Meningioma – A spectrum of varied case presentations: A case series

Abstract

Meningiomas are most common primary intracranial neoplasm. They arise from the arachnoid cap cells. They were previously divided into WHO grade I, grade II and grade III depending on their histological features and clinical features. However, in the new WHO 2021 updates it has been assigned a single group. Meningiomas may arise in the brain and spinal cord. An integrated approach based on clinical examination, history, radiology and histopathology aids in diagnosis. Herein we present a case series of a spectrum of clinico-pathological presentations of meningiomas. A 35-year-old female presented with headache. After clinical examination and on CT scan an intracranial lesion was noted. Craniotomy was performed and tissues examination was consistent with meningothelial meningioma. A 55-year-old female presented with pain in the limbs associated with weakness to the orthopaedics clinic. On neurological examination there was loss of power in the limbs. MRI spine revealed a round extramedullary intradural mass at T7 level. Laminectomy was done and histopathological examination showed features of Psammomatous meningioma, based on histomorphology and immunohistochemistry.A 32-year-old female presented to the Surgery clinics with dizziness and headache which was progressive and not responding to medications. MRI revealed an ovoid enhancing mass involving left parieto-occipital region, with a provisional diagnosis of meningioma. A report of Transitional meningioma was given based on histomorphology and immunohistochemistry. A 40-year-old female presented to the ophthalmic clinic with complaints of diplopia and disturbances in gait. Fundus examination revealed disc oedema and retinal vessel narrowing. MRI revealed large ovoid extra axial mass, with a provisional diagnosis of meningioma. A report of Secretory meningioma was signed out on histomorphology and immunohistochemistry.