Case ReportTwo novel cases of spinal clear cell meningioma with vertebra involvement
Introduction
Clear cell meningioma (CCM) had been included in the World Health Organization (WHO) classification as a special variant of meningioma for about 20 years. The current understanding is that CCM is a very rare but aggressive tumor of meningiothelial origin [1], [2]. Histologically, it is characterized by sheets of polygonal cells with clear cytoplasm. Different from other types of meningiomas, it was defined as a grade II tumor according to WHO due to its aggressive behavior, distinguishing from other varieties of meningioma [1], [2]. However, incidence of clear cell meningioma in spine (SCCM) is not clear. As a variant of intradural neoplasm, SCCM seldom occurs with obvious bone involvement. Here for the first time, we report two unusual cases of SCCM with prominent bone destruction and a systematic review of SCCM was made to recognize its clinic characteristics. All the details regarding the surgical procedures (including potential benefits as well as risks and complications) were introduced to the patients or their family members, then informed consents were obtained from them.
Section snippets
Clinic and image features
A 50-year-old man presented with lumbosacral pain and gradually developed weakness of lower extremities for 2 months, followed by urination and defecation function disturbance. At the time of admission, the strength of his lower extremities was in grade 4/5. Magnetic resonance imaging (MRI) and iliac artery CT angiography (CTA) revealed a giant neoplasm that had involved almost the whole sacrum, extending toward the pre-sacral region (Fig. 1). Moreover, the internal iliac arteries were found to
Discussion
CCM is the rarest subtype of meningiomas, representing 0.2–0.8% [14], [29], [30]. Zorludemir et al. [14] and Oviedo et al. [3] revealed that CCM had a high local recurrence rate and a more aggressive clinical course than ordinary meningiomas. These differences to ordinary ones led to the classification of a grade II type in 2000.
To explore clinical features of SCCM, we make the literature search through Medline Database of PubMed with key words “spine” and “clear cell meningioma” or
Conflicts of interest
None.
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Cited by (3)
Spinal Clear Cell Meningiomas: Clinical Features and Factors Predicting Recurrence
2020, World NeurosurgeryCitation Excerpt :Probability values <0.05 were considered statistically significant. Based on our inclusion criteria, 43 articles were included, comprising 84 patients with spinal CCMs.3,7-48 Key characteristics of the included studies are shown in Table 1.
Central nervous system clear cell meningioma: a systematic literature review
2024, Neurosurgical Review
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These authors contributed equally to this study.