md-medicaldata

Authors

Veljko Pantelić¹(1997), Milica Gleđa¹(1998), Bojan Jelača^1,2(1985)

¹Univerzitetski klinički centar Vojvodine, Klinika za neurohirurgiju, Novi Sad, Srbija
²Univerzitet u Novom Sadu, Medicinski fakultet Novi Sad, Srbija

 

UDK: 616.714-006-089

The paper was received / Rad primljen 08.10.2025.

Accepted / Rad prihvaćen: 14.10.2025.

 

Correspondence to:

Veljko Pantelić
Univerzitetski klinički centar Vojvodine,
Klinika za neurohirurgiju
Hajduk Veljkova 1-9,
21000, Novi Sad,
e-mail: vpantelic97@gmail.com

 

 

Sažetak

 

 

Uvod: Intraparenhimski meningeomi predstavljaju retku i dijagnostički izazovnu grupu intrakranijalnih tumora. Njihova intraaksijalna lokalizacija i atipične radiološke karakteristike često dovode do obmanjujućih preoperativnih nalaza otežavajući planiranje neurohirurškog lečenja. Prikaz slučaja: Prikazana je pacijentkinja starosti 23 godine sa epileptičkim napadom. CT i MR pregledi glave ukazivali su na intraaksijalnu leziju u desnom frontalnom režnju sa intralezionim kalcifikatima i diskretnim psotkontrastnim pojačanjem, što je sugerisalo na glijalni tumor. Pacijentkinja je elektivno hirurški zbrinuta; intraoperativno je uočena jasno ograničena, elastična i vaskularizovana lezija. Uzorci su poslati na patohistološku analizu koja je potvrdila Meningeoma meningotheliale partim psamosum. Kontrolni MR pregledi godinu i dve godine nakon operacije nisu pokazali recidiv, a pacijentkinja nije imala nove epileptične napade. Zaključak: Iako retki, intraparenhimski meningeomi mogu izazvati dijagnostičku konfuziju zbog svoje intraaksijalne lokalizacije i atipičnih radioloških karakteristika. Multidisciplinarni pristup, uključujući detaljnu neuroradiološku procenu, intraoperativnu patohistološku analizu i hirurško uklanjanje, od ključnog je značaja za postizanje ablacije tumorske promene i povoljne prognoze. Pravovremeno prepoznavanje ovih tumora omogućava adekvatno planiranje terapije, smanjuje rizik od postoperativnih komplikacija i recidiva i naglašava potrebu za uključivanjem intraparenhimskog meningeoma u diferencijalnu dijagnozu intraaksijalnih lezija.

 

Ključne reči:

meningeom, glijalni tumori, generalizovani tonično-klonični napadi, diferencijalna dijagnoza

 

 

 

Abstract

 

Introduction Intraparenchymal meningiomas represent a rare and diagnostically challenging group of intracranial tumors. Their intra-axial location and atypical radiological features often lead to misleading preoperative findings, complicating the planning of neurosurgical management. Case report We report a 23-year-old female patient who presented with an epileptic seizure. CT and MRI scans of the head revealed an intra-axial lesion in the right frontal lobe with intralesional calcifications and subtle post-contrast enhancement, suggesting a glial tumor. The patient underwent elective surgical treatment; intraoperatively, a well-demarcated, elastic, and vascularized lesion was observed. Tissue samples were sent for histopathological analysis, which confirmed a meningothelial meningioma with partial psammomatous features (WHO I). Follow-up MRI scans at one and two years postoperatively showed no recurrence, and the patient did not experience further seizures. Conclusion Although rare, intraparenchymal meningiomas can cause diagnostic confusion due to their intra-axial location and atypical radiological characteristics. A multidisciplinary approach, including detailed neuroradiological assessment, intraoperative histopathological analysis, and surgical resection, is essential for achieving complete tumor removal and a favorable prognosis. Timely recognition of these tumors allows appropriate treatment planning, reduces the risk of postoperative complications and recurrence, and underscores the importance of including intraparenchymal meningioma in the differential diagnosis of intracranial lesions.

 

Key words:

Meningioma, glioma, generalized tonic-clonic seizures, differential diagnosis

 

 

 

 

References:

1. Ogasawara C, Philbrick BD, Adamson DC. Meningioma: A review of epidemiology, pathology, diagnosis, treatment, and future directions. Biomedicines. 2021;9(3):319.
2. Ohba S, Abe M, Hasegawa M, Hirose Y. Intraparenchymal Meningioma: Clinical, Radiologic, and Histologic Review. World Neurosurg. 2016;92:23-30.
3. Papic V, Lasica N, Jelaca B, Vuckovic N, Kozic D, Djilvesi D, et al. Primary intraparenchymal meningiomas: a case report and a systematic review. World Neurosurg. 2017;108:989.e9-989.e21.
4. Ogasawara C, Philbrick BD, Adamson DC. Intraparenchymal meningioma: clinical, radiologic, and histologic review. World Neurosurg. 2016;92:23-30.
5. Khojah O, Aljohani S, Aldahlawi A, Samkari A, Alzahrani M. Intraparenchymal meningioma in the parieto-occipital region: A case report of a diagnostically challenging tumor. Surg Neurol Int. 2023 Apr 14;14:135.
6. Li Z, Tang T, Yan Z, Lu Y, Liu M, Huang H, et al. Leveraging pathological markers of lower-grade glioma to predict the occurrence of secondary epilepsy: a retrospective study. Sci Rep. 2025;15(1):23907.
7. Kommu VR, Kodandapani S, Perubhotla LM, Sudhir R. An intraparenchymal meningioma mimicking glioma: a case report with review of literature. International Journal of Neurooncology. 2022;5(1):14-17.
8. Jadik S, Stan AC, Dietrich U, Pietilä TA. Intraparenchymal meningioma mimicking cavernous malformation: a case report. J Med Case Rep. 2014;8:467.
9. Matsuda M, Sugii N, Sakamoto N, Yamano A, Ishikawa E. Significance of 5-ALA-guided fluorescence in resection of meningiomas: a prospective clinical study. Cancers (Basel). 2025;17(7):1191.
   

PDF: 05-Pantelić V. et al MD-Medical Data 2025;17(3) 167-169.pdf