Secretory meningioma with remarkable brain edema: A case report

We report a case of secretory meningioma in a 64-year-old woman who presented with depression and abnormal behavior. MRI demonstrated a well-enhanced tumor in the left middle fossa. The tumor was 3 cm in diameter and accompanied by remarkable brain edema in the left temporal lobe. Carotid angiograms showed multiple aneurysms of the bilateral internal carotid arteries. Through a left frontotemporal craniotomy, total removal of the tumor and neck clipping of the aneurysm of the left internal carotid artery were performed. After surgery, the patient's symtoms improved and the edema disappeared. The tumor cells had many eosinophilic pseudopsammoma bodies. On immunohistochemistry, the tumor was positive for CEA and EMA and diagnosed as secretory meningioma. Tumor cells were also positive for VEGF, which was possibly related to the severe brain edema in this case. Clinical and histopathological features of secretory meningioma are discussed.