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Washington University Experience | NEOPLASMS (MENINGIOMA) | Anaplastic | 22A1 Meningioma, anaplastic (Case 22) H&E 4X
Case 22 History ---- The patient was a 62 year old woman who first underwent a resection for a WHO grade II meningioma in 8/2012. She subsequently underwent external beam radiation, which was completed on 11/2012. The tumor recurred and she underwent stereotactic radiosurgery in 9/2014. She was again diagnosed with recurrence in the same area and underwent a resection of the recurrent tumor in 1/2016, which showed a WHO grade II atypical meningioma. Subsequent MRI showed a residual nodule in the area of the surgery, and she underwent resection in June 2016, which showed a WHO grade I meningioma. She had two additional surgeries for recurrent meningioma in 1/2017 and 9/2017. She had repeated fractionated radiotherapy in October 2017. MRI in September 2018 showed concern for tumor growth, and she was referred to BJH for clinical trials and other treatment options. ---- 22A1-3 This is a spindle cell neoplasm with abundant tumor necrosis. The tumor focally forms whorls and fascicles. Hypercellularity and sheeting architecture are also appreciated but small cell change and macronucleoli are not. Mitotic activity is brisk (focally >20/10HPF).
