case_images: PMC10598861_01
case_images: Brain MRI images of the patient. Enhanced images in sagittal, coronal, and transverse views of the brain demonstrated multiple round-like and irregular uniformly enhanced lesions in the left frontoparietal lobe and cerebral longitudinal fissure, with compression and deformation of the brain tissue, deviation of the brain midline, and dural adhesion, accompanied by obvious bone destruction, and no obvious edema around the lesions [(A-C) illustrate the given information]. The majority of meningiomas exhibiting evident space-occupying effects were successfully excised, leading to a significant alleviation of brain tissue compression. The restoration of brain midline symmetry was essentially achieved; however, a complete resection of the tumor along the intracranial midline was not accomplished. This observation was confirmed by postoperative imaging data obtained after 6 months [(D-F) illustrate the given information].
case_images: fneur-14-1253915-g0001.jpg
case_images: PMC10598861_01_fneur-14-1253915-g0001.jpg
case_images: F1
case_images: Moreover, brain magnetic resonance imaging (MRI) showed multiple round lesions in the left frontoparietal lobe and cerebral longitudinal fissure, accompanied by bone destruction, and the lesion was uniformly enhanced during enhancement (Figure 1). The postoperative imaging revealed partial excision of the intracranial meningiomas, resulting in significant alleviation of brain tissue compression and remarkable improvement in cervicothoracic spinal cord compression (Figures 1, 2 illustrate the given information).
case_images: Spinal cord MRI images of patient. Sagittal enhanced T1 scan of the cervical and thoracic spinal cord showed multiple circular and irregular homogeneous enhanced lesions in the spinal cord, and spindle-shaped homogeneous enhanced lesions in the epidural space, with obvious compression and deformation of the spinal cord, accompanied by bone destruction. Axial enhanced T1 scan of the spinal cord demonstrated homogeneous enhancement of the lesion, lower signal intensity in the center of the tumor than that in the periphery, compression, and deformation of the spinal cord, and spinal dural adhesion [(A-D) illustrate the given information]. The cervicothoracic spinal cord meningiomas with evident space-occupying effect were successfully excised, leading to significant alleviation of compression on the spinal cord tissue. However, a complete resection of the tumors in the upper cervical and lower thoracic spinal cord was not achievable. This observation was confirmed by postoperative imaging data obtained 6 months later [(E-H) illustrate the given information].
case_images: fneur-14-1253915-g0002.jpg
case_images: PMC10598861_01_fneur-14-1253915-g0002.jpg
case_images: F2
case_images: The MRI of the spinal cord showed multiple round and irregular lesions in the cervical and thoracic spinal cord with bone destruction, uniformly enhanced during enhancement (Figure 2). The postoperative imaging revealed partial excision of the intracranial meningiomas, resulting in significant alleviation of brain tissue compression and remarkable improvement in cervicothoracic spinal cord compression (Figures 1, 2 illustrate the given information).
case_images: Histopathological results of the lesions. HE staining of the lesion tissue in the left parietal lobe (A) and cervicothoracic spinal cord (B) showed psammoma bodies around the tumor cells and mature bone tissue formation around the tumor cells (H&E stain, original magnification x 40). Immunohistochemical results of the lesions in the left parietal lobe (C) and cervicothoracic spinal cord (D) showed that the neoplastic meningothelial cells are immunoreactive for epithelial membrane antigen (EMA) (x10), progesterone receptor (PR) (x10), somatostatin receptor 2 (SSTR2)(x10), and Ki67 ~5%.
case_images: fneur-14-1253915-g0003.jpg
case_images: PMC10598861_01_fneur-14-1253915-g0003.jpg
case_images: F3
case_images: Immunohistochemical examination of the lesion showed the EMA (+), PR (+), CD34 (-), GFAP (-), SSTR2 (+), S100 (+), and Ki67 (~3%) (Figure 3).