Meningioma quistico, un desafio diagnostico / Cystic meningioma, a diagnostic challenge

RESUMEN

Objective: to present 3 cases of intracranial cystic meningiomas with histological confirmation; and to review this relatively uncommon finding. Description cystic meningiomas account for about 2-4 por ciento of intracranial meningiomas and their clinical presentation is similar to that of noncystic meningiomas; but in some cases, quick neurological deterioration may occur, perhaps due to rapid intratumoral cyst expansion among other causes. These lesions have been mistaken for astrocytomas, hemangioblastomas, neuroblastomas and metastasis. A thorough radiographic examination allows us to make the diagnosis of meningiomas in a high percentage of cases; however, even with CAT scanning. MRI and cerebral arteriography, diagnosis of cystic meningiomas is difficult. Tumor cells may be present in the cyst wall, so that resection of the solid portion alone carries the chance of tumor recurrence. Because of that, a total cyst excision in some cases is the goal to prevent tumor recurrence. Intervention in the last three years, we have operated three cases of cystic meningiomas, two females and one male patien among 35-43 years old, all of them went to gross total surgical removal (Simpson II) of the solid and cystic portion; the pathological examination revealed a "meningothelial type"in two of them and a "sincitial type" in the other. Conclusion: proper surgical management depends on early recognition so that curative excision is not replaced by palliative surgery