Atypical meningioma with calvarial involvement

Discussion:

Patient went on to have a resection. 

Histology

MICROSCOPIC DESCRIPTION:

The sections show a moderately cellular meningioma with infiltration into the attached dura. Several nests are in vascular spaces in the dura. The tumor forms whorls. No sheeting arrangement is seen. The tumor cells have enlarged ovoid nuclei with prominent nucleoli. There are up to 12 mitoses per 10 high power fields. Scattered small areas of necrosis are noted. A small amount of cerebral cortex is present and no brain invasion is identified. There is no evidence of malignant change. The features are those of an atypical meningioma. The Ki-67 index is about 18%. Most of the tumor cells are progesterone receptor negative.

Sections of the bone show full thickness invasion by meningioma. 

DIAGNOSIS:

Atypical meningioma (WHO Grade II)

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