[A meningioma in the posterior fossa without dural attachment: case report]

Abstract

An extremely rare case of a meningioma in the posterior fossa without dural attachment has been reported. The patient was a 56-year-old male whose chief manifestation was the abnormality of his CT scan. His past history included gastric and colonic polyp when he was 54, 55 years old, and non-Hodgkin's lymphoma before hospitalization in our department. CT scan showed a small round non-enhancing lesion located at the lateral site of the right cerebellar cortex. T1 weighted image of MRI showed a homogeneous low intensity lesion with partial enhancing with Gd-DTPA. Proton image showed a remarkable low intensity lesion which showed an extramedullary mass. Right retromastoid craniectomy was performed. The mass was an extramedullary tumor which had no relation with the cerebellar cortex and dura matter. The arachnoid membrane around the tumor was intact. The tumor was totally resected and the patient had no neurological deficits. Histopathologically, the tumor was delineated into laminar structures by collagen fiber. Tumor cells were spindle in shape and made a whorling formation. There was no psammoma body and it had a hyperchromatic nuclei without mitotic features. Electron microscopic studies revealed no typical interdigitation but irregularity of the cell membrane. Abundant collagen fibers were in contact with basement membrane of the tumor. According to these findings, we diagnosed fibroblastic meningioma with atypical forms. Meningiomas without dural attachment are rare in adults, especially extremely rare of the posterior fossa. There are only 23 previous reports of "meningioma of the posterior fossa without dural attachment". Cantore divided these meningiomas into three groups (IV ventricle, inferior tela choroidea and cisterna magna).(ABSTRACT TRUNCATED AT 250 WORDS)