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Museum of Pathology

BILATERAL MENINGIOMAS INVOLVING BRAIN

BILATERAL MENINGIOMAS INVOLVING BRAIN

Clinical History

Following parturition 19 years before admission this 56 year old female began to suffer from generalized epileptiform fits. For 15 years this had been associated with severe retro-orbital headache and for 12 months with nausea and vomiting. The patient stated that following a fit there was left-sided weakness. Examination revealed a right and left nystagmus on lateral deviation, a left facial paresis, left-sided hyperreflexia and absent right-sided reflexes. The right side of the body was also colder compared with the left. Skull x-ray showed evidence of raised intracranial pressure. 2 large dense areas of calcification were present in the brain: one near the midline in the anterior portion of the parietal area, and the second on the right side situated more laterally in the posterior parietal area. In the ward the patient deteriorated and died.

Pathology

The specimen is of 2 pieces of brain sliced coronally. That on the right shows a well encapsulated lobulated tumour 4 x 5 cm, pinkish colour, with some scattered haemorrhagic areas, situated within the lateral ventricle on the left-hand side of the brain. The tumour is well-defined and is displacing and not invading cerebral tissue. Similar, but more variegated tumour, is shown on the left. There is a small projection inferiorly, 1.5 cm in diameter and the ventricular cavity may be seen between the main tumour and this projection. A small area of softening, 1 cm in diameter, is present in the parietal region. Histological examination showed these to be typical meningiomas with plentiful calcified granules (psammoma bodies).