Giant Intraparenchymal Meningioma in a Female Child: Case Report and Literature Review

Abstract

Background: Intraparenchymal meningiomas without dural attachment are extremely rare, especially in female children. To our knowledge, fibrous intraparenchymal meningioma located in the temporal lobe has never been reported in female children. The significance in the differential diagnosis of lesions in the temporal lobe should be emphasized.

Case presentation: A 12-year-old girl was admitted to our hospital, complaining of recurrent generalized seizures for 2 months. Magnetic resonance imaging demonstrated a solid lesion located in the temporal lobe. The lesion underwent gross total resection. Histopathological examination indicated that the lesion was a fibrous meningioma. Postoperative rehabilitation was uneventful.

Conclusion: This case report presents an extremely unusual intraparenchymal fibrous meningioma of the temporal lobe with peritumoral edema and reviewed 21 intraparenchymal meningioma cases in children and to discuss the clinical presentation and treatment, differential diagnosis, and radiological features.

Keywords: fibrous; intraparenchymal; meningioma; temporal lobe.

Figure 1

A–F: Preoperative magnetic resonance imaging demonstrating a solid mass of temporal lobe. The tumor viewed with MRI showed isointensity on T1-weighted images (A) and high intensity on T2-weighted images (B) and homogeneous enhancement on T1-weighted gadolinium Enhancement, but no dural tail sign was noted (C–E). CTA showed that the middle cerebral artery adhered closely to the tumor and shifted medially (F). Three-month after the operation, magnetic resonance imaging shows no evidence of disease recurrence (G–I).

Figure 2

Hematoxylin-eosin staining exhibiting a mass composed of interlacing collagen fiber bundles and spindle-shaped cells with oval nuclei that were arranged in streaming or whorl-like patterns. ((A) original magnification, ×100; (B) original magnification, ×400).

Figure 3

Immunohistochemical staining showing positive for CD34 ((A) original magnification, ×400), EMA ((B) original magnification,×200), Vimentin ((C) original magnification, ×200), SSTR2 ((D) original magnification, ×200), Ki-67 labeling index being approximately 1% ((E) original magnification, ×400).