Meningioma With Tyrosine-Rich Crystalloids: A Case Report and Review of the Literature

• Type of Material: Article
• Authors: Erik Reinertsen, Emory University; Stewart G. Neill, Emory University; Kambiz Nael, Icahn School of Medicine at Mount Sinai; Daniel J Brat, Emory University; Costas G. Hadjipanayis, Mount Sinai Beth Israel Hospital
• Language: English
• Date: 2018-04-01
• Publisher: SAGE Publications (UK and US)
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2017, © The Author(s) 2017.
• Final Published Version (URL): http://dx.doi.org/10.1177/1066896917727100
• Title of Journal or Parent Work: International Journal of Surgical Pathology
• ISSN: 1066-8969
• Volume: 26
• Issue: 2
• Start Page: 157
• End Page: 160
• Keywords: tyrosine; meningioma; crystalloid
• Research Categories: Health Sciences, General; Health Sciences, Medicine and Surgery

Abstract

We report a case of fibrous meningioma with tyrosine-rich crystalloid in the frontal lobe of a middle-aged woman. The patient presented with a history of several years of worsening headaches and blurry vision, which progressed to include syncopal episodes and right-sided weakness. Imaging demonstrated a dural-based extra-axial mass arising from the right orbital roof and extending superiorly along the right frontal convexity causing right-to-left midline shift. The patient underwent a craniotomy and operative resection. Tumor architecture and cytology was similar to that of a Schwannian neoplasm, with spindled cells arranged in a fascicular architecture and displaying focal nuclear palisading. Immunohistochemical stains confirmed a diagnosis of fibrous meningioma. Light microscopy demonstrated extracellular deposits of eosinophilic crystalline material parallel to the spindled tumor cells, reminiscent of “tyrosine-rich” crystals described in salivary gland neoplasms. This is the third meningioma featuring tyrosine-rich crystalloid reported in the literature; we also summarize the previous 2 reports.