The Management of a Giant Convexity en Plaque Anaplastic Meningioma with Gerstmann Syndrome: A Case Report of Surgical Outcomes in a 76-Year-Old Male

Autor: Corneliu Toader, Felix Mircea Brehar, Mugurel Petrinel Radoi, Matei Serban, Razvan-Adrian Covache-Busuioc, Ghaith S. Aljboor, Radu M. Gorgan
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Diagnostics, Vol 14, Iss 22, p 2566 (2024)
Druh dokumentu: article
ISSN: 14222566
2075-4418
DOI: 10.3390/diagnostics14222566
Popis: Background: This case report highlights a rare presentation of a giant convexity en plaque anaplastic meningioma, located in the left frontoparietal parasagittal region, infiltrating the superior sagittal sinus, and associated with Gerstmann syndrome. This study aims to explore the clinical challenges, surgical management, and potential reversibility of neurological deficits induced by the tumor, including those characteristic of Gerstmann syndrome. Methods: A 76-year-old male patient presented with a history of worsening expressive aphasia and cognitive impairments, culminating in a generalized seizure. Preoperative imaging confirmed a 4 × 6 cm highly vascularized tumor with significant peritumoral edema. The patient underwent near-total resection of the tumor, aiming for a Simpson grade 2 resection, while managing hypervascularity and brain edema. Histological analysis confirmed the diagnosis of anaplastic meningioma (WHO Grade III), showing features such as necrosis, brain invasion, and high mitotic activity. Results: Post-surgical follow-up demonstrated significant improvement in the patient’s neurological deficits, particularly in expressive language and cognitive function, suggesting a potential reversal of Gerstmann syndrome. Postoperative imaging revealed a moderate degree of cerebral collapse and absence of contrast leakage. Two-month follow-up confirmed no recurrence of neurological deficits. Conclusions: This case emphasizes the complexity of managing giant convexity en plaque anaplastic meningiomas, particularly when associated with Gerstmann syndrome. Surgical resection, despite the challenges posed by tumor size, hypervascularity, and peritumoral edema, can lead to significant neurological recovery, highlighting the potential reversibility of tumor-induced Gerstmann syndrome.
Databáze: Directory of Open Access Journals
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