Nasoethmoidal Meningioma with Cytogenetic Features of Tumor Aggressiveness in a 16-Year-Old Child

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Abstract
The case of a 16-year-old girl is presented who was admitted to our hospital because of severe frontal headache. Magnetic resonance scans revealed a nasoethmoidal tumor on the right side, with erosion of the skull base and invasion of the right orbit. A needle biopsy specimen revealed the histological diagnosis of a fibroblastic meningioma (WHO grade II), with histochemically determined partial activity loss of alkaline phosphatase. The tumor was completely resected by a combined intracranial-transbasal and transnasal approach. In this case, we found a meningioma with deletion of the short arm of chromosome 1 through a translocation between chromosomes 1 and 11 [t(1;11)] as well as additional chromosomal aberrations, including partial or complete monosomy of chromosomes 2, 6, 7, 11, 13 and 22, a cytogenetic pattern known to be associated with elevated tumor aggressiveness in meningiomas of adult patients. Accordingly, this juvenile meningioma may biologically correspond to a WHO grade II adult-type meningioma with an increased risk of recurrence. Therefore, we incorporated this patient into an intensified schedule of postoperative care.