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Meningiomatosis of the upper extremities accompanied by choroid plexus meningioma

Djuliana Stoilova, Georgi Mladenov, Yasen Georgiev, Giorgos Andronikou, Ridian Nedelko

Abstract

Introduction: Meningiomatosis is an extremely rare condition characterized by the presence of mul­tiple meningiomas. Ectopic meningiomas are uncommon tumors arising usually in the head or neck and even more rarely they can occur in the lung, mediastinum or skin.

Materials and methods: In this case a 60-year-old man was admitted to a Dermatology ward due to tumor-like lesions on the fingers of both hands. The lesions began appearing three years before the admission being only a cosmetic malaise. However at the time of admittance the patient suffered pain and difficulty in the movement of the small joints of the hand. Biopsy of three lesions was performed, revealing cells characteristic for meningiomas. At the same time, the patient developed a speech dis­order and right-side hemiparesis. After a consult with a neurosurgeon, the patient underwent a con­trast-enhanced computed tomography scan of the brain. It showed a hyperdense tumor formation in the left lateral ventricle that increased in density after application of intravenous contrast. No defor­mation or dislocation signs were observed.

Results: The patient was planned for elective surgery and underwent a dehydration therapy. Three days later a left-sided parieto-occipital craniotomy was performed and through an intergyral ap­proach the occipital horn of left lateral ventricle was reached. After evacuation of cerebral spinal flu­id and retraction of occipital lobe, the microscope was positioned. The tumor was solid and adhered to the choroid plexus. After microdissection of the choroid plexuses` vessels a total tumor mass resec­tion was performed. The next day after surgery the neurological exam revealed no signs of pathology. Full recovery of the neurologic deficit at discharge was observed.

Conclusions: In summary, due to its slow growth and lack of symptoms patients often look for other specialists rather than neurosurgeons. Only three cases similar to this case report have been report­ed in the literature.


Keywords

ectopic meningioma; meningiomatosis




DOI: http://dx.doi.org/10.14748/ssvs.v2i0.4621

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