Cystic Meningiomas: Correlation between Radiologic and Histopathologic Features

Abstract

Background: Tumors with cysts often correlate with gliomas, metastatic tumors, or hemangioblastomas, which require differentiation.

Methods: Thirty-eight cases of cyst associated-meningioma based on preoperative radiologic studies and histologic confirmations were reviewed from November 1998 to July 2017.

Results: A total of 395 cases of meningioma were observed in the 20 years, and surgical treatment of intracranial meningioma was performed in 120 cases. Thirty-eight (9.6%) cases of cyst associated meningiomas were analyzed. Nauta type I was the most common type of cyst (39.5%) and the most frequent histopathological subtype was meningothelial type (36.8%).

Conclusion: Statistically there were no significant associations between meningioma histopathological type and associated cysts; however, the rate of World Health Organization grade II was higher in cyst associated meningiomas than in unrelated meningiomas. This correlation was weak, in accordance with the meningioma grade.

Keywords: Cyst; Histopathology; Intracranial meningioma; Neuropathology; Radiology.

Fig. 1. Nauta type I cyst. Cystic lesion is located at center of tumor. A: MRI with contrast enhancement T1-weighted image of cysts with low signal intensity are observed in the center of the tumor with contrast enhancement. B: T2-weighted image shows high signal intensity, indicating a cystic lesion.

Fig. 2. Nauta type II cyst. The cyst is located within the tumor but it is located at the periphery and the rim of the cystic lesion shows contrast enhancement (A and C). In T2-weighted image, the cystic portion appears as high signal intensity (B).

Fig. 3. Nauta type III cyst which does not show any enhancement on the contrast medium (A), is adjacent to the surrounding brain. The mass is part of the cyst wall. The cystic lesion has the isosignal intensity as the cerebrospinal fluid in the ventricle (B).

Fig. 4. Nauta type IV cyst which is peritumoral type. A: Tumor located in temporal convexity show enhancement on T1-weighted image with contrast and adjacent cysts are observed. B: The cystic portion shows high signal intensity at T2-weighted image.