Cystic meningiomas: beyond the solid tumor, a challenge in diagnosis
Edinson David Berrio Perea, Julio César Delgado Arce, Elizabeth Escamilla Chávez, Isaias Gutierrez Chavez, Maximiliano Estrada Roldan, Fabiola Alejandra Becerra Arciniega, Pablo David Guerrero Suárez
Abstract
Background. Cystic meningiomas (CMs) are rare variants of meningiomas characterized by atypical radiological and histopathological features. These lesions imply significant diagnostic challenges due to their resemblance to other cystic brain lesions, such as gliomas, metastases, arachnoid cysts, and neurocysticercosis in endemic areas. This report aims to highlight the clinical and imaging findings that aid in distinguishing cystic meningiomas from other lesions, and to discuss their surgical management. Case Presentation. We describe two cases of cystic meningiomas in adult patients. The first case involves a 59-year-old patient who presented with tonic-clonic seizures, initially misdiagnosed with racemose neurocysticercosis. Imaging studies revealed a type IV cystic meningioma, successfully treated with surgical resection. The second case describes a 58-year-old patient with progressive lower limb weakness and diplopia. Imaging identified a type III cystic meningioma, which was also managed with complete surgical resection. Both patients recovered well postoperatively, while histopathological diagnoses confirmed benign transitional meningiomas. Conclusions. Cystic meningiomas are uncommon but crucial differential diagnoses for cystic brain lesions. Early recognition and appropriate surgical management are essential to ensure favorable outcomes. Imaging techniques, particularly MRI, play a paramount role in diagnosis, while histopathological evaluation confirms the nature of the lesion.
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References
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Submitted date:
04/13/2025
Accepted date:
04/21/2025
Publication date:
10/09/2025
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