Late appearance of meningioma at the site of partially removed oligodendroglioma

Case report

Restricted access

✓ A case is presented in which a meningioma and a glioma grew in the region where, 23 years before, a glial tumor had been partially removed and irradiated. The authors suggest that surgical trauma and ionizing radiation may have influenced the tumor's development.

Article Information

Address reprint requests to: Julio H. Garcia, M.D., University of Maryland Hospital, 22 South Greene, Baltimore, Maryland 21201.

© AANS, except where prohibited by US copyright law.

Headings

Figures

  • View in gallery

    Histological preparations of the first tumor, removed at the age of 17. The cells have large nuclei and scanty cytoplasm; no specific patterns break the monotony of their arrangement. Left: PTAH, × 40. Right: PTAH, × 100.

  • View in gallery

    Arteriography of tumor recurrence. Upper Left: Lateral projection shows downward and posterior displacement of the callosomarginal and pericallosal arteries and branches of the anterior Sylvian artery. The anterior ethmoidal (ant eth) branch of the ophthalmic artery can be seen entering the anterior fossa and supplying the anterior falx artery (ant falx). Upper Right: Enlargement of this view shows that the periphery of the large tumor (outlined by arrows) is delimited by abundant newly formed vessels and an early draining vein (most anterior arrow); both of these features are commonly seen in gliomas. In the upper portion of the tumor there is a “sunburst” appearance (crossed arrow) supplied by the anterior falcial and a branch of the pericallosal arteries, findings characteristic of a meningioma. Lower Left: Anteroposterior view shows a frontal shift of the pericallosal and callosomarginal arteries. The anterior falx artery ascends to the left of the midline and increases in caliber slightly as it reaches the upper part of the tumor. A large polar branch of the callosomarginal artery (arrow) enters the upper portion of the tumor.

  • View in gallery

    Photomicrographs characteristic of the two neoplasms resected 23 years after the first tumor removal. Upper: Meningiomatous portion with elongated, fusiform cells arranged in whorls. Psammoma bodies, now shown, were also easily demonstrated. H & E, × 25. Lower: Gliomatous portion of tumor. Small cells with a scanty cytoplasm are arranged in pseudorosette patterns consistent with oligodendroglioma. Lower Left: H & E, × 25. Lower Right: PTAH, × 100.

References

  • 1.

    Alexander WS: Multiple primary intracranial tumors. Meningioma associated with a glioma. Report of a case. J Neuropathol Exp Neurol 7:81881948Alexander WS: Multiple primary intracranial tumors. Meningioma associated with a glioma. Report of a case. J Neuropathol Exp Neurol 7:81–88 1948

    • Search Google Scholar
    • Export Citation
  • 2.

    Brooks WHNetsky MGNormanseil DEet al: Depressed cell-mediated immunity in patients with primary intracranial tumors. Characterization of a humoral immunosuppressive factor. J Exp Med 36:163116471972Brooks WH Netsky MG Normanseil DE et al: Depressed cell-mediated immunity in patients with primary intracranial tumors. Characterization of a humoral immunosuppressive factor. J Exp Med 36:1631–1647 1972

    • Search Google Scholar
    • Export Citation
  • 3.

    Cushing HEisenhardt L: Meningiomas. Their Classification Regional Behavior Life History and Surgical End Results. Springfield, IllCharles C Thomas1938Cushing H Eisenhardt L: Meningiomas. Their Classification Regional Behavior Life History and Surgical End Results. Springfield Ill Charles C Thomas 1938

    • Search Google Scholar
    • Export Citation
  • 4.

    Gass HVan Wagener WP: Meningioma and oligodendroglioma adjacent in the brain. Case report. J Neurosurg 7:4404431950Gass H Van Wagener WP: Meningioma and oligodendroglioma adjacent in the brain. Case report. J Neurosurg 7:440–443 1950

    • Search Google Scholar
    • Export Citation
  • 5.

    Geissenger JDBucy PC: Astrocytomas of the cerebellum in children: long-term study. Arch Neurol 24:1251351971Geissenger JD Bucy PC: Astrocytomas of the cerebellum in children: long-term study. Arch Neurol 24:125–135 1971

    • Search Google Scholar
    • Export Citation
  • 6.

    Kornblith PLDohan FCWood WCet al: Human astrocytoma: serum-mediated immunologic response. Cancer 33:151215191974Kornblith PL Dohan FC Wood WC et al: Human astrocytoma: serum-mediated immunologic response. Cancer 33:1512–1519 1974

    • Search Google Scholar
    • Export Citation
  • 7.

    Mayo CMBarron KD: Concurrent glioma and primary intracranial sarcoma. A report of 2 cases and review of the literature. Neurology (Minneap) 16:6626721966Mayo CM Barron KD: Concurrent glioma and primary intracranial sarcoma. A report of 2 cases and review of the literature. Neurology (Minneap) 16:662–672 1966

    • Search Google Scholar
    • Export Citation
  • 8.

    Modan BBaidatz DMart Het al: Radiation-induced head and neck tumors. Lancet 1:2772791974Modan B Baidatz D Mart H et al: Radiation-induced head and neck tumors. Lancet 1:277–279 1974

    • Search Google Scholar
    • Export Citation
  • 9.

    Norwood CWKelly DLDavis CH Jret al: Irradiation-induced mesodermal tumors of the central nervous system: report of two meningiomas following x-ray treatment for gliomas. Surg Neurol 2:1611641964Norwood CW Kelly DL Davis CH Jr et al: Irradiation-induced mesodermal tumors of the central nervous system: report of two meningiomas following x-ray treatment for gliomas. Surg Neurol 2:161–164 1964

    • Search Google Scholar
    • Export Citation
  • 10.

    Roberts MGerman WJ: A long-term study of patients with oligodendrogliomas. Follow-up of 50 cases, including Dr. Harvey Cushing's series. J Neurosurg 24:6977001966Roberts M German WJ: A long-term study of patients with oligodendrogliomas. Follow-up of 50 cases including Dr. Harvey Cushing's series. J Neurosurg 24:697–700 1966

    • Search Google Scholar
    • Export Citation
  • 11.

    Rubinstein LJ: The development of contiguous sarcomatous and gliomatous tissue in intracranial tumors. J Pathol Bacteriol 71:4414591956Rubinstein LJ: The development of contiguous sarcomatous and gliomatous tissue in intracranial tumors. J Pathol Bacteriol 71:441–459 1956

    • Search Google Scholar
    • Export Citation
  • 12.

    Rubinstein LJ: Morphological problems of brain tumors with mixed cell population. Acta Neurochir (Wien) (Suppl) 10:1411581964Rubinstein LJ: Morphological problems of brain tumors with mixed cell population. Acta Neurochir (Wien) (Suppl) 10:141–158 1964

    • Search Google Scholar
    • Export Citation
  • 13.

    Rubinstein LJ: Tumors of central nervous system. in Atlas of Tumor Pathology 2nd Series Washington DCArmed Forces Institute of Pathology1972Rubinstein LJ: Tumors of central nervous system in Atlas of Tumor Pathology 2nd Series. Washington DC Armed Forces Institute of Pathology 1972

    • Search Google Scholar
    • Export Citation
  • 14.

    Russell DSRubinstein LJ: Pathology of Tumors of the Nervous System ed 3. BaltimoreWilliams & Wilkins1971Russell DS Rubinstein LJ: Pathology of Tumors of the Nervous System ed 3. Baltimore Williams & Wilkins 1971

    • Search Google Scholar
    • Export Citation
  • 15.

    Shuangshoti S: Neoplasms of mixed mesenchymal and neuroepithelial origin: liposarcomatous meningioma combined with gliomas. J Neurol Neurosurg Psychiatry 36:3773821973Shuangshoti S: Neoplasms of mixed mesenchymal and neuroepithelial origin: liposarcomatous meningioma combined with gliomas. J Neurol Neurosurg Psychiatry 36:377–382 1973

    • Search Google Scholar
    • Export Citation
  • 16.

    Shuangshoti SNetsky MG: Brain tumor of mixed mesenchymal and neuroepithelial origin. Case report. J Neurosurg 34:8088131971Shuangshoti S Netsky MG: Brain tumor of mixed mesenchymal and neuroepithelial origin. Case report. J Neurosurg 34:808–813 1971

    • Search Google Scholar
    • Export Citation
  • 17.

    Shuangshoti SNetsky MG: Neoplasms of mixed mesenchymal and neuroepithelial origin: relation to “monstrocellular sarcoma” or “Giant-celled glioblastoma.” J Neuropathol Exp Neurol 30:2903091971Shuangshoti S Netsky MG: Neoplasms of mixed mesenchymal and neuroepithelial origin: relation to “monstrocellular sarcoma” or “Giant-celled glioblastoma.” J Neuropathol Exp Neurol 30:290–309 1971

    • Search Google Scholar
    • Export Citation
  • 18.

    Shuangshoti SNetsky MGJane JA: Neoplasms of mixed mesenchymal and neuropithelial type with consideration of the relationship between meningioma and neurilemoma. J Neurol Sci 14:2772911971Shuangshoti S Netsky MG Jane JA: Neoplasms of mixed mesenchymal and neuropithelial type with consideration of the relationship between meningioma and neurilemoma. J Neurol Sci 14:277–291 1971

    • Search Google Scholar
    • Export Citation
  • 19.

    Walsh JGye RConnelley TJ: Meningioma: a late complication of head injury. Med J Aust 1:9069081969Walsh J Gye R Connelley TJ: Meningioma: a late complication of head injury. Med J Aust 1:906–908 1969

    • Search Google Scholar
    • Export Citation
  • 20.

    Zimmerman HMNetsky MGDavidoff LM: Atlas of Tumors of the Nervous System. PhiladelphiaLea and Febiger1956Zimmerman HM Netsky MG Davidoff LM: Atlas of Tumors of the Nervous System. Philadelphia Lea and Febiger 1956

    • Search Google Scholar
    • Export Citation

TrendMD

Metrics

Metrics

All Time Past Year Past 30 Days
Abstract Views 110 110 9
Full Text Views 170 144 0
PDF Downloads 70 54 0
EPUB Downloads 0 0 0

PubMed

Google Scholar