October 2009 Archives


This 2 year old was noted to have a head tilt for 1 week.  A well-circumscribed, enhancing lesion near the foramina of Luschka displaced the pons.

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Meningioma with clear cell features

The patient is a 5 year old who had a meningioma involving the cavernous sinus at age 2 1/2.  The tumor recurred within 2 years and has not responded well to radiation therapy.
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Clear cell meningioma:

  • Incidence: 0.2 % of all meningiomas, rarest variant
  • WHO Grade II
  • Age: Younger patients
  • Sex:Female predilection in Ped CCMs
  • Locations: Cerebellopontine angle and Intraspinal
  • Recurrence: High rate, up to 61%

Histology:  Solid, clear glycogen rich cells, round and innocuous nuclei, inconspicuous nucleoli,  lack mitotic activity,  distinctive hyalinised stroma.

Immunohistochemistry:  EMA +ve,Vimentin +ve, Inhibin -ve,GFAP -ve , PAS +ve diastase sensitive material.High MIB-1 LI accounts for the high-recurrence rate.

DDX:Differential diagnoses include microcystic meningioma, hemangioblastoma, clear cell ependymoma and metastatic carcinoma.

References: Greenfield's Neuropathology, Sixth Edition

1: Clear cell meningioma, an uncommon variant of meningioma: a clinicopathologic study of nine cases. J. Neurooncol. 2007 Feb;81(3):315-21.

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