Colnat-Coulbois Sophie, Kremer Stephane, Weinbreck Nicolas, Pinelli Catherine, Auque Jean
Department of Neurosurgery, University Hospital of Nancy, France.
Surg Neurol. 2008 Apr;69(4):398-402; discussion 402. doi: 10.1016/j.surneu.2006.11.072. Epub 2007 Sep 6.
Lipomatous meningioma is a rare but, most of the time, benign tumor. Its pathogenesis is still debated: it is usually considered to be part of the metaplastic meningioma, but several authors recently suggested that fat accumulation inside the tumor was related to metabolic disorders of the meningothelial cells.
We report 2 cases of lipomatous meningioma. Both patients were women older than 60 years. One patient suffered from headache and seizures, the other one presented with behavioral disturbance. Radiological features depended on the amount of fat accumulation within the tumor. Surgical treatment allowed complete resection in both cases without any complications. Both meningiomas were of transitional-type and were apparently composed of 2 populations of cells: meningothelial cells and lipid-laden cells resembling mature adipocytes. Immunohistochemical study showed that lipid-laden cells expressed EMA, CD99, and progesteron receptor, favoring a meningothelial differentiation rather than an adipocytic lineage.
Our study strongly suggests that lipomatous meningioma results from an accumulation of lipid inside meningothelial cells rather than a true metaplasia.
脂肪性脑膜瘤是一种罕见但多数情况下为良性的肿瘤。其发病机制仍存在争议：通常被认为是化生型脑膜瘤的一部分，但最近有几位作者提出肿瘤内的脂肪堆积与脑膜内皮细胞的代谢紊乱有关。
我们报告2例脂肪性脑膜瘤病例。两名患者均为60岁以上女性。一名患者患有头痛和癫痫发作，另一名患者表现为行为障碍。影像学特征取决于肿瘤内脂肪堆积的程度。手术治疗使两例均得以完全切除且无任何并发症。两个脑膜瘤均为过渡型，显然由两种细胞组成：脑膜内皮细胞和类似成熟脂肪细胞的富含脂质的细胞。免疫组化研究表明，富含脂质的细胞表达EMA、CD99和孕激素受体，提示为脑膜内皮分化而非脂肪细胞谱系。
我们的研究强烈提示，脂肪性脑膜瘤是由于脑膜内皮细胞内脂质堆积所致，而非真正的化生。
