The patient proceeded to craniotomy and resection of the largest lesions.
Histopathology
MACROSCOPIC DESCRIPTION: 1. "Brain tumour": Two pieces of firm tissue, each 4mm. All in for frozen section. FS DIAGNOSIS: Meningioma - some nuclear atypia (AET). A1. 2. "Brain tumour": An ovoid piece of soft pink fawn tissue 27x14x10mm with attached grey membranous tissue 11x7x1mm at one edge of the specimen. TS x9. A2. (SWB) 3. "Posterior temporal tumour": A portion of brain tissue 36x26x17mm. A6. 4. "Left sphenoid tumour": Multiple fragments of soft and rubbery tan tissue measuring in aggregate 35x35x15mm. A5. (MAS)
MICROSCOPIC DESCRIPTION: 1-4. The sections show moderately cellular tumours with infiltration into the attached dura. They form fascicles and whorls. No sheeting arrangement is seen. The tumour cells have moderately enlarged nuclei and focal conspicuous nucleoli. There is 1 mitosis per 10 high power fields. The blood vessels contain foreign body material, consistent with preoperative embolisation. There is no necrosis. No brain parenchyma is seen. The tumour cells are EMA and PR positive. The Ki-67 index is about 3%. The features are those of meningiomata. There are insufficient features for atypical or malignant change.
DIAGNOSIS: 1-4. Brain tumours: Meningiomata (WHO Grade I).