Secretory meningioma: a rare entity that can be confused radiologically and pathologically with malignant tumors

AbstractMeningiomas are slow growing, extra axial brain tumors that originating from the meningothelial cells of arachnoid. Meningiomas most common tumors, however secretory meningiomas extremely rare variant and can be confused radiologically pathologically with malignant tumors. A 48 years old male was presented a complaint headache visual impairment in left eye. Magnetic resonance imaging revealed an mass lesion pontocerebellar region, 57x48x30 mm size, marked edema around mass. Microscopically, tumoral consisting ofuniform oval-round nuclei, thin vesiculated chromatin, moderately eosinophilic cytoplasm observed. The presence epithelial differentiation characterized by pseudopsammom structures formed lumens containing secretion appointed among tumor cells. Eosinophilic within were highlighted histochemical periodic acid schiff (PAS) stain. Immunoreaction observed surrounding carcinoembryonic antigen (CEA), membrane (EMA) pan cytokeratin (Pan-CK). Tumor immunopositive Vimentin progesterone receptor (PR). Ki67 proliferation index determined as <1%. No necrosis or mitosis detected. reported ‘‘secretory meningioma’’. additional treatment applied to case no recurrence detected 32 month follow-up after surgical resection. Although not clinically important due their benign course, differantial diagnosis is critical, since they malign because radiologically, elevated serum CEA levels differentiation.