A 74-year-old woman with a history of a seizure disorder had been followed for several years with a stable and unsymptomatic left parasagittal dural-based brain tumor presumed to be a benign meningioma. Recently, though, the lesion increased in size and hemorrhaged, leaving her significantly paretic on the right side. Neurosurgery thereupon performed a craniotomy for tumor removal. Intraoperative frozen section diagnosis was meningioma. But, upon receipt of the permanent sections, I was impressed by the staghorn vessels at low power and hemangiopericytoma immediately came to mind.
|Staghorn vessels prominent in region below dot marks|
|Psammoma body consistent with original impression that this was simply a meningioma|
|Whirled architecture consistent with meningioma|
|High-power view of clear cell portion of specimen|
|Nephrectomy specimen from 2003 showing renal cell carcinoma, clear cell type|
|Positive RCC Immunohistochemistry|
Han, HS, et al. Metastatic renal cell carcinoma in a meningioma: a case report. J Korean Med Sci. 2000 October 15 (5):593-597.
Here's case number two!
Follow-up: The patient received radiation to the tumor bed and is recovering.