11/20/2006 Case 1: Meningioma with gemistocyte-like cells

Clinical History:

A 64 year old man who experienced "twitching" of the face and jaw one month prior to admission. One week prior he had a focal motor seizure. Admitted to another hospital, an MRI showed a 6 x 5 x 3.5 cm posterior frontal convexity mass, apparently dural based. A gross total was excision performed.

Diagnostic Notes:

The images shown were of dura with an attached neoplasm, composed almost entirely of sheets of cells with round bland nuclei lying at one edge of a cell body with prominent eosinophilic cytoplasm. These cells strongly resemble gemistocytic astrocytes. However in one focus the tumor had typical meningothelial whorl architecture. The diagnosis is; Meningioma with Gemistocyte-Like Cells This variant of meningioma was described by Kepes in his 1982 monograph and in his AANP Presidential address. It is a rare variant which mimics gemistocytic astrocytoma and may possibly be confused with rhabdoid meningioma. No prognostic associations are known; these are not thought to be aggressive and are not rhabdoid meningiomas (which had not been described at the time that Kepes described these tumors).

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