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Washington University Experience | NEOPLASMS (MENINGIOMA) | Anaplastic | 3A0 Case 3 History
Case 3 History ---- The patient was a 44-year-old woman with a remote history of pituitary adenoma resected in 1989, followed by recurrence, which was treated with fractionated radiation therapy at an outside facility in 2000. In 2006, she developed a right sphenoid wing meningioma, consistent with an atypical meningioma WHO grade II by mitotic activity (8/10HPF), macronucleoli, small cell change, and spontaneous necrosis. Subsequently, she underwent gamma knife radiosurgery to the anterior cranial fossa in 2008. In 2010, she developed an additional recurrence and underwent surgical resection with 4 mitoses/10HPF and a Ki67 proliferative index of 14%. The patient was then noted to have further progression. In 2012, she was begun on somatostatin and a trial of Avastin, which failed due to further progression. She underwent proton treatment completed in July 2013. Following her MRI (3A1-3) the mass was noted to have increased in size as compared with imaging performed in January 2016. Operative procedure: Right fronto-temporal craniotomy for tumor resection.
