Pizzoni C, Sarandria C, Pierangeli E
Neurosurgical Complex Operating Unit , SS. Annunziata Hospital, Taranto, Italy.
J Neurosurg Sci. 2009 Sep;53(3):113-7.
Clear-cell meningioma (CCM) is a rare subtype of meningioma which occurs at a younger age and has a higher recurrence rate than other subtypes (WHO grade II). CCM usually occur in younger patients and is located in the posterior fossa and spine. The authors report the first case of olfactory groove mixed clear-cell meningioma. A 66-year-old woman was admitted to the SS. Annunziata Hospital (Taranto, Italy) in January 2007 with a two-year history of subtle changes in personality and mental function. On neurologic examination she presented a loss of sense of smell. The magnetic resonance imaging (MRI) showed an olfactory groove meningioma. The computed tomography (CT) and MRI features of CCM are not different from those of common meningiomas. The tumor was totally removed by frontolateral approach on January 24, 2007). Histological examination showed that the tumor was composed of sheet-like uniform and polygonal cells, with abundant clear cytoplasm, and small and bland nuclei. The cytoplasm was heavily laden with granular periodic acid Schiff-positive and diastase-sensitive material representing glycogen. There were no rich vascular networks but scattered collagen bundles within the tumour, little foci areas of necrosis and whorls of meningothelial cells. The neoplastic cells were positive for epithelial membrane antigen (EMA) and vimentin, and negative for glial fibrillary acidic protein (GFAP)? S-100?chromogranin A; Ki-67 labelling showed an index of 1%. The final diagnosis was mixed clear-cell meningioma. Until now only 38 intracranial CCM cases had been reported in English language literature. Different diagnoses for CCM include lesions with clear cell appearance such metastases of renal cell carcinoma and sarcoma, hemangioblastoma, ependymoma, oligodendroglioma, germinoma, chordoma, pleomorphic xanthoastrocytoma, lipid-rich glioblastoma, microcystic and lipomatous meningioma.
透明细胞型脑膜瘤（CCM）是脑膜瘤的一种罕见亚型，发病年龄较轻，复发率高于其他亚型（世界卫生组织二级）。CCM通常发生于较年轻患者，位于后颅窝和脊柱。作者报告了首例嗅沟混合型透明细胞型脑膜瘤。一名66岁女性于2007年1月入住意大利塔兰托的圣安娜医院，有两年人格和精神功能细微变化病史。神经系统检查发现她嗅觉丧失。磁共振成像（MRI）显示为嗅沟脑膜瘤。CCM的计算机断层扫描（CT）和MRI特征与常见脑膜瘤无异。2007年1月24日通过额颞部入路将肿瘤完全切除。组织学检查显示肿瘤由片状均匀多边形细胞组成，胞质丰富透明，核小且无异型性。胞质内富含颗粒状过碘酸希夫染色阳性且对淀粉酶敏感的物质，代表糖原。肿瘤内无丰富血管网络，但有散在胶原束，少量坏死灶及脑膜内皮细胞漩涡。肿瘤细胞上皮膜抗原（EMA）和波形蛋白阳性，胶质纤维酸性蛋白（GFAP）、S-100、嗜铬粒蛋白A阴性；Ki-67标记指数为1%。最终诊断为混合型透明细胞型脑膜瘤。截至目前，英文文献中仅报道了38例颅内CCM病例。CCM的不同诊断包括具有透明细胞外观的病变，如肾细胞癌和肉瘤转移、血管母细胞瘤、室管膜瘤、少突胶质细胞瘤、生殖细胞瘤、脊索瘤、多形性黄色星形细胞瘤、富含脂质的胶质母细胞瘤、微囊性和脂肪瘤样脑膜瘤。
