Kim Hyun-Doo, Choi Chan-Young, Lee Dong-Joon, Lee Chae-Heuck
Department of Neurosurgery, Ilsan Paik Hospital, College of Medicine, Inje University, Goyang, Korea.
J Korean Neurosurg Soc. 2011 May;49(5):292-5. doi: 10.3340/jkns.2011.49.5.292. Epub 2011 May 31.
A rare case of intraventricular meningioma that arose in the atrium of the left lateral ventricle was identified in a 51-year-old woman. Gross total removal was performed by transcortical approach. Histopathological findings showed meningothelial meningioma with a focal atypical area which had 8% of Ki-67 labeling index (LI). A large recurrence extending into the ipsilateral quadrigeminal cistern and opposite medial occipital lobe developed approximately 41 months after the first operation. The specimens obtained from the second resection showed atypical meningioma with 20% of Ki-67 LI but there were no anaplastic area. The patient underwent fractionated stereotactic radiotherapy. However, multiple local distant metastases were found in the occipital and cerebellar cortex suggesting cerebrospinal fluid dissemination apparently 24 months after the second operation. This report presents chronological progression of a rare intraventricular atypical meningioma with more aggressive transformation.
一名51岁女性被确诊患有罕见的起源于左侧脑室心房的脑室内脑膜瘤。通过经皮质入路进行了肿瘤全切。组织病理学检查结果显示为脑膜内皮型脑膜瘤，伴有一个局灶性非典型区域，其Ki-67标记指数（LI）为8%。首次手术后约41个月，肿瘤复发并广泛扩展至同侧四叠体池和对侧枕叶内侧。第二次切除标本显示为非典型脑膜瘤，Ki-67 LI为20%，但无间变区域。患者接受了分次立体定向放射治疗。然而，在第二次手术后约24个月，在枕叶和小脑皮质发现了多个局部远处转移灶，提示明显的脑脊液播散。本报告呈现了一例罕见的具有更具侵袭性转变的脑室内非典型脑膜瘤的病程进展。
