Xanthomatous Meningioma: A Case Report

Özet

Meningioma is a neoplasm derived from meningothelial cells. Grade1 meningiomas consist of 9 different subtypes. One of the raresubtypes is metaplastic meningioma. Metaplastic meningioma could be defined as ‘’xanthomatous meningioma’’ in the presenceof prevalent xanthomatous changes. A 32-year-old male patient presented to the outpatient clinic with complaints of vertigo andtinnitus. Magnetic resonance imaging revealed a large mass lesion of 7.4 cm in the right frontal region with an extra-axial localization.Resection material demonstrated a neoplasm composed of classical meningothelial meningioma areas accompanied with areasof xanthomatous changes, containing cells with clear, vacuolated cytoplasm. Epithelial membrane antigen (EMA), vimentin, andprogesterone expression were evident in both xanthomatous and meningothelial meningioma areas. Additionally, CD68 positivitywas also observed in xanthomatous areas. EMA positivity is a neoplastic marker for xanthomatous cells and is a critical marker todifferentiate these cells from macrophages, which is crucial for pathologists in the differential diagnosis. Xanthomatous meningiomasare quite rare and our case presentation is the 7th one in the current literature.