• Journal of Korean Neurosurgical Society
• /
• 제37권3호
• /
• pp.235-237
• /
• 2005

Meningioma without dural attachment usually occurs in the intraventricular region, the pineal region, and the sylvian fissure. However, subcortical meningioma located far from such locations is extremely rare. The authors report a case of subcortical anaplastic meningioma without any dural attachment in a 41-year-old woman.

• Journal of Korean Neurosurgical Society
• /
• 제47권6호
• /
• pp.464-466
• /
• 2010

A 59-year-old female presented with headache and dizziness for one year. Magnetic resonance imaging revealed a $52{\times}28$ mm, wellcircumscribed, homogenously enhancing mass lesion without dural attachment located in the left lateral cerebellomedullary cistern. The tumor was excised, and a histological diagnosis was a mixed pattern meningioma of meningothelial and fibroblastic type. A meningioma in the posterior fossa without dural attachment is quite rare. We report a rare case of lateral cerebellomedullary cistern meningioma without dural attachment with literature review.

• Journal of Korean Neurosurgical Society
• /
• 제56권1호
• /
• pp.58-60
• /
• 2014

Spinal meningiomas typically adhere to the dura matter. Non-dural based spinal meningiomas are rare and most are clear cell meningiomas. We report here the first case of a fibrous meningioma with non-dural attachment. The patient was a 49-year-old female, who complained of numbness in the legs and a gait disturbance. Magnetic resonance imaging revealed a $1.7{\times}1.4-cm$ mass in the C7-T1 intra-dural extramedullary space, showing peripheral gadolinium enhancement without a "dural tail sign". A complete microsurgical resection was performed. The mass was covered with a white membrane but was not adhered to the dura, and its appearance was consistent with a neurilemmoma. The histopathological diagnosis was fibrous-type meningioma. The recovery of the patient was uneventful. No surgical complications and no recurrence of the tumor had occurred at the 6-month follow-up.

• Journal of Korean Neurosurgical Society
• /
• 제49권1호
• /
• pp.71-74
• /
• 2011

A 34-year-old female patient was presented with leg and hip pain for 6 months as well as voiding difficulty for 1 year. Magnetic resonance imaging revealed a well-demarcated mass lesion at L2-3. The mass was hypo-intense on T1- and T2-weighted images with homogeneous gadolinium enhancement. Surgery was performed with the presumptive diagnosis of intradural extramedullary meningioma. Complete tumor removal was possible due to lack of dural adhesion of the tumor. Histologic diagnosis was clear cell meningioma, a rare and newly included World Health Organization classification of meningioma usually affecting younger patients. During postoperative 2 years, the patient has shown no evidence of recurrence. We report a rare case of cauda equina clear cell meningioma without any dural attachment.

• Journal of Korean Neurosurgical Society
• /
• 제52권6호
• /
• pp.558-560
• /
• 2012

The 5-aminolevulinic acid (5-ALA)-induced tumor fluorescence is a useful intraoperative marker for the diagnosis and the detection of various malignancies, but its use in meningioma is only reported infrequently. In meningioma, a complete resection of the tumor mass is crucial for the prevention of recurrence and postoperative morbidities. Deep sylvian meningioma is a rare type of meningioma where complete tumor removal is complicated by its deep anatomical location and close involvement with the middle cerebral artery. From our experience, 5-ALA-mediated fluorescence facilitated a safe excision whilst preserving critical neurovascular structures. To our best knowledge, this is first report from use of 5-ALA in a deep sylvian meningioma.

• Journal of Korean Neurosurgical Society
• /
• 제41권2호
• /
• pp.120-122
• /
• 2007

Meningiomas arise from meningothelial cells that line the arachnoid membrane. So most meningiomas are dural-based lesion. But meningiomas without dural-attachment do occur and are less common. We report our experience of intraparenchymal sylvian fissure menigioma. A 21-year-old female presented with a one-month history of headache that was associated with long-term intermittent partial seizure. CT revealed about $4.5{\times}4.3{\times}5.5cm$ sized calcified mass with enhancement in right temporal lobe. On MR imaging, the lesion was observed in the right temporal lobe that was low-signal intensity on T2WI and iso-signal intensity on T1WI with well enhancement. Operation was performed via right orbitocranial approach. The internal surface of dura was intact. Tumor was totally removed except the capsule of tumor adhered to main trunk of middle cerebral artery. The histopathology showed meningioma, psammomatous type. Intraparenchymal meningioma should be considered in the differential diagnosis of intraaxial lesions in patients of any age group.

• Investigative Magnetic Resonance Imaging
• /
• 제17권4호
• /
• pp.308-311
• /
• 2013

심부실비우스열뇌수막종은 뇌수막종의 드문 형태이다. 본 증례를 합하여 한국에서 총 4증례가 보고 되었다. 이전 병력이 없던 43세 남자가 경련발작을 주소로 본원에 내원하였다. 자기공명영상에서 오른 심부실비우스열에 테두리가 조영증강되는 종괴가 발견되었고 경막과의 연결성은 없었다. 수술적 제거 후 심부실비우스뇌수막종으로 진단되었다.

• Journal of Korean Neurosurgical Society
• /
• 제61권1호
• /
• pp.120-126
• /
• 2018

Intraparenchymal meningiomas without dural attachment are extremely rare, especially when they occur in basal ganglia region in child. An 8-year-old boy was admitted at our hospital, complaining of recurrent headache and vomiting for 3 months. Neurological examination showed impaired vision and mild paresis of the left extremities. Magnetic resonance imaging demonstrated a lesion located in the right basal ganglia region extending to superasellar cistern with solid, multiple cystic and necrotic components. Computed tomography revealed calcification within the mass. Due to the anterior cerebral artery involvement, a subtotal resection was achieved and postoperative radiotherapy was recommended. Histopathological examination indicated that the lesion was an atypical meningioma. The postoperative rehabilitation was uneventful. Mildly impaired vision and motor weakness of left extremities improved significantly and the patient returned to normal life after surgery. To our knowledge, intraparenchymal atypical meningioma in basal ganglia extending to superasellar cistern was never reported. The significance in differential diagnosis of lesions in basal ganglia should be emphasized.