Abstract
A case of meningioangiomatosis without association with von Recklinghausen's disease is reported.
A 39-year-old man was admitted because of head injury. Computed tomography (CT) scan showed right acute epidural hematoma, left intracerebral hematoma, and a mass with calcification in the right parietal region. Craniotomy, evacuation of epidural hematoma, and external decompression were performed. Enhanced CT scan revealed that the mass was slightly enhanced around calcification. Angiography demonstrated an avascular mass. Cranioplasty and partial removal of the mass were carried out. Microscopically, irregularly-branched thick-walled blood vessels extended into the gray matter from the meningeal surface, and proliferated blood vessels were surrounded by wavy or concentric arrangement of spindle-form cells in association with intervening neural tissue. A diagnosis of meningioangiomatosis was made. Spindle-form cells were not found to contain S-100 protein. Electron microscopic findings demonstrated that the proliferating cells were composed of spindle-form nuclei rich in heterochromatin and slender cytoplasm containing microfilaments, in association with desmosomal junctions and basal lamina-like structure on occasion. These findings disclosed that spindle-form cells were not derived from Schwann cells but that they may be meningothelial cells in origin.
