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Query: UMLS:C0012833 (dizziness)
 9,689 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

"Primary" ear and temporal bone meningiomas are tumors that are frequently misdiagnosed and unrecognized, resulting in inappropriate clinical management. To date, a large clinicopathologic study of meningiomas in this anatomic site has not been reported. Thirty-six cases of ear and temporal bone meningiomas diagnosed between 1970 and 1996 were retrieved from our files. Histologic features were reviewed, immunohistochemical analysis was performed (n = 19), and patient follow-up was obtained (n = 35). The patients included 24 females and 12 males, aged 10-80 years (mean, 49.6 years), with female patients presenting at an older age (mean, 52.0 years) than male patients (mean, 44.8 years). Patients presented clinically with hearing changes (n = 20), otitis (n = 7), pain (n = 5), and/or dizziness/vertigo (n = 3). Symptoms were present for an average of 24.6 months. The tumors affected the middle ear (n = 25), external auditory canal (n = 4), or a combination of temporal bone and middle ear (n = 7). The tumors ranged in size from 0.5 to 4.5 cm in greatest dimension (mean, 1.2 cm). Radiographic studies demonstrated a central nervous system connection in 2 patients. Histologically, the tumors demonstrated features similar to those of intracranial meningiomas, including meningothelial (n = 33), psammomatous (n = 2), and atypical (n = 1). An associated cholesteatoma was identified in 9 cases. Immunohistochemical studies confirmed the diagnosis of meningioma with positive reactions for epithelial membrane antigen (79%) and vimentin (100%). The differential diagnosis includes paraganglioma, schwannoma, carcinoma, melanoma, and middle ear adenoma. Surgical excision was used in all patients. Ten patients developed a recurrence from 5 months to 2 years later. Five patients died with recurrent disease (mean, 3.5 years), and the remaining 30 patients were alive (n = 25, mean: 19.0 years) or had died (n = 5, mean: 9.5 years) of unrelated causes without evidence of disease. We conclude that extracranial ear and temporal bone meningiomas are rare tumors histologically similar to their intracranial counterparts. They behave as slow-growing neoplasms with a good overall prognosis (raw 5-y survival, 83%). Extent of surgical excision is probably the most important factor in determining outlook because recurrences develop in 28% of cases.
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PMID:Primary ear and temporal bone meningiomas: a clinicopathologic study of 36 cases with a review of the literature. 1264 Jan 4

The January Case of the Month (COM). A 56 year-old female presented with a 5-month history of dizziness, focal motor seizures and progressive immobility. CT scan showed a large frontal tumor with a meningioma-like pattern. The patient underwent right frontal craniotomy and complete resection of the tumor. Biopsy showed lymphoid infiltrates consisting predominantly of centrocyte-like cells admixed with plasma cells and lymphoid follicles. Immunohistochemistry revealed CD20-positive cells and light chain restriction with reactive T cells. These appearances are characteristic of the MALT-type lymphomas. There was no evidence of systemic lymphoma. The patient is symptom-free 18 months after complete resection. MALT lymphoma is rare but recognized subtype of primary meningeal lymphoma. MALT lymphoma of dura tends to be relatively indolent, with excellent prognosis. It is suggested that meningeal MALT-type lymphoma may follow on from a pre-existing inflammatory process.
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PMID:January 2003: 56-year-old female with right frontal tumor of the dura. 1294 31

We report a case of primary intraventricular malignant meningioma in a 74-year-old man who presented with progressive weakness of the left limbs and dizziness, The preoperative magnetic resonance (MR) imaging of the head initially suggested that a glioblastoma multiforme or a metastatic lesion might be present. But later, the excised tumor was histologically diagnosed as a primary malignant meningioma. So far, only a few cases of intraventricular malignant meningioma have been reported. The MR imaging of this tumor has rarely been described in the literature. In the present case, the mass lesion showed hyperintensity on the T1-weighted image (T1WI) and hypointensity on the T2-weighted image (T2WI) which was not commonly seen in meningioma. The unusual MR imaging of this case may be attributed to the intratumoral hemorrhage. Although intraventricular malignant meningioma is difficult to diagnose based on MR or computed tomographic images alone, the characteristics of the MR images in the present case may offer an option for preoperative differential diagnosis of intraventricular tumors.
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PMID:Intraventricular malignant meningioma: one case report. 1294 71

A 51-year-old woman presented with a fourth ventricle meningioma manifesting as a 2-week history of dizziness and vomiting. Computed tomography (CT) and magnetic resonance (MR) imaging revealed a round mass lesion in the fourth ventricle. Thallium-201 chloride single photon emission computed tomography (201TlCl SPECT) showed high and rapid uptake on the early image and rapid washout on the delayed image. The preoperative diagnosis of meningioma could be established based on these findings. Total removal of the tumor was successfully performed. 201TlCl SPECT is useful for the preoperative diagnosis of fourth ventricle meningioma combined with CT, MR imaging, and angiography.
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PMID:Usefulness of thallium-201 chloride single photon emission computed tomography for the preoperative diagnosis of fourth ventricle meningioma--case report. 1568 99

A 67-year-old male presented with a clear cell ependymoma with symptoms of ataxic gait and dizziness. Magnetic resonance imaging showed a ring enhanced and circumscribed mass lesion with some cysts in the left cerebellar hemisphere, and the vertebral artery angiogram showed the vascurality of the tumor fed by both the left posterior inferior cerebellar artery and the left superior cerebellar artery mainly. They demonstrated suspicious finding of metastatic tumor, glioblastoma, or cystic meningioma. Surgery via the left suboccipital approach revealed a whitish and solid tumor, which was demarcated from the cerebellar parenchyma and had no continuity with the 4th ventricle. Total resection of the tumor was successfully performed. The hematoxilyn-eosin staining of the surgical specimen was similar to hemangioblastoma or oligodendroglioma, however, immunohistochemical findings for glial fibrillary acidic protein, vimentin, epithelial membrane antigen, and factor VIII were compatible with clear cell ependymoma. The patient's postoperative course was uneventful, and his symptoms improved. Clear cell ependymoma is known as a variant of ependymoma, which is usually located at the foramen of Monro. We think that the immunohistochemical study is highly helpful for the diagnosis of the cerebellar tumor with atypical presentation such as our case.
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PMID:[Immunohistochemical study is helpful for the diagnosis of cerebellar clear cell ependymoma with atypical radiological findings--case report]. 1627 26

Meningioma of the internal auditory canal is very rare. There are only 15 previous reports of intracanalicular meningioma. The authors add a case report of a patient with meningioma of the internal auditory canal. A 31-year-old woman presented with a one-year history of headache, dizziness, hearing loss and left facial paralysis. An MRI of the temporal bone demonstrated a tiny isointense intracanalicular tumor with inhomogeneous enhancement. In the operative field carried out by translabyrinthine approach, the tumor was found in the IAC without intracranial involvement. Pathology revealed a meningioma. The patient was followed up for 2 years without recurrence.
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PMID:Meningioma of the internal auditory canal: a case report. 1647 Nov 23

There are numerous histologic variants of meningioma. Among the more uncommon are intracranial masses composed of meningiomatous and plasma cell-lymphocytic elements. We report a 22-year-old woman with lymphoplasmacyte-rich meningioma who initially presented with dizziness and progressive headache. Neuroradiologic images revealed typical meningiomas of the sphenoid ridge with extensive perifocal edema. Complete macroscopic removal of the tumor was performed. Histologic examination revealed a meningioma with massive infiltrates of plasma cells and lymphocytes. Brain computed tomography on the 6th postoperative day revealed total removal of the tumor with marked reduction of brain edema. Complete resolution of symptoms occurred with no evidence of tumor recurrence during 2 years of follow-up.
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PMID:Sphenoid ridge lymphoplasmacyte-rich meningioma. 1687 41

An 80-year-old male visited the hospital as an outpatient with a head injury sustained in a traffic accident. Brain computed tomography incidentally revealed a left frontal lobe tumor measuring 5 cm in a diameter. The patient had a history of taking chlormadinone acetate (a progesterone agonist) prescribed several years previously as treatment for benign prostatic hypertrophy. The tumor was seen as an isointense lesion on T(1)-weighted magnetic resonance (MR) images with enhancement by gadolinium, and as a heterogeneously hyperintense mass on T(2)-weighted MR images. The tentative diagnosis was left frontal meningioma attached to the sphenoid ridge or sphenoid plane. The patient was managed conservatively because of his advanced age and no symptoms or progression were observed during a 9-month follow-up period. The medication for benign prostatic hypertrophy was changed from chlormadinone acetate to naftopidil (an alpha-2-blocker) about 9 months after his first presentation. The patient presented again 2 years later complaining of dizziness. Computed tomography and MR imaging performed at this time revealed remarkable regression of the tumor. The signal intensity change with regression of the tumor on T(2)-weighted images was observed as a hypointense lesion. Thus, we wish to emphasize that treatment of meningiomas, especially those diagnosed incidentally, must be based on a thorough consideration of any history of hormonal therapy with prostate disease.
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PMID:Spontaneous regression of an asymptomatic meningioma associated with discontinuation of progesterone agonist administration. 1849 98

Primary central nervous system (CNS) marginal zone B-cell lymphoma (MZBL) is very rare and shows an indolent disease course with potential of being cured. It seems to originate from meningothelial cells, and the most common site of occurrence is the dura of the cerebral convexity. Primary CNS MZBL is often misdiagnosed as meningioma because of its similar tumor locations and appearances on magnetic resonance imaging (MRI). Surgery, radiation therapy, chemotherapy, and combinations of these are considered treatment modalities depending on the case. Herein, we describe an 18-year-old man who presented with acute onset of right-sided central facial nerve palsy, right-sided hemiparesis with motor power grade 4+, dizziness, and dysarthria. After an MRI scan of the brain, wherein he was first diagnosed with high-grade glioma, a biopsy sample showed that he had primary CNS MZBL arising in the left basal ganglia. He was treated with radiation therapy, which resulted in complete remission for 1 year and 10 months up to the date of this case report. It is important to diagnose primary CNS MZBL correctly because it is curable without unnecessary invasive treatment in cases of localized disease.
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PMID:Primary central nervous system marginal zone B-cell lymphoma of the Basal Ganglia mimicking low-grade glioma: a case report and review of the literature. 1885 86

Metastatic meningioma is extremely rare, occurring in an estimated 0.1% of cases. We report a case of pediatric meningioma metastatic to cervical soft tissue and lymph nodes. An 8-year-old boy presented with headaches, dizziness, and involuntary eye flickering. Magnetic resonance imaging (MRI) revealed a 7.5-cm parasagittal, dural-based mass with venous sinus encasement. Therapeutic embolization was followed by bilateral craniotomy, achieving subtotal resection. Histopathologic examination revealed an atypical meningioma with regions of hypercellularity, small cell morphology, sheeting architecture, increased mitoses, and brain invasion. Surveillance MRI studies showed growth of residual tumor and enlarging cervical soft tissue masses with posterior triangle lymphadenopathy. Radiation and surgical resection were employed for the intracranial tumor burden; resection of the soft tissue masses revealed metastatic meningioma, with soft tissue infiltration and metastasis to 8 lymph nodes. This case demonstrates the aggressive biologic potential of pediatric meningiomas, with potential for distant spread via cerebrospinal fluid leakage and lymphatic invasion.
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PMID:Aggressive pediatric meningioma with soft tissue and lymph node metastases: a case report. 1908 45


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