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KMID : 0942820120110020163
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Journal of Korean Brain Tumor Society
2012 Volume.11 No. 2 p.163 ~ p.168
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Progressive Malignant Transformation of Recurrent Meningioma : A Case Report
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Lee Won-Seok
Gwak Ho-Shin
Hong Eun-Kyung
Yoo Heon
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Abstract
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We report a case of 39 year old man with stepwise malignant progression from benign to anaplastic meningioma with a transition of atypical meningioma. He received the 1st time craniotomy 5 years ago for parasagittal meningioma and the histopathological diagnosis was benign meningioma of WHO grade 1. Radiation was given to residual tumor at 54 Gy/27 fractions. Four years after the craniotomy, the tumor recurred. Second craniotomy was done and the biopsy was atypical meningioma of WHO grade 2. Residual tumor in the superior sagittal sinus regrew one year later and the third craniotomy was done with excision of involved superior sagittal sinus. The pathological diagnosis was still atypical meningioma, then. Three months after the 3rd craniotomy, the tumor recurred on both parasagittal area and remote cortical surface. The 4th craniotomy was done and the biopsy was turned out to be anaplastic meningioma of WHO grade 3. Adjuvant chemotherapy was given one month after, and the tumor showed mixed response of partial remission and new lesion. The 5th craniotomy was done for both residual tumor and bone flap infection and adjuvant chemotherapy was given again. Five months later, stereotactic radiosurgery was performed for residual enhancing lesion, which was in stable state. With this case, we’d like to discuss about possible genetic alterations associated with the malignant transformation of meningioma, and what can be effective therapy for such residual or recurrent meningiomas.
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KEYWORD
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Meningioma, Malignant, Transformation, Recurrence, Radiation
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