Brain Pathology Case of the Month - May 2002

Contributed by Monika A Wrzolek, MD(1) and David Zagzag, MD(2)
(1) Staten Island University Hospital,   (2) New York University School of Medicine

Published on line in May 2002


Case 1. A thirty-eight year old man presented with new onset seizures. Physical and neurological examination s were unremarkable. Routine preoperative laboratory work-up was noncontributory. CT scan revealed left frontal extra-axial mass with localized bony sclerosis of the skull, peritumoral edema and shift to the right. Post contrast scan showed strong homogeneous enhancement of the lesion (Fig. 1). The patient had gross total resection of the mass, which on both clinical and radiological grounds was believed to be a meningioma. Postoperative course was uneventful, and he was asymptomatic when last seen three years after the surgery.

Case 2. A 69-year old woman presented with bilateral headaches and episodes of syncope. Physical and neurological examination was unremarkable. CT scan of the head revealed a left tentorial mass, with somewhat irregular contour, which enhanced on contrast study (Fig. 2). Presumptive diagnosis of a meningioma was made, and she underwent gross total resection of the tumor. After the pathological diagnosis was rendered, the patient was referred to a hematologist. Clinical evaluation revealed no other sites of disease. There was no evidence of recurrence when she was last seen five years after surgery.



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