Brain Tumor Res Treat.  2016 Oct;4(2):94-99. 10.14791/btrt.2016.4.2.94.

Clinical and Radiological Characteristics of Angiomatous Meningiomas

• Hwang J
• Kong DS
• Seol HJ
• Nam DH
• Lee JI
• Choi JW

• KMID: 2356976
• DOI: http://doi.org/10.14791/btrt.2016.4.2.94

Abstract

BACKGROUND
Angiomatous meningioma is a rare histological subtype of meningioma. Therefore, this specific medical condition is rarely reviewed in the literature. In the present work, we report the clinical and radiological features with postoperative outcomes of angiomatous meningioma.
METHODS
This retrospective study included the patients who were pathologically diagnosed with angiomatous meningioma after surgical resection between February 2010 and September 2015 in our institute. We analyzed the clinical data, radiological manifestation, treatment and prognosis of all patients.
RESULTS
The 15 patients (5 males and 10 females) were diagnosed with angiomatous meningioma during the study period. The median age of patients at the time of surgery was 63 years (range: 40 to 80 years). According to Simpson classification, 7, 5, and 3 patients achieved Simpson grade I, II, and IV resection, respectively. In the follow-up period, recurrence was noted in one patient. Ten out of the 15 patients showed homogeneous enhancement. Two patients demonstrated cystic changes. There was no occurrence of calcification or hemorrhage in our patients. Characteristically, 14 out of 15 patients showed signal voids of vessels. Significant peritumoral edema was observed in the majority of tumors (67%).
CONCLUSION
Angiomatous meningiomas are rare benign meningioma. Brain images of angiomatous meningioma usually demonstrate signal void signs and peritumoral edema. In the present study, angiomatous meningiomas showed good prognosis after surgical resection.

Keyword

Angiomatous meningioma; Brain edema; Magnetic resonance imaging; Recurrence

MeSH Terms

Brain
Brain Edema
Classification
Edema
Follow-Up Studies
Hemorrhage
Humans
Magnetic Resonance Imaging
Male
Meningioma*
Prognosis
Recurrence
Retrospective Studies

Figure

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  Fig. 1 MRI and histologic findings of case 4. A: The preoperative T1-weighted brain MRI with gadolinium enhancement demonstrates about 3 cm sized homogeneous enhancing mass. B: The preoperative T2-weighted brain MRI shows the signal voids of blood vessels. C: Histologic findings of angiomatous meningioma show predominence of vascular proliferations over the tumor cells. The vascular channels contain a mixture of delicate and thick walls with variable sizes (Hematoxylin and eosin stain, ×200). D: No recurrence is verified in the last follow-up images after 14 months from operation.

• 

  Fig. 2 MRI and histologic findings of case 15. A: The preoperative T1-weighted brain MRI with gadolinium enhancement shows a large cystic mass with mild midline shift. B: The preoperative T2-weighted brain MRI shows no definite signal voids of blood vessels and demonstrated significant brain edema. C: Histologic findings of angiomatous meningioma. In this case, most are small with hyalinized walls. Surrounding meningothelial cells have relatively uniform round to oval shape nuclei and nuclear pseudoinclusions with eosinophilic cytoplasm and indistinct cell borders (Hematoxylin and eosin stain, ×200). D: The postoperative T1-weighted MRI with gadolinium enhancement demonstrates that there is no residual mass at the tumorectomy site. E: The follow-up MRI after 13 months from surgery shows a small nodular enhancing lesion (T1-weighted with gadolinium enhancement). F: The latest follow-up MRI displays growth of recurrent tumor in inferior frontal gyrus (T1-weighted with gadolinium enhancement).

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