Meningioma secretório: relato de dois casos

Stávale, João Norberto; Malheiros, Suzana Maria Fleury; Gabbai, Alberto Alain

doi:10.1590/S0004-282X1997000300021

Resumos

Foram estudados dois meningiomas meningoteliais obtidos em cirurgia com inclusões hialinas ou corpos pseudopsamomas. Ambos mostraram expressão de antígeno carcinoembriônico e citoqueratina em células circundando corpos hialinos. Havia difusa imunoexpressão de vimentina e antígeno epitelial de membrana exceto nas células com inclusões hialinas. Ambos se acompanhavam de intenso edema cerebral. Um dos casos apresentava tumores múltiplos, provavelmente meningiomas. É importante não interpretar esta variante de meningioma como neoplasia metastática, o que pode resultar em tratamento paliativo de um tumor potencialmente curável.

meningioma secretário; imuno-histoquimica; edema cerebral; meningiomas múltiplos

Two surgically removed meningotheliomatous meningiomas with hyaline inclusions or pseudopsammoma bodies were studied. Both meningiomas showed expression of carcinoembryonic antigen and cytokeratin in the cells surrounding the hyaline bodies. There was widespread vimentin and epithelial membran antigen except in the cells with hyaline inclusions. Clinically both had a severe cerebral edema. One of the cases showed multiple tumors, problably meningiomas. It is important not to misinterpret this variant of meningioma as metastatic neoplasm which may result in palliative treatment of a potentially curable tumor.

secretory meningioma; immunohistochemistry; cerebral edema; multiple meningiomas

Meningioma secretório: relato de dois casos

Secretory meningioma: a report of two cases

João Norberto Stávale^I; Suzana Maria Fleury Malheiros^II; Alberto Alain Gabbai^II

^IUniversidade Federal de São Paulo - Escola Paulistana de Medicina: Departamento de Anatomia Patológica

^IIUniversidade Federal de São Paulo - Escola Paulistana de Medicina: Disciplina de Neurologia

RESUMO

Foram estudados dois meningiomas meningoteliais obtidos em cirurgia com inclusões hialinas ou corpos pseudopsamomas. Ambos mostraram expressão de antígeno carcinoembriônico e citoqueratina em células circundando corpos hialinos. Havia difusa imunoexpressão de vimentina e antígeno epitelial de membrana exceto nas células com inclusões hialinas. Ambos se acompanhavam de intenso edema cerebral. Um dos casos apresentava tumores múltiplos, provavelmente meningiomas. É importante não interpretar esta variante de meningioma como neoplasia metastática, o que pode resultar em tratamento paliativo de um tumor potencialmente curável.

Palavras-chave: meningioma secretário, imuno-histoquimica, edema cerebral, meningiomas múltiplos.

ABSTRACT

Two surgically removed meningotheliomatous meningiomas with hyaline inclusions or pseudopsammoma bodies were studied. Both meningiomas showed expression of carcinoembryonic antigen and cytokeratin in the cells surrounding the hyaline bodies. There was widespread vimentin and epithelial membran antigen except in the cells with hyaline inclusions. Clinically both had a severe cerebral edema. One of the cases showed multiple tumors, problably meningiomas. It is important not to misinterpret this variant of meningioma as metastatic neoplasm which may result in palliative treatment of a potentially curable tumor.

Key wors: secretory meningioma, immunohistochemistry, cerebral edema, multiple meningiomas.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Aceite: 3-abril-1997.

Dr. João Norberto Stávale - Departamento de Anatomia Patológica - Universidade Federal de São Paulo - Rua Botucatu 740 - 04023-900 São Paulo SP - Brasil.

1. Alguacil-Garcia A, Pettigrew NM, Sima AAF. Secretory meningioma: a distinct subtype of meningioma. Am J Surg Pathol 1986; 10:102-111.
2. Burger PC, Scheithauer BW. Tumors of the central nervous system. Washington: Armed Forces Institute of Pathology, 1994:272-275.
3. Challa VR, Moody DM, Marshall RB, Kelly DL Jr. The vascular component in meningiomas associated with several cerebral edema. Neurosurgery 1980;7:363-368.
4. Ejeckam GC, Azadeh B, Hamad A. Secretory meningioma. Histopathology 1992;21:475-477
5. Hara M, Shimoyama K, Mochimatsu Y Secretory meningiomas associated with marked cerebral edema and intranuclear vacuoles (Poster session). Xllth International Congress of Neuropathology. 1994;4:440.
6. Kepes J. Observations on the formation of psammoma bodies and pseudopsammoma bodies in meningiomas. J Neuropathol Exp Neurol 1961;20:255- 262.
7. Kleihues P, Burger PC, Scheithauer BW. Histologic classification of tumours of the central nervous system. New York: Springer- Verlag, 1993.
8. Louis DN, Hamilton AJ, Sobel RA, Ojemann RG. Pseudopsammomatous meningioma with elevated serum carcicoembryonic antigen: a true secretory meningioma. J Neurosurg 1991 ;74:129-132.
9. Philippon J, Foncin JF, Grob R, Srour A, Poisson M, Pertiuset BF. Cerebral edema associated with meningiomas: possible role of a secretory-excretory phenomenon. Neurosurgery 1984;14:295-301.
10. Russell DS, Rubinstein LS. Pathology of tumors of the nervous system. Ed 5. Baltimore: Williams and Wilkins, 1989:452-473.
11. Tsunoda S, Takeshima T, Sakaki T et al. Secretory meningioma with elevated serum carcinoembryonic antigen level. Surg Neurol 1992;37:415-418.
12. de Vries J, Wakhloo AK. Cerebral oedema associated with WHO-I, WHO-II, and WHO-III - Meningiomas: correlation of clinical, computed tomographic, operative and histological findings. Acta Neurochir (Wien) 1993;125:34-40.

Datas de Publicação

Publicação nesta coleção
18 Out 2010
Data do Fascículo
Set 1997

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Alguacil-Garcia A, Pettigrew NM, Sima AAF. Secretory meningioma: a distinct subtype of meningioma. Am J Surg Pathol 1986; 10:102-111.

[2] 2. Burger PC, Scheithauer BW. Tumors of the central nervous system. Washington: Armed Forces Institute of Pathology, 1994:272-275.

[3] 3. Challa VR, Moody DM, Marshall RB, Kelly DL Jr. The vascular component in meningiomas associated with several cerebral edema. Neurosurgery 1980;7:363-368.

[4] 4. Ejeckam GC, Azadeh B, Hamad A. Secretory meningioma. Histopathology 1992;21:475-477

[5] 5. Hara M, Shimoyama K, Mochimatsu Y Secretory meningiomas associated with marked cerebral edema and intranuclear vacuoles (Poster session). Xllth International Congress of Neuropathology. 1994;4:440.

[6] 6. Kepes J. Observations on the formation of psammoma bodies and pseudopsammoma bodies in meningiomas. J Neuropathol Exp Neurol 1961;20:255- 262.

[7] 7. Kleihues P, Burger PC, Scheithauer BW. Histologic classification of tumours of the central nervous system. New York: Springer- Verlag, 1993.

[8] 8. Louis DN, Hamilton AJ, Sobel RA, Ojemann RG. Pseudopsammomatous meningioma with elevated serum carcicoembryonic antigen: a true secretory meningioma. J Neurosurg 1991 ;74:129-132.

[9] 9. Philippon J, Foncin JF, Grob R, Srour A, Poisson M, Pertiuset BF. Cerebral edema associated with meningiomas: possible role of a secretory-excretory phenomenon. Neurosurgery 1984;14:295-301.

[10] 10. Russell DS, Rubinstein LS. Pathology of tumors of the nervous system. Ed 5. Baltimore: Williams and Wilkins, 1989:452-473.

[11] 11. Tsunoda S, Takeshima T, Sakaki T et al. Secretory meningioma with elevated serum carcinoembryonic antigen level. Surg Neurol 1992;37:415-418.

[12] 12. de Vries J, Wakhloo AK. Cerebral oedema associated with WHO-I, WHO-II, and WHO-III - Meningiomas: correlation of clinical, computed tomographic, operative and histological findings. Acta Neurochir (Wien) 1993;125:34-40.