We present two cases of clear cell meningioma (CCM) in the intracranial and intraspinal region with anaplastic features. On histological examination, both the tumors exhibited unusual anaplastic appearances with nuclear pleomorphism, a high mitotic activity and necrosis, which were different from classical CCMs. The tumor cells were immunoreactive to epithelial membrane antigen (EMA) and vimentin with a high MIB-1 index of 40%. Total excision of the tumors was performed in both cases. The male patient was found to have local recurrence and lateral ventricle metastasis 3 months after the total excision. We reviewed the clinicopathological features, disagnosis and prognosis of the disease. We recommend that postoperative adjuvant radiotherapy or chemotherapy be performed after total tumor excision, and MRI scan every 3-6 months is mandatory during the initial follow-up period.
Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Male ; Meningeal Neoplasms ; immunology ; pathology ; therapy ; Meningioma ; immunology ; pathology ; therapy ; Mucin-1 ; immunology ; Vimentin ; immunology

Secretory meningioma have been described as a distinct variant of meningioma based on their histologic, immunohistochemical and ultrastructural features of epithelial and secretory differentiation of meningothelial cells with accumulation of secretory material in the form of hyaline inclusion. Secretory meningioma is also a benign tumor having similar biological behaviour to that of typical meningiomas: hence, it is important for it to be recognized and diagnosed correctly to avoid unnecessary radiation and chemotherapy. Here we present a case of secretory meningioma with typical morphologic features. The patient was a 56-year-old woman with bilateral visual disturbance. A well-circumscribed mass was present in the left frontal lobe of cerebrum with surrounding edema. The tumor was composed of whorls of meningothelial cells and abundant intra- and extracellular eosinophilic hyaline inclusions which showed immunoreactivity for epithelial membrane antigen(EMA) and carcinoembryonic antigen(CEA). Ultrastructural features also supported epithelial and secretory differentiation of tumor cells.
Brain Neoplasms/immunology/*pathology ; CA-15-3 Antigen/analysis ; Carcinoembryonic Antigen/analysis ; Case Report ; Female ; Human ; Meningioma/immunology/*pathology ; Middle Age ; Tomography Scanners, X-Ray Computed