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CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2020; 39(02): 149-153
DOI: 10.1055/s-0040-1708894
Case Report | Relato de Caso
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Lymphoplasmacyte-Rich Meningioma of the Third Ventricle: Case Report

Meningioma linfoplasmocítico do terceiro ventrículo: Relato de caso
Marcelo Paglioli Ferreira 
1   Department of Neurosurgery, Hospital São José, Complexo Hospitalar Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, rs, Brazil
,
Eduardo Cambruzzi 
1   Department of Neurosurgery, Hospital São José, Complexo Hospitalar Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, rs, Brazil
,
Otávio Garcia Martins 
2   Department of Neurosurgery, Universidade Federal de Pelotas, RS, Brazil
,
Guilherme Gago 
1   Department of Neurosurgery, Hospital São José, Complexo Hospitalar Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, rs, Brazil
,
Antônio Delacy Martini Vial 
1   Department of Neurosurgery, Hospital São José, Complexo Hospitalar Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, rs, Brazil
› Author Affiliations
Further Information

Publication History

08 October 2019

27 January 2020

Publication Date:
24 April 2020 (online)

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Abstract

Introduction Meningiomas are the most common primary intracranial tumors, accounting for up to 35% of the neoplasms in this category. Approximately 10–20% of these neoplasms are histologically atypical, and the lymphoplasmacyte-rich meningioma (LPM) corresponds to a very rare subtype of meningioma that is characterized histopathologically by massive infiltrates of inflammatory cells. The case described in the present study is the sixth case of an intraventricular LPM found in the literature and the first case considering the location in the third ventricle.

Case Description A 21-year-old male without previous comorbidities sought medical attention due to visual impairment (complaining of intermittent visual blur) for 2 months. A magnetic resonance imaging of the brain confirmed the presence of a well-delimited solid mass in the third ventricle of 3.0 × 2.3 cm with a cystic component that extended itself inferiorly and distorted the visual pathway anatomy. Neurosurgeons decided to access the lesion using an interhemispheric transcallosal approach with a transforaminal access, and the lesion was resected completely. The patient has an ambulatorial endocrinological follow-up and is neurologically stable 6 months after the procedure. No new visual deficits were noted.

Conclusion Lymphoplasmacyte-rich meningioma is a very rare intracranial tumor, and the involvement of the third ventricle make this case unique

Resumo

Introdução Os meningiomas são os tumores intracranianos primários mais comuns, responsáveis por até 35% das neoplasias nessa categoria. Aproximadamente 10–20% desses tumores são histologicamente atípicos, e o meningioma linfoplasmocítico (LPM) corresponde a um subtipo muito raro que é caracterizado histopatologicamente por infiltrados maciços de células inflamatórias. Este é o sexto caso encontrado na literatura de uma LPM intraventricular e o primeiro caso considerando a localização no terceiro ventrículo.

Descrição do caso Um paciente do sexo masculino de 21 anos de idade, sem comorbidades anteriores, procurou atendimento médico devido a deficiência visual (queixa de borramento visual intermitente) por 2 meses. Foi submetido a uma ressonância magnética do cérebro que confirmou a presença de uma massa sólida bem delimitada no terceiro ventrículo de 3,0 × 2,3 cm, com um componente cístico que se estendia inferiormente e distorcia a anatomia da via óptica. Foi decidido acessar a lesão usando uma abordagem transcalosa inter-hemisférica com acesso transforaminal, e a lesão foi ressecada completamente. O paciente tem acompanhamento endocrinológico ambulatorial e está neurologicamente estável 6 meses após o procedimento. Nenhum novo déficit visual foi observado.

Conclusão A LPM é um tumor intracraniano muito raro, e o envolvimento do terceiro ventrículo torna esse caso único.

Keywords

intracranial tumor - meningioma - lymphoplasmacyte-rich meningioma - intraventricular tumor - neuro-oncology

Palavras-chave

tumor intracraniano - meningioma - meningioma linfoplasmocítico - tumor intraventricular - neuro-oncologia
 

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