Secretory meningioma: A diagnostic pitfall.
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Date
2014-04
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Abstract
Context: Secretory meningioma is a rare subtype of meningiomas,
displaying epithelial and secretory differentiation of meningothelial cells. It
has unique radiological, morphological, and immunohistochemical features,
but runs a benign course. Radiological picture because of the variable
degrees of peritumoral edema can be confused with aggressive neoplasms.
Morphologically, it is diffi cult to distinguish secretory meningioma from other
tumors having a clear cell appearance and aggressive clinical behavior.
Materials and Methods: Retrospective analysis over a period of 16 years
(1997-2012) brought out fi ve cases diagnosed as secretory meningioma. The
slides were restained and subject to special stains and immunohistochemistry
and the clinical details were retrieved. Results: On histopathology, the tumors
showed a characteristic vacuolated appearance due to the presence of variably
sized intracytoplasmic lumina. Another unique feature was the presence of
hyaline inclusions within these intracytoplasmic lumina and in the intercellular
spaces. These inclusions were periodic acid-Schiff positive diastase-resistant,
yellowish-orange on Elastic Van Giesson stain and strongly carcinoembryonic
antigen positive. Conclusion: Owing to its rarity and unique morphology
secretory meningioma poses a diagnostic challenge to the pathologists. As this
tumor follows a benign course, it is crucial to correctly diagnose this entity to
avoid unnecessary over treatment.
Description
Keywords
Carcinoembryonic antigen, hyaline inclusions, secretory meningioma
Citation
Tyagi Ruchita,Vasishta Rakesh Kumar, Kakkar Nandita, Radotra Bishan Dass, Mukherjee K K. Secretory meningioma: A diagnostic pitfall. Indian Journal of Pathology & Microbiology. 2014 Apr-Jun 57 (2): 183-186.