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Washington University Experience | NEOPLASMS (MENINGIOMA) | Gross Pathology | 72A1 NCL (Case 72) Gross_1

Case 72 History ---- This patient was a 50 year old woman with a 15 year course of gradual cognitive and functional deterioration as part of a kindred with adult onset neuronal ceroid lipofuscinosis (Kufs disease). Her neurologic symptoms began with new-onset generalized tonic-clonic seizures and progressed to myoclonus, psychosis and profound dementia. ---- The tissue section reveals a meningioma (WHO grade 1) without evidence of brain invasion. Although the tumor shows a suggestion of sheet-like growth and some moderately prominent nucleoli in a subset of cells, the overall findings are insufficient to merit the designation of atypical meningioma. The only imaging performed was a CT scan 15 years prior to her death which was reported as unremarkable. I am not sure who prepared and photographed this case at autopsy but they should be proud of this preparation which graphically teaches that a “benign” WHO Grade 1 meningioma can cause significant damage to the underlying brain. My gratitude to them! ---- 72A1,2 A pink, soft mass (7 cm x 6 cm x 6 cm) was adherent to the dura mater and apparently penetrated it and depressed the right dorsal prefrontal lobe by 4 cm causing gross distortion. Notice the knobby (“bosselated”) appearance.

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