Clear cell meningiomas—case presentation, review of radiographic identifiers, and treatment approaches

TL;DR

This paper presents a pediatric case of spinal clear cell meningioma and discusses diagnostic and treatment approaches to improve outcomes.

Contribution

The paper provides a case report and review of radiographic and clinical features specific to spinal clear cell meningiomas in pediatric patients.

Findings

Gross total resection was achieved in a pediatric patient with a lumbar clear cell meningioma.

Radiographic features can help differentiate spinal clear cell meningiomas from other tumors.

Factors like Ki-67 index and spinal segment involvement predict recurrence in these tumors.

Abstract

Spinal clear cell meningiomas (CCMs) are a rare histological subtype of meningiomas that pose preoperative diagnostic challenges due to their radiographic similarities with other lesions. They are also more aggressive, exhibiting higher rates of recurrence, particularly in pediatric patients. Overcoming diagnostic challenges of these tumors can improve patient outcomes. In this report, we describe a case of a pediatric patient presenting with a lumbar CCM in whom we were able to obtain gross total resection. Our report reviews previously identified predictors of CCM recurrence, including the Ki-67 proliferation index, number of spinal segments involved, and hormonal influences related to age and sex. We describe the characteristic radiographic features that differentiate spinal CCMs from other tumors to improve pre-operative diagnosis. Furthermore, we provide our rationale for adjuvant therapy for pediatric patients to refine treatment protocols for these rare tumors.

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