Dement Neurocogn Disord.  2013 Sep;12(3):81-85. 10.12779/dnd.2013.12.3.81.

Papillary Meningioma Presenting as Rapidly Progressive Dementia and Parkinsonism

Affiliations
  • 1Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Korea. siuy@cmcnu.or.kr
  • 2Department of Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 3Department of Neurology, Veterans Hospital, Seoul Medical Center, Seoul, Korea.

Abstract

There are a variety of different causes of parkinsonism including PD, secondary parkinsonism, and the parkinsonism plus syndromes. Secondary parkinsonism is caused by structural, toxic, metabolic, or infectious mechanisms. Among structural causes, intracranial neoplasms are a rare cause of secondary parkinsonism. Moreover, there are almost never case reports with intracranial space-occupying lesions resulting in parkinsonism associated with rapid cognitive impairment. Therefore, we report herein a 37-year-old woman diagnosed with papillary meningioma who presented with parkinsonism associated with rapidly progressive cognitive impairment mimicking diffuse Lewy body disease.

Keyword

Parkinsonism; Cognitive impairment; Meningioma

MeSH Terms

Adult
Brain Neoplasms
Dementia
Female
Humans
Lewy Body Disease
Meningioma
Parkinson Disease, Secondary
Parkinsonian Disorders

Figure

  • Fig. 1 Brain magnetic resonance images show a large mass (size 8×7.2×7 cm) with gadolinium enhancement and cystic change in right frontotemopral region, which compresses the right basal ganglia and lateral ventricle and causes mid-line shift to the left side by mass effect.

  • Fig. 2 Brain perfusion SPECT also indicates increased perfusion of the right frontal region including mass lesion and decreased perfusion of right frontal and parieto-occipital regions, and both basal ganglia.

  • Fig. 3 It shows papillary meningioma with perivascular pseudorosettes, cellular dehiscence, and variable quantities of eosinophilic cytoplasm attached to the dura (×100). The submitted specimen is a dural-based tumor with a bosselated surface. On sections, it is yellow tan with necrosis on the cut surface. On microscopic findings, it has poor cellular cohesion, perivascular pseudorosettes, foci of geographic necrosis, and prominent nucleoli with positive for EMA and vimentine, negative for GFAP, and high Ki-67 index (10.3%). The diagnosis is papillary meningioma, grade III by WHO.


Reference

1. Hughes AJ, Daniel SE, Lees AJ. Improved accuracy of clinical diagnosis of lewy body parkinson's disease. Neurology. 2001; 57:1497–1499.
Article
2. Tolosa E, Wenning G, Poewe W. The diagnosis of parkinson's disease. Lancet Neurol. 2006; 5:75–86.
Article
3. Bostantjopoulou S, Katsarou Z, Petridis A. Relapsing hemiparkinsonism due to recurrent meningioma. Parkinsonism Relat Disord. 2007; 13:372–374.
Article
4. Krauss JK, Paduch T, Mundinger F, Seeger W. Parkinsonism and rest tremor secondary to supratentorial tumours sparing the basal ganglia. Acta Neurochir (Wien). 1995; 133:22–29.
Article
5. Salvati M, Frati A, Ferrari P, Verrelli C, Artizzu S, Letizia C. Parkinsonian syndrome in a patient with a pterional meningioma: case report and review of the literature. Clin Neurol Neurosurg. 2000; 102:243–245.
Article
6. Lusis E, Gutmann DH. Meningioma: an update. Curr Opin Neurol. 2004; 17:687–692.
Article
7. Adhiyaman V, Meara J. Meningioma presenting as bilateral parkinsonism. Age Ageing. 2003; 32:456–458.
Article
8. McKeith IG, Dickson DW, Lowe J, Emre M, O'Brien JT, Feldman H, et al. Diagnosis and management of dementia with lewy bodies: Third report of the dlb consortium. Neurology. 2005; 65:1863–1872.
Article
9. Hunter R, Blackwood W, Bull J. Three cases of frontal meningiomas presenting psychiatrically. Br Med J. 1968; 3:9–16.
Article
Full Text Links
  • DND
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr