intraventricular meningioma

Malignant

intraventricular meningioma with craniospinal dissemination and concurrent pulmonary metastasis. Primary MIVM and first local recurrence. (A) CT scan, showing a huge hyperdense mass lesion in the trigone with central necrosis. (B) MRI scan, demonstrating heterogeneous enhancement of the lesion. (C) Histopathological findings revealing anaplastic meningioma with cellular pleomorphism, nuclear atypia, and geographic necrosis (H & E 400×). (D) Postoperative MRI scan, displaying no residual tumor. (E) MRI scan, disclosing local recurrence. (F) MRI scan, showing a huge residual cavity after the second craniotomy.

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Massive

intracranial hemorrhage caused by intraventricular meningioma: case report. Non-contrast axial (a-d), coronal (e, f), and sagittal (g, h) CT scans on admission revealing a large heterogeneous mass lesion in the trigone of the left lateral ventricle with intraventricular hemorrhage extending to the right lateral ventricle

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Case report

of calcified intraventricular meningioma and review of literature. Axial image of brain shows hyperdense lesion in the trigone of the left lateral ventricle extending into the occipital horn of the left lateral ventricle.

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Case report

of calcified intraventricular meningioma and review of literature. Plain TIWI axial images show hypointense lobulated lesion in the trigone of the left lateral ventricle extending into the occipital horn of the left lateral ventricle.

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Case report

of calcified intraventricular meningioma and review of literature. Plain T2WI axial images shows hypointense lobulated lesion in the trigone of the left lateral ventricle. Well-defined hyperintense cystic lesion adjacent to the lesion, suggestive of peritumoral cyst.

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Case report

of calcified intraventricular meningioma and review of literature. The leison in trigone of the left lateral ventricle shows blooming on FFE images, consistent with calcification.

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Case report

of calcified intraventricular meningioma and review of literature. On post contrast study, the lesion shows peripheral rim of enhancement.

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Cerebrospinal

fluid dissemination of anaplastic intraventricular meningioma: report of a case presenting with progressive brainstem dysfunction and multiple cranial nerve palsies. Brain MRI of the present patient at admission (a –c), and 17 days (d–f) and 40 days (g–i) after admission. Fluid attenuated inversion recovery (FLAIR) images at admission showed no gross abnormality, including in the brainstem and cranial nerves (a, b), although a mass-enhancing lesion was observed in the trigone of the left lateral ventricle on T1-weighted imaging (c). 17 days after admission, FLAIR images revealed slight hyperintensity in the exit for the trigeminal nerve and the left cerebellar hemisphere (d, e), and diffusion-weighted imaging (DWI) showed hyperintensity in the left cerebellar hemisphere (f). At the final MRI at 40 days after admission, diffuse high-intensity lesions and hydrocephalus were observed in the brainstem and cerebellum on FLAIR (g, h) and DWI revealed multiple hyperintense lesions in the bilateral cerebellar hemispheres (i)

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Radiopaedia • CC-by-nc-sa 3.0 • de

Intraventricular meningiomas, although are rare intracranial tumors, are a common type of intraventricular neoplasm in adults. They account for less than 3% of all meningiomas.

On imaging, they classically present as vividly enhancing solid mass at the trigone of the lateral ventricles.

Epidemiology

Most intraventricular meningiomas presentbetween the 3 and 6 decades with a recognized female predilection (M:F ratio of 1:2) .

Clinical presentation

Intraventricular meningiomas present usually due to mass effect, either by direct compression of the adjacent brain or from obstruction to normal CSF drainage with resultant hydrocephalus.

Pathology

Intraventricular meningiomas are thought to arise from mengingothelial inclusion bodies located in the tela choroidea and/or mesenchymal stroma of the choroid plexus . In general, these meningiomas are most commonly of the fibrous meningiomas .

Location

They are most frequently (80%) seen at the trigone of the lateral ventricles and, for reasons that are not clear, slightly more frequently on the left. Considering the distribution of meningiomas, the intraventricular location is comparatively more common in children (20% of pediatric meningiomas).

Radiographic features

Their signal and attenuation characteristics are the same as other meningiomas, demonstrating essentially isodensity and intensity to grey matter precontrast and vivid, usually homogenous enhancement following administration of contrast. Compared to extra-axial meningiomas, a greater proportion is calcified (50% compared to 20% for standard meningioma).

For further discussion of the radiographic appearances of these tumors, refer to the general article: meningioma.

Treatment and prognosis

As is the case with other meningiomas, provided complete excision is possible, surgical excision is curative and therefore the treatment of choice.

Differential diagnosis

The differential somewhat depends on the location of the tumor and age of the patient, however, in general considerations should include:

glial tumor
- ependymoma
- astrocytoma
choroid plexus metastases
- renal cell carcinoma
- melanoma
choroid plexus papilloma (particularly in children)
CNS lymphoma

intraventricular meningioma

Epidemiology

Clinical presentation

Pathology

Location

Radiographic features

Treatment and prognosis

Differential diagnosis

See also

Siehe auch:

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