spread and distant SCF metastasis to the
cervical cord.
Clinical Presentation. This 27-year-old female was admitted
to the hospital with radiological findings suggestive of a primary brain
tumor or a metastasis.
After subtotal resection and during radiotherapy,
follow-up MRI revealed recurrence, metastasis to meninges at the high
cervical level, and diffuse basal leptomeningeal enhancement indicating
infiltrating tumor.
She died approximately 3 months after onset of symptoms.
Results. Histological examination revealed rhabdoid and papillary meningioma
with high proliferation rate (80% of MIB1-positive cells), necrosis and
extensive brain invasion.
It was positive for vimentin and S-100 protein,
showed focal epithelial membrane antigen expression and accumulation of
intermediate filaments on ultrastructural examination.
The recurrent tumor
diffusely infiltrated leptomeninges and subarachnoid space.
Conclusion. This
is a rare example of mixed, rhabdoid and papillary variant of meningioma,
located entirely within the brain parenchyma and accompanied by a fulminant
clinical course.
The combination of the histological anaplasia with the
highest reported proliferation rate, and loss of the cohesion of neoplastic
cells led to diffused infiltration of the leptomeninges and metastasis to
the spinal cord.
PMID: 15696777 [PubMed - in process]
Source: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15696777
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