PRIMARY MENINGEAL GLIOMA

A 59 yr old man presented with headaches and was shown to have a poste rior fossa tumor arising from the inferior surface of the tentorium ce rebelli. At operation the tumor was discrete from the cerebellum and w as thought to be a meningioma. Pathological examination showed the tum or had features similar to those of a meningioma. It consisted of inte rlacing bundles of spindle cells with a considerable amount of connect ive tissue. Some mitoses were present. The tumor cells, however, showe d abundant staining for glial fibrillary acidic protein indicating the ir astrocytic nature. The tumor was diagnosed as astrocytoma Grade 2. The tumor 'recurred' 4 mths later and a second surgical removal was at tempted. Pathological examination showed features similar to those in the first operative specimen but this time invasion of the cerebellum was present. Deep x-ray treatment (D.X.R.T.) did not alter the tumor g rowth which proved fatal 7 mths after presentation. The differential d iagnosis of an apparently meningeal-based tumor includes the rare enti ty of primary meningeal glioma. The case is presented as an example of this rare entity which both clinically and pathologically may be mist aken for a meningioma. The prognosis of intracranial solitary primary leptomeningeal gliomas is variable with recurrence and survival being months to years.