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Case Reports
. 2022 Oct 7;11(10):20584601221131480.
doi: 10.1177/20584601221131480. eCollection 2022 Oct.

Glioblastoma, IDH-wildtype with leptomeningeal metastasis to Meckel's cave: A case report

Toshiki Murata  1 , Masazumi Matsuda  1 , Tetsugaku Shinozaki  1 , Koichi Ishiyama  1
Affiliations
Case Reports

Glioblastoma, IDH-wildtype with leptomeningeal metastasis to Meckel's cave: A case report

Toshiki Murata et al. Acta Radiol Open. .

Abstract

Meckel's cave or the trigeminal cistern is a subarachnoid space near the apex of the petrous portion of the temporal bone and contains cerebrospinal fluid and the Gasserian ganglion, which divides into the ophthalmic (V1), maxillary (V2), and mandibular (V3) nerves. Infectious, inflammatory, congenital, and neoplastic lesions can occur in Meckel's cave. Leptomeningeal metastasis of glioblastoma (GBM), IDH-wildtype to Meckel's cave is rare. We encountered a case of leptomeningeal metastasis of GBM to Meckel's cave in an elderly female patient who presented with pain around her right eye. Magnetic resonance imaging revealed enhancing lesions in the right temporal lobe and cervical spinal cord. The pathological diagnosis of GBM was confirmed after biopsy of the cervical spinal cord lesion, which showed hyperaccumulation of fluorodeoxyglucose (FDG) on FDG-positron emission tomography. This case indicates that metastatic lesions can also occur in Meckel's cave.

Keywords: FDG-PET; IDH-wildtype; Meckel’s cave; glioblastoma; leptomeningeal metastasis.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
The lesion in Meckel’s cave. (a) The axial T2-weighted image shows a mass in the right Meckel’s cave (red circle). (b) The axial T1-weighted image shows that the mass is iso-intense compared with the brain substance (red circle). (c) The axial gadolinium (Gd)-enhanced T1-weighted image shows marked Gd enhancement of the mass (red circle). (d) On fluorodeoxyglucose (FDG)-positron emission tomography, a slightly higher FDG accumulation of FDG is observed in the right Meckel’s cave (red circle) than that in the contralateral Meckel’s cave.
Figure 2.
Figure 2.
Lesions in the right temporal lobe and right Sylvian fissure. (a) The axial gadolinium (Gd)-enhanced T1-weighted image shows Gd-enhancing cystic lesions in the right temporal lobe and along the right Sylvian fissure (red circle). (b) The fluorodeoxyglucose (FDG)-positron emission tomographic image shows no accumulation of FDG in the right temporal lobe and right Sylvian fissure.
Figure 3.
Figure 3.
The cervical spinal cord lesion. (a) The sagittal gadolinium (Gd)-enhanced T1-weighted image reveals a Gd-enhancing nodule at the C2 level (red arrow). (b) The axial Gd-enhanced T1-weighted image reveals a Gd-enhancing nodule at the C2 level (red arrow). (c) The fluorodeoxyglucose (FDG)-positron emission tomographic image shows high accumulation of FDG in the nodule at the C2 level (red arrow).
Figure 4.
Figure 4.
Hematoxylin and eosin staining and immunostaining results. (a) The hematoxylin and eosin-stained section shows necrosis, microvascular proliferation, and atypical mitotic figures. (b) Atypical astrocytes are glial fibrillary acidic protein (GFAP)-positive. (c) MIB-1 positivity is high (more than 50%).
Figure 5.
Figure 5.
Imaging results after initiating treatment. (a) The axial gadolinium (Gd)-enhanced T1-weighted image shows a marked increase in the size of temporal lobe lesions (red circle) and (b) The axial Gd-enhanced T1-weighted image shows an enlargement of the lesion in the right Meckel’s cave (red arrow), and a mass is seen in the contralateral Meckel’s cave as well (red circle).
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References

    1. Chetan RS, Gyanendra K, Pradeep S, et al. Metastases to Meckel's cave: report of two cases and comparative analysis of malignant tumors with meningioma and schwannoma of Meckel's cave. Clin Neurol Neurosurg 2010; 112: 927–932. - PubMed
    1. Lorna SW, Ilona MS, Christopher LS, et al. MR imaging of the trigeminal ganglion, nerve, and the perineural vascular plexus: normal appearance and variants with correlation to cadaver specimens. AJNR 2003; 24: 1317–1323. - PMC - PubMed
    1. Ashwani K, Donald WC, Ernesto B. The Meckel cave: computed tomographic study. Part I: normal anatomy; Part II: Pathology. Radiology 1984; 152: 425–433. - PubMed
    1. Benjamin K, Errol MB. The trigeminal nerve cistern. Radiology 1973; 108: 597–602. - PubMed
    1. VandeVyver V, Lemmerling M, Van Hecke W, et al. MRI findings of the normal and diseased trigeminal nerve ganglion and branches a pictorial review. JBR-BTR 2007; 90: 272–277. - PubMed

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