Non-Dura Based Intaspinal Clear Cell Meningioma

A 34-year-old female patient was presented with leg and hip pain for 6 months as well as voiding difficulty for 1 year. Magnetic resonance imaging revealed a well-demarcated mass lesion at L2-3. The mass was hypo-intense on T1- and T2-weighted images with homogeneous gadolinium enhancement. Surgery was performed with the presumptive diagnosis of intradural extramedullary meningioma. Complete tumor removal was possible due to lack of dural adhesion of the tumor. Histologic diagnosis was clear cell meningioma, a rare and newly included World Health Organization classification of meningioma usually affecting younger patients. During postoperative 2 years, the patient has shown no evidence of recurrence. We report a rare case of cauda equina clear cell meningioma without any dural attachment.

Clear Cell Meningioma of Cauda Equina without Dural Attachment

We report a 17-year-old woman presented with a one-month history of lower back pain and radiating pain in the left leg. Examination revealed Lasegues sign in left leg with mild weakness of the plantar flexion of the left big toe. Magnetic resonance image revealed a well enhanced intradural lesion at the S1-2 level. Following a subtotal laminectomy of S1 and an intradural exposure, the roots of the cauda equina draped the tumor loosely without any attachment to the dura or cauda equina. The tumor was removed en bloc. The patient's recovery was uneventful. Histological examination confirmed a clear cell meningioma.

Clear Cell Meningioma

Clear cell meningioma is a recently recognized morphologically unique entity. It shows no sex predilection, affects primarily the lumbar region, and the cerebellopontine angle. Despite its benign appearance, it may be aggressive, particularly in intracranial cases. All lesions are moderately cellular, with the exception of stromal hyalinization. The tumor consists largely of a sheet- like or somewhat lobular pattern of polygonal cells, the cytoplasm of which is clear. No close association is noted between the recurrence or the clinical outcome and factors such as mitotic activity, the PCNA index, and the DNA ploidy status. But the MIB-1 proliferation index is appreciably higher in recurrent tumors. We experienced a case of clear-cell meningioma showing a characteristic histologic finding. A 39-year-old man was admitted due to the recent onset of right-sided, facial-nerve palsy, left hemiparesis and general weakness. A CT scan of the head showed a well defined mass in the petroclival area. After surgical resection, the patient was in good condition, but 1 year later symptoms recurred. A CT scan of the head showed a huge, recurrent petroclival tumor with adhesion to the surrounding brain parenchyme.

Clear Cell Meninioma: Case Report

Clear cell meningioma is a recently recognized variant of meningiomas. We present a case of a 47-year old man with clear cell meningioma which involved right cerebellar hemisphere. Magnetic resonance imaging revealed a 3(34cm sized well enhanced round nodular lesion with mild mass effect. He underwent suboccipital craniectomy with a successful total removal of the tumor. To our knowledge, this is the first report of clear cell meningioma in our country.