2005 Volume 14 Issue 5 Pages 341-346
We report a rare case of a peritumoral cyst that appeared with a recurrent meningioma after subtotal resection. A 62-year-old man presented with a total aphasia and right hemiparesis. He had undergone a subtotal removal of a left sphenoid ridge meningioma when he was 49 years old. Nine years after his initial operation, a peritumoral cyst emerged from the surrounding brain with perifocal edema, and gradually enlarged with the growing residual tumor. The cyst subsequently became symptomatic. He and his family refused aggressive surgical treatment, and selected the therapeutic option of cyst-aspiration through an Ommaya reservoir system placed under the scalp. As a result, progression of the cyst was arrested, and his symptoms completely disappeared. Four years later, the cyst grew again immediately after head trauma. However, it was successfully treated using the same procedure. We discuss the possible mechanism of this rare event during the clinical course. The present findings strongly suggest that long-standing brain edema plays a significant role in the underlying mechanism of formation of peritumoral cysts associated with meningiomas.
