angiomatous meningioma

What is Angiomatous Meningioma?

Angiomatous meningioma is a rare subtype of meningioma, accounting for 2.1-2.59% of all meningiomas [4][12]. It is characterized by the presence of numerous vascular spaces within a typical meningioma [3][9].

Key Features:

• Vascularization: Angiomatous meningiomas are distinguished by their abundance of well-formed vascular channels, sinusoids, or capillaries, which prevail on the background of an otherwise typical meningioma [2].
• WHO Grade I Tumor: This variant is classified as a Grade I tumor according to the World Health Organization (WHO) classification [5][13].
• Microcystic Subtype: Angiomatous meningiomas often coexist with the microcystic subtype of meningioma [6].

Clinical and Radiological Features:

• Age of Onset: The mean age of onset for angiomatous meningiomas is 51.8 years old, which is similar to that of general meningiomas (49.7 years old) [1].
• Five-Year Recurrence Rate: The five-year recurrence rate for angiomatous meningiomas is 5.3%, which is lower than the overall recurrence rate for meningiomas (7%) [1].

Genetic Alterations:

• Chromosome Gains: Angiomatous meningiomas contain multiple chromosome alterations, particularly gains of chromosomes 5 and 20 [10].
• DNA Methylation Profiling: DNA methylation profiling has distinguished six methylation classes in adults, including benign (ben), intermediate (int) A and B, and malignant (mal) classes [10].

Cytogenetic Profile:

• Polysomies of Chromosomes: Angiomatous meningiomas demonstrate a distinct cytogenetic profile characterized by polysomies of at least one chromosome, often involving chromosomes 5, 13, and 20 [11].

Understanding Angiomatous Meningiomas

Angiomatous meningiomas are a rare type of benign brain tumor that can cause various symptoms, depending on their location and size. These tumors are characterized by their rich blood vessel supply, which can lead to peritumoral edema (swelling around the tumor) and signal void signs on magnetic resonance imaging (MRI).

Common Symptoms

The most common symptoms associated with angiomatous meningiomas include:

• Headaches [6]
• Epilepsy or seizures [5, 9]
• Weakness in the arms or legs [3, 5]
• Vision changes, such as

Diagnostic Tests for Angiomatous Meningioma

Angiomatous meningioma, a rare type of meningioma, can be challenging to diagnose. However, various diagnostic tests can help confirm the presence of this condition.

• Immunohistochemistry: This test is used to confirm the diagnosis of angiomatous meningioma if histopathology fails to prove it [7]. The tumor cells show positivity for epithelial membrane antigen (EMA) [3].
• Contrast-Enhanced MRI: Contrast-enhanced magnetic resonance imaging (MRI) can be used to make a tentative diagnosis of meningioma, including angiomatous meningioma [8][9]. This test is also useful for long-term follow-up.
• Histological Examination: Histopathology is essential in diagnosing angiomatous meningioma. The histological findings show predominance of vascular channels over meningothelial elements [6].
• Genetic Analysis: Genetic analysis can help identify specific genetic alterations associated with angiomatous meningioma, such as gains of 5 and 20 chromosomes [10].

Other Diagnostic Considerations

It's essential to consider other conditions that may mimic angiomatous meningioma, such as schwannomas. The main differential diagnosis in this case is meningioma versus solitary fibrous tumor.

• Meningioma: Meningiomas are the most common primary tumors of the cranial and spinal compartments [11]. They represent 39.7% of all primary central nervous system tumors.
• Solitary Fibrous Tumor: Solitary fibrous tumors are rare, benign neoplasms that can occur in the meninges.

Recurrence and Progression

Angiomatous meningiomas demonstrate a distinct cytogenetic profile, with polysomies of at least one chromosome, especially in chromosomes 5, 13, and 20 [12]. The loss of 1p is related to tumor progression and a higher recurrence rate seen in higher-grade tumors.

References:

[3] Context: Immunohistochemistry test for angiomatous meningioma [6] Context: Histological examination findings for angiomatous meningioma [7] Context: Diagnostic tests for angiomatous meningioma, including immunohistochemistry [8] Context: Contrast-enhanced MRI for diagnosing meningiomas [9] Context: Tentative diagnosis of meningioma using contrast-enhanced MRI [10] Context: Genetic analysis for identifying specific genetic alterations in angiomatous meningioma [11] Context: Meningiomas as the most common primary tumors of the cranial and spinal compartments [12] Context: Cytogenetic profile of angiomatous meningioma, including polysomies and loss of 1p

Based on the provided context, it appears that drug treatment for angiomatous meningioma is not a primary or widely used approach.

• According to search result 9, "Meningioma treatments in Arlington, VA, vary depending on the characteristics of the tumor. While surgical treatment aims to achieve the maximum safe resection..." This suggests that surgery is the mainstay of treatment for angiomatous meningioma.
• Search result 11 mentions that "The first treatment for a malignant meningioma is surgery, if possible." This implies that surgery is the initial treatment approach, and additional treatments may be considered after surgery.
• Search result 15 states that "Medicine therapy, also called chemotherapy, rarely is used to treat meningiomas. But it may be used when the meningioma doesn't respond to surgery and radiation." This indicates that chemotherapy is not a commonly used treatment for angiomatous meningioma, but may be considered in cases where other treatments are ineffective.

It's worth noting that search result 2 mentions that "Gross total resection is still the treatment of choice" for angiomatous meningioma, which further emphasizes the importance of surgical resection as a primary treatment approach.

In summary, while there is limited information on drug treatment specifically for angiomatous meningioma, it appears that surgery and possibly radiation therapy are more commonly used approaches. Chemotherapy may be considered in cases where other treatments are ineffective, but it is not a widely used or primary treatment option.

References: * [9] Meningioma treatments in Arlington, VA, vary depending on the characteristics of the tumor. * [11] The first treatment for a malignant meningioma is surgery, if possible. * [15] Medicine therapy, also called chemotherapy, rarely is used to treat meningiomas.

The differential diagnosis for an angiomatous meningioma includes several conditions that can mimic its appearance and behavior. Some of the key differentials are:

• Hemangiopericytoma: This is a type of tumor that is often considered in the differential diagnosis for angiomatous meningioma. It is characterized by its rich vascular structure, which can make it difficult to distinguish from an angiomatous meningioma [1].
• Solitary Fibrous Tumor (SFT): SFTs are rare tumors that can occur in the meninges and are often considered in the differential diagnosis for angiomatous meningioma. They are characterized by their fibrous appearance and can be difficult to distinguish from an angiomatous meningioma [2].
• Hemangioblastoma: This is a type of tumor that is often considered in the differential diagnosis for angiomatous meningioma. It is characterized by its cystic appearance and can be difficult to distinguish from an angiomatous meningioma, especially when it occurs in the spinal cord [3].
• Intracranial Hemangiopericytoma: This is a type of tumor that is often considered in the differential diagnosis for angiomatous meningioma. It is characterized by its rich vascular structure and can be difficult to distinguish from an angiomatous meningioma, especially when it occurs in the brain [4].

It's worth noting that the differential diagnosis for angiomatous meningioma can be challenging due to its unique appearance and behavior. Immunohistochemistry and radiological features are often used to confirm the diagnosis of angiomatous meningioma if histopathology is inconclusive [5].