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Extensive Growth of an Anaplastic Meningioma

DOI: 10.1155/2013/527184

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Abstract:

We present the case of a 30-year-old male patient with an almost complete destruction of the calvarial bone through an anaplastic meningioma diagnosed in line with dizziness. Neuroimaging revealed an extensive growing, contrast enhancing lesion expanding at the supra- and infratentorial convexity, infiltrating and destroying large parts of the skull, and infiltrating the skin. Due to progressive ataxia and dysarthria with proven tumor growth in the posterior fossa in the continuing course, parts of the tumor were resected. A surgical procedure with the aim of complete tumor resection in a curative manner was not possible. Six months after the first operation, due to a new tumor progression, most extensive tumor resection was performed. Due to the aggressive and destructive growth with a high rate of recurrence and tendency of metastases, anaplastic meningiomas can be termed as malignant tumors. The extrinsic growth masks the tumor until they reach a size, which makes these tumors almost unresectable. In the best case scenarios, the five-year survival is about 50%. With the presented case, we would like to show the aggressive behavior of anaplastic meningiomas in a very illustrative way. Chemotherapy, radiotherapy, and surgery reach their limits in this tumor entity. 1. Introduction Meningiomas are usually slowly growing tumors, arising from the arachnoid, and account for 13 to 26% of all intracranial tumors [1]. Parasagittal meningiomas are most frequently seen in up to 20.8%, followed by localisation at the convexity in up to 15.2%, tuberculum sellae in 12.9%, and sphenoid wing in 11.9% [2]. Meningiomas are classified by the World Health Organisation (WHO) into three grades [3–5]. Grade 1 meningiomas are benign lesions and are found in 90% of all cases. Grade 2 meningiomas—also called atypical meningiomas—occur in 5 to 7% of all cases and have a semi-benign behaviour with a higher rate of recurrence compared to grade 1 lesions. Anaplastic meningiomas are diagnosed in only 1 to 3% and are very aggressively growing lesions with the highest recurrence rates after surgical removal of 50% to 75% [3, 6–8]. Despite the wellknown entity of anaplastic meningiomas, physicians are surprised from time to time, facing bizarre manifestations of this disease. Concerning this, we present an exceptional case of a young man with extensive growth of an anaplastic meningioma located supra- and infratentorially with huge destruction of the skull. 2. Case Presentation A 30-year-old male patient presented with pulsation of the skull and dizziness during bending down.

References

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