BACKGROUND Meningioma in the cerebellopontine angle(CPA)without dural attachment is extremely rare.We report a unique case of meningioma derived from the superior petrosal vein without dural attachment.CASE SUMMARY A ...BACKGROUND Meningioma in the cerebellopontine angle(CPA)without dural attachment is extremely rare.We report a unique case of meningioma derived from the superior petrosal vein without dural attachment.CASE SUMMARY A 44-year-old right-handed woman presented with a two-month history of headache and tinnitus.Brain magnetic resonance imaging showed a well-defined contrast-enhancing lesion in the right CPA without a dural tail sign.Tumor resection was performed using a right retro sigmoid approach.A dural attachment was not seen at the tentorium or posterior surface of the petrous pyramid.The tumor was firmly adherent to the superior petrosal vein.The origin site was cauterized and resected with the preservation of the superior petrosal vein.A diagnosis of meningothelial meningioma was made.The patient’s headache and tinnitus gradually disappeared,and a recurrence was not observed five years after the surgery.CONCLUSION The rare occurrence of meningioma without dural attachment makes it difficult to determine dural attachment before surgery.The absence of dural attachment makes it easy to completely resect such tumors.Vessels related to tumors should be removed carefully,considering the possible presence of tumor stem cells in the microvessels.展开更多
In this editorial,we comment on an article by Ruan et al published in a recent issue of the World Journal of Clinical Case.Pulmonary meningothelial proliferative lesions,including primary pulmonary meningiomas,minute ...In this editorial,we comment on an article by Ruan et al published in a recent issue of the World Journal of Clinical Case.Pulmonary meningothelial proliferative lesions,including primary pulmonary meningiomas,minute pulmonary meningothelial-like nodules,and metastatic pulmonary meningiomas are rare pulmonary lesions.These lesions are difficult to differentiate from lung cancers based on clinical and imaging manifestations.Herein,we briefly introduce the clinical,imaging,and pathological characteristics of these lesions and discuss their pathogenesis to strengthen the current understanding of pulmonary meningothelial proliferative lesions in clinical diagnosis and therapy.展开更多
Background: The simultaneous presence of a pituitary adenoma and a meningioma is a rare and underreported condition. The randomly encountered cases need to be reported to further allow our understanding of this collis...Background: The simultaneous presence of a pituitary adenoma and a meningioma is a rare and underreported condition. The randomly encountered cases need to be reported to further allow our understanding of this collision tumors that are still not understood nor fully described. Patients and Method: We report a case of coexisting nonfunctioning pituitary adenoma and a left temporal lobe meningioma revealed by a 1-year history of progressive vision loss and occasional headaches in a 56-year-old woman. Her clinical condition worsened in the last 5 months with ptosis, cavernous sinus syndrome, and ophthalmoplegia of the right eye without papilledema. There was an improvement in the visual symptoms after subtotal resection of both lesions through a right frontotemporal craniotomy. Histology confirmed a collision tumor. The patient was referred for adjuvant treatment with gamma knife radiosurgery. He was doing well and back to his usual duties 6 months later. Conclusion: A gross total or subtotal resection with adjuvant therapy is the gold standard for the surgical management of collision tumors for a favorable patient outcome.展开更多
Background: There is limited information regarding adjuvant treatment for malignant meningiomas. Although external whole-brain irradiation is recommended, the patient’s family in our case rejected this modality. Nota...Background: There is limited information regarding adjuvant treatment for malignant meningiomas. Although external whole-brain irradiation is recommended, the patient’s family in our case rejected this modality. Notably, traditional chemotherapy was ineffective. Aim: I speculated if the exfoliation of graphene could disassemble the three-dimensional (3D) structures of the graphene because the tumor mass or the blood clots including the graphene consisted of inhomogeneous materials. Therefore, I aimed to explore another possible mechanism for the instant removal of inhomogeneous materials. Method: Herein, I report a case of anaplastic papillary meningioma. A 59- year-old man presented with partial complex seizures and recurrent headaches following craniotomy for the removal of a mass with a right frontotemporal convexity 10 years ago. Computed tomography (CT) and magnetic resonance imaging demonstrated a right frontotemporal mass with diffuse contrast enhancement and extensive surrounding edema. A right frontotemporal flap was performed. The tumor and the infiltrated dura were removed, but massive intraoperative bleeding occurred and the right middle cerebral artery was clipped at the M2 territory. Postoperatively, the follow-up CT scan revealed hydrocephalus. Accordingly, a ventriculoperitoneal shunt was placed. The patient suffered from left hemiplegia as a sequela of intraoperative bleeding. Four months later, the follow-up CT scan showed chronic epidural hematoma in the right frontotemporoparietal region. The patient also had an altered level of consciousness. Results: The patient’s level of consciousness was restored after infusion of a NaCl + KCl solution with instant disappearance of the mass. Conclusion: There may be another mechanism for disassembling the inhomogeneous graphene-containing complex, such as quantum fluctuation of the graphene exfoliation with pair annihilation or relation to tissue engineering by the graphene.展开更多
Introduction: Meningiomas are tumors formed by arachnoid cells, typically attached to the inner surface of the dura mater. Malignant forms are rare and no case has been reported in the Malagasy literature. The objecti...Introduction: Meningiomas are tumors formed by arachnoid cells, typically attached to the inner surface of the dura mater. Malignant forms are rare and no case has been reported in the Malagasy literature. The objective of our study is to report two Malagasy cases of malignant meningioma and to discuss the epidemiological and anatomical-clinical particularities of this tumor. Observation: The first patient, a 41-year-old woman, presented with a rapidly progressive intracranial hypertension syndrome. The patient had undergone surgery two years earlier for a grade II meningioma and had no family history of meningioma, neurofibromatosis, or personal history of brain irradiation or head trauma. Her brain scan showed a heterogeneous polylobed left parieto-occipital mass with a meningeal implantation base. The anatomopathological examination of the samples revealed a malignant meningioma. The second patient was a 33-year-old man, operated for grade I meningioma eleven months before admission, with no other personal or family history. The patient was hospitalized for tumor recurrence with signs of intracranial hypertension. The brain computed tomography (CT) scan showed a heterogeneous extra-axial tumor in right temporo-parietal lobe. Surgical excision was performed. On histological examination, a proliferation of tumor cells of meningothelial appearance with papillary architecture was observed, leading to the diagnosis of malignant meningioma. Conclusion: Malignant meningioma is a rare and serious entity. The clinical manifestations are nonspecific and imaging may mimic a low-grade meningioma. The diagnosis of certainty is histological and is based on essentially morphological criteria. The latter condition the overall survival of the patient and the therapeutic conduct.展开更多
Meningiomas in children are rare. They represent only 1% to 3% of all intracranial tumors. It was a case report of a childhood girl meningioma, which is from the rare tumor and presenting by seizures, evolving in an a...Meningiomas in children are rare. They represent only 1% to 3% of all intracranial tumors. It was a case report of a childhood girl meningioma, which is from the rare tumor and presenting by seizures, evolving in an apyretic context. She had no notion of irradiation or particular personal history apart from wearing glasses since the age of 5 years. She weighed 70 kg (BMI = 31). Biological examinations were normal. The brain scan showed a left frontal extra-axial tumor process measuring 76 × 60 × 55 mm. Tumor resection was performed. Macroscopically, the surgical specimen was found to be 8 firm, lobulated, yellowish-white fragments measuring 14 × 11 × 2 cm and weighing 150 g in total. The histological examination showed a proliferation of meningothelial cells, with a tendency to stratify and to roll up on each other in an onion bulb shape, without excess of mitoses and without cortical infiltration, evoking a meningioma. Meningioma in children remains a rare tumor. In our case, seizures were the only revealing signs of this disease. Cerebral computed tomography oriented the diagnosis. Anatomopathological examination was essential for confirmation.展开更多
Summary: Optic nerve tumors are rare tumors, representing 3% - 5% of intracranial tumors developing mainly along the optic nerve and/or the chiasm. Optic nerve meningiomas are histologically benign tumors whose severi...Summary: Optic nerve tumors are rare tumors, representing 3% - 5% of intracranial tumors developing mainly along the optic nerve and/or the chiasm. Optic nerve meningiomas are histologically benign tumors whose severity is linked to diagnostic and especially therapeutic difficulties. The Optic nerve meningioma is the second leading cause of optic nerve tumor after glioma. Observation: We report the case of a 49-year-old woman from South Asia, who consults an ophthalmology department for progressive visual loss in her right eye for about a year with her glasses and would like to renew her optical correction. Having no particular medical history apart from left unilateral blindness is known for approximately 15 years. Magnetic Resonance Imaging (IRM) cerebral found a tissue mass with a clear outline and polylobules on the left temporo-peduncular. Through this case, we describe the circumstances of discovery of the disease, the clinical characteristics, as well as our diagnostic approach. Conclusion: In the majority of cases, these are benign tumours, the circumstances of which are discovered in multiple ways. A mostly unilateral and non-improvable loss of visual acuity must attract our attention. Renewing glasses may be the reason for discovering the disease. Today Magnetic Resonance Imaging (IRM) remains an important and capital examination for the diagnosis and monitoring of this pathology.展开更多
Background: Skull vault lesions are rare and represent 1% - 2% of all bone masses. Most cerebral metastases are the intra axial tumors, whereas extra-axial masses mimicking meningioma are extremely rare. Case presenta...Background: Skull vault lesions are rare and represent 1% - 2% of all bone masses. Most cerebral metastases are the intra axial tumors, whereas extra-axial masses mimicking meningioma are extremely rare. Case presentation: A 35-year-old woman with a history of mastectomy left breast cancer 5 years below radiotherapy was referred to the neurosurgery department with a parietal extra-axial mass parietal evolving for one year. CT scan with Magnetic resonance imaging revealed an extra-axial tumor with lysis bone. A craniotomy was performed to remove the mass that was located extra-axial. Histopathological examination revealed metastasis. Conclusions: Lesion skull vaults are rare but they should be considered in the differential diagnosis of intraosseous meningioma lesions. In this report, we discuss the clinical aspects of cases we observed, in which the metastasis bone was found thanks to the histological examination of a calvarial mass after surgery.展开更多
本文为回顾性研究,遵守《赫尔辛基宣言》,经过兰州大学第二医院伦理委员会批准,免除受试者知情同意,批准文号:2023A-169。患者女,60岁,因“右上肢麻木无力三个月,加重一周”于2018年5月至兰州大学第二医院就诊。专科检查:神志清,格拉斯...本文为回顾性研究,遵守《赫尔辛基宣言》,经过兰州大学第二医院伦理委员会批准,免除受试者知情同意,批准文号:2023A-169。患者女,60岁,因“右上肢麻木无力三个月,加重一周”于2018年5月至兰州大学第二医院就诊。专科检查:神志清,格拉斯哥昏迷评分(Glasgow Coma Scale,GCS)15分,查体合作,自动体位,言语清晰,记忆力、理解力、定向力检查未见异常。双侧瞳孔等大等圆,对光反射存在。四肢肌张力正常,四肢体肌力5级,四肢未见肌肉萎缩及震颤。右上肢麻木,以右手手指为著,其余四肢深浅感觉检查未见异常,双侧指鼻试验、跟膝胫试验正常。闭目难立征(−)。颈软无抵抗,双侧克氏征、布氏征均为阴性。实验室检查结果未见明显异常。展开更多
文摘BACKGROUND Meningioma in the cerebellopontine angle(CPA)without dural attachment is extremely rare.We report a unique case of meningioma derived from the superior petrosal vein without dural attachment.CASE SUMMARY A 44-year-old right-handed woman presented with a two-month history of headache and tinnitus.Brain magnetic resonance imaging showed a well-defined contrast-enhancing lesion in the right CPA without a dural tail sign.Tumor resection was performed using a right retro sigmoid approach.A dural attachment was not seen at the tentorium or posterior surface of the petrous pyramid.The tumor was firmly adherent to the superior petrosal vein.The origin site was cauterized and resected with the preservation of the superior petrosal vein.A diagnosis of meningothelial meningioma was made.The patient’s headache and tinnitus gradually disappeared,and a recurrence was not observed five years after the surgery.CONCLUSION The rare occurrence of meningioma without dural attachment makes it difficult to determine dural attachment before surgery.The absence of dural attachment makes it easy to completely resect such tumors.Vessels related to tumors should be removed carefully,considering the possible presence of tumor stem cells in the microvessels.
文摘In this editorial,we comment on an article by Ruan et al published in a recent issue of the World Journal of Clinical Case.Pulmonary meningothelial proliferative lesions,including primary pulmonary meningiomas,minute pulmonary meningothelial-like nodules,and metastatic pulmonary meningiomas are rare pulmonary lesions.These lesions are difficult to differentiate from lung cancers based on clinical and imaging manifestations.Herein,we briefly introduce the clinical,imaging,and pathological characteristics of these lesions and discuss their pathogenesis to strengthen the current understanding of pulmonary meningothelial proliferative lesions in clinical diagnosis and therapy.
文摘Background: The simultaneous presence of a pituitary adenoma and a meningioma is a rare and underreported condition. The randomly encountered cases need to be reported to further allow our understanding of this collision tumors that are still not understood nor fully described. Patients and Method: We report a case of coexisting nonfunctioning pituitary adenoma and a left temporal lobe meningioma revealed by a 1-year history of progressive vision loss and occasional headaches in a 56-year-old woman. Her clinical condition worsened in the last 5 months with ptosis, cavernous sinus syndrome, and ophthalmoplegia of the right eye without papilledema. There was an improvement in the visual symptoms after subtotal resection of both lesions through a right frontotemporal craniotomy. Histology confirmed a collision tumor. The patient was referred for adjuvant treatment with gamma knife radiosurgery. He was doing well and back to his usual duties 6 months later. Conclusion: A gross total or subtotal resection with adjuvant therapy is the gold standard for the surgical management of collision tumors for a favorable patient outcome.
文摘Background: There is limited information regarding adjuvant treatment for malignant meningiomas. Although external whole-brain irradiation is recommended, the patient’s family in our case rejected this modality. Notably, traditional chemotherapy was ineffective. Aim: I speculated if the exfoliation of graphene could disassemble the three-dimensional (3D) structures of the graphene because the tumor mass or the blood clots including the graphene consisted of inhomogeneous materials. Therefore, I aimed to explore another possible mechanism for the instant removal of inhomogeneous materials. Method: Herein, I report a case of anaplastic papillary meningioma. A 59- year-old man presented with partial complex seizures and recurrent headaches following craniotomy for the removal of a mass with a right frontotemporal convexity 10 years ago. Computed tomography (CT) and magnetic resonance imaging demonstrated a right frontotemporal mass with diffuse contrast enhancement and extensive surrounding edema. A right frontotemporal flap was performed. The tumor and the infiltrated dura were removed, but massive intraoperative bleeding occurred and the right middle cerebral artery was clipped at the M2 territory. Postoperatively, the follow-up CT scan revealed hydrocephalus. Accordingly, a ventriculoperitoneal shunt was placed. The patient suffered from left hemiplegia as a sequela of intraoperative bleeding. Four months later, the follow-up CT scan showed chronic epidural hematoma in the right frontotemporoparietal region. The patient also had an altered level of consciousness. Results: The patient’s level of consciousness was restored after infusion of a NaCl + KCl solution with instant disappearance of the mass. Conclusion: There may be another mechanism for disassembling the inhomogeneous graphene-containing complex, such as quantum fluctuation of the graphene exfoliation with pair annihilation or relation to tissue engineering by the graphene.
文摘Introduction: Meningiomas are tumors formed by arachnoid cells, typically attached to the inner surface of the dura mater. Malignant forms are rare and no case has been reported in the Malagasy literature. The objective of our study is to report two Malagasy cases of malignant meningioma and to discuss the epidemiological and anatomical-clinical particularities of this tumor. Observation: The first patient, a 41-year-old woman, presented with a rapidly progressive intracranial hypertension syndrome. The patient had undergone surgery two years earlier for a grade II meningioma and had no family history of meningioma, neurofibromatosis, or personal history of brain irradiation or head trauma. Her brain scan showed a heterogeneous polylobed left parieto-occipital mass with a meningeal implantation base. The anatomopathological examination of the samples revealed a malignant meningioma. The second patient was a 33-year-old man, operated for grade I meningioma eleven months before admission, with no other personal or family history. The patient was hospitalized for tumor recurrence with signs of intracranial hypertension. The brain computed tomography (CT) scan showed a heterogeneous extra-axial tumor in right temporo-parietal lobe. Surgical excision was performed. On histological examination, a proliferation of tumor cells of meningothelial appearance with papillary architecture was observed, leading to the diagnosis of malignant meningioma. Conclusion: Malignant meningioma is a rare and serious entity. The clinical manifestations are nonspecific and imaging may mimic a low-grade meningioma. The diagnosis of certainty is histological and is based on essentially morphological criteria. The latter condition the overall survival of the patient and the therapeutic conduct.
文摘Meningiomas in children are rare. They represent only 1% to 3% of all intracranial tumors. It was a case report of a childhood girl meningioma, which is from the rare tumor and presenting by seizures, evolving in an apyretic context. She had no notion of irradiation or particular personal history apart from wearing glasses since the age of 5 years. She weighed 70 kg (BMI = 31). Biological examinations were normal. The brain scan showed a left frontal extra-axial tumor process measuring 76 × 60 × 55 mm. Tumor resection was performed. Macroscopically, the surgical specimen was found to be 8 firm, lobulated, yellowish-white fragments measuring 14 × 11 × 2 cm and weighing 150 g in total. The histological examination showed a proliferation of meningothelial cells, with a tendency to stratify and to roll up on each other in an onion bulb shape, without excess of mitoses and without cortical infiltration, evoking a meningioma. Meningioma in children remains a rare tumor. In our case, seizures were the only revealing signs of this disease. Cerebral computed tomography oriented the diagnosis. Anatomopathological examination was essential for confirmation.
文摘Summary: Optic nerve tumors are rare tumors, representing 3% - 5% of intracranial tumors developing mainly along the optic nerve and/or the chiasm. Optic nerve meningiomas are histologically benign tumors whose severity is linked to diagnostic and especially therapeutic difficulties. The Optic nerve meningioma is the second leading cause of optic nerve tumor after glioma. Observation: We report the case of a 49-year-old woman from South Asia, who consults an ophthalmology department for progressive visual loss in her right eye for about a year with her glasses and would like to renew her optical correction. Having no particular medical history apart from left unilateral blindness is known for approximately 15 years. Magnetic Resonance Imaging (IRM) cerebral found a tissue mass with a clear outline and polylobules on the left temporo-peduncular. Through this case, we describe the circumstances of discovery of the disease, the clinical characteristics, as well as our diagnostic approach. Conclusion: In the majority of cases, these are benign tumours, the circumstances of which are discovered in multiple ways. A mostly unilateral and non-improvable loss of visual acuity must attract our attention. Renewing glasses may be the reason for discovering the disease. Today Magnetic Resonance Imaging (IRM) remains an important and capital examination for the diagnosis and monitoring of this pathology.
文摘Background: Skull vault lesions are rare and represent 1% - 2% of all bone masses. Most cerebral metastases are the intra axial tumors, whereas extra-axial masses mimicking meningioma are extremely rare. Case presentation: A 35-year-old woman with a history of mastectomy left breast cancer 5 years below radiotherapy was referred to the neurosurgery department with a parietal extra-axial mass parietal evolving for one year. CT scan with Magnetic resonance imaging revealed an extra-axial tumor with lysis bone. A craniotomy was performed to remove the mass that was located extra-axial. Histopathological examination revealed metastasis. Conclusions: Lesion skull vaults are rare but they should be considered in the differential diagnosis of intraosseous meningioma lesions. In this report, we discuss the clinical aspects of cases we observed, in which the metastasis bone was found thanks to the histological examination of a calvarial mass after surgery.
文摘目的探讨脑膜瘤患者术后静脉血栓栓塞症(Venous thrombus embolism,VTE)形成的风险因素,构建VTE形成列线图模型并进行验证。方法选取2020年1月-2022年12月新疆医科大学第一附属医院神经外科接受手术治疗的417例脑膜瘤患者为研究对象,采用单因素分析和多因素Logistic回归分析筛选417例脑膜瘤患者术后发生VTE的影响因素,构建列线图模型,并对模型进行内部验证。结果417例患者中150例(36%)发生了VTE,Logistic回归分析显示,年龄大于60岁、住院天数、D-二聚体、术后血钠、低密度脂蛋白为独立风险因素(P<0.05)。基于上述独立风险因素所构建的列线图模型,校准度(χ^(2)=6.424,P=0.781)和区分度[曲线下面积(Area under curve,AUC)=0.841,95%CI:0.800~0.882]良好。校准曲线与决策曲线显示,模型一致性及获益良好。结论以年龄大于60岁、住院天数、D-二聚体、术后血钠、低密度脂蛋白构建的脑膜瘤患者术后VTE发生的列线图模型具有较高的预测价值,可为脑膜瘤患者术后VTE的护理措施提供依据。
文摘本文为回顾性研究,遵守《赫尔辛基宣言》,经过兰州大学第二医院伦理委员会批准,免除受试者知情同意,批准文号:2023A-169。患者女,60岁,因“右上肢麻木无力三个月,加重一周”于2018年5月至兰州大学第二医院就诊。专科检查:神志清,格拉斯哥昏迷评分(Glasgow Coma Scale,GCS)15分,查体合作,自动体位,言语清晰,记忆力、理解力、定向力检查未见异常。双侧瞳孔等大等圆,对光反射存在。四肢肌张力正常,四肢体肌力5级,四肢未见肌肉萎缩及震颤。右上肢麻木,以右手手指为著,其余四肢深浅感觉检查未见异常,双侧指鼻试验、跟膝胫试验正常。闭目难立征(−)。颈软无抵抗,双侧克氏征、布氏征均为阴性。实验室检查结果未见明显异常。
