MENINGIOMA-06 CYSTIC MENINGIOMA CASE STUDY AND LITERATURE REVIEW

BACKGROUND: Intracranial meningiomas are generally solid tumors with a characteristic radiological appearance. The incidence of cystic meningioma is very low. withe an estimated frequency of 1.6 to 11.7%. It is often misinterpreted on radiological only the anatomopathological exams study can confirm the diagnosis. We report an unusual case of cystic meningioma through which we discuss pathogenic, clinical, radiological and therapeutic characteristics. CASE: The patient is a 46 years old woman, with left parieto-occipital headaches for three months with recent appearance of right hemiparesis. The brain scan showed a lesion occupying the left posterior cystic parietal space with a solid nodule and perilesional edema, and enhancement of the solid component and cystic wall. The patient was operated using a left posterioparietal approach.The intraoperative appearance was that of a well defined encapsulated lesion attached to the dura mater, whitish in colour with a cystic part containing xanthochromic liquid and a solid nodule. The tumor is completely extra-axial with a plane of cleavage relative to the peritumoral cortical surface having facilitated its complete excision. Histological examination of the resected confirmed the diagnosis of cystic meningioma. There was no recurrence after 20 months of follow up. CONCLUSION: Cystic meningioma is a rare entity. The diagnosis is often difficult to make preoperatively. Dural tail is a specific radiological sign, but not enough to evoke the diagnosis of meningioma with total precision. The surgical excision must be complete especially before signs of contrast of the cystic wall, in order to avoid a possible recurrence or anaplastic transformation.