Intraventricular meningioma
Updates to Article Attributes
Intraventricular meningiomas, although are rare intracranial tumours,tumours usually encountered in adults and are asomewhat distinct from the far more common type of intraventricular neoplasm in adults They account for less than 3% of all meningiomas.
On imaging, they classically present as vividly enhancing solid mass at the trigone of of the lateral ventricles.
Epidemiology
Intraventricular meningiomas are rare, accounting for only 0.5-3% of all meningiomas 7. Nonetheless, because of the overall rarity of intraventricular tumours after childhood, they account for 10-15% of all intraventricular neoplasm in adults 7.
Most intraventricular meningiomas presentbetween the 3rd and 6th decades 3,6 with a recognised female predilection (M:F ratio of 1:2) 4,6,7. They are rare in childhood 7.
Clinical presentation
Intraventricular meningiomas present usually due to mass effect, either by direct compression of the adjacent brain or from obstruction to normal CSF drainage with resultant hydrocephalus.
Pathology
Intraventricular meningiomas are thought to arise from mengingothelial inclusion bodies located in the tela choroidea and/or mesenchymal stroma of the choroid plexus 5,6,7. In general, these meningiomas are most commonly of the fibrous meningiomas 5.
Location
They are most frequently (80%) seen at the trigone of the lateral ventricles and, for reasons that are not clear, slightly more frequently on the left. Considering the distribution of meningiomas, the intraventricular location is comparatively morecommon in children (20% of paediatric meningiomas).
- 80% trigone of the lateral ventricle
- 15% third ventricle
- 5% fourth ventricle
Radiographic features
Their signal and attenuation characteristics are the same as other meningiomas, demonstrating essentially isodensity and intensity to grey matter precontrast and vivid, usually homogeneous enhancement following administration of contrast. Compared to extra-axial meningiomas, a greater proportion is calcified (50% compared to 20% for standard meningioma).
The vascular supply depends on the location but generally is from the arterial supply of the adjacent choroid plexus 7.
For further discussion of the radiographic appearances of these tumours, refer to the general article: meningioma.
Treatment and prognosis
As is the case with other meningiomas, provided complete excision is possible, surgical excision is curative and therefore the treatment of choice. Recurrence rate following resection is fairly low, ~5% 7.
Differential diagnosis
The differential somewhat depends on the location of the tumour and age of the patient, however, in general considerations should include:
- glial tumour
- choroid plexus metastases
- choroid plexus papilloma (particularly in children)
- CNS lymphoma
- central neurocytoma
See also
-<p><strong>Intraventricular meningiomas</strong>, although are rare intracranial tumours, are a common type of <a href="/articles/intraventricular-neoplasms-and-lesions">intraventricular neoplasm</a> in adults. They account for less than 3% of all meningiomas. </p><p>On imaging, they classically present as vividly enhancing solid mass at the <a href="/articles/trigone-of-the-lateral-ventricle">trigone</a> of the <a href="/articles/lateral-ventricle-1">lateral ventricles</a>.</p><h4>Epidemiology</h4><p>Most intraventricular meningiomas present<sup> </sup>between the 3<sup>rd</sup> and 6<sup>th</sup> decades <sup>3,6</sup> with a recognised female predilection (M:F ratio of 1:2) <sup>4,6</sup>.</p><h4>Clinical presentation</h4><p>Intraventricular meningiomas present usually due to mass effect, either by direct compression of the adjacent brain or from obstruction to normal CSF drainage with resultant <a href="/articles/obstructive-hydrocephalus">hydrocephalus</a>.</p><h4>Pathology</h4><p>Intraventricular meningiomas are thought to arise from <a href="/articles/mengingothelial-inclusion-bodies">mengingothelial inclusion bodies</a> located in the <a href="/articles/tela-choroidea">tela choroidea</a> and/or <a href="/articles/mesenchymal-stroma">mesenchymal stroma</a> of the <a href="/articles/choroid-plexus">choroid plexus</a> <sup>5,6</sup>. In general, these meningiomas are most commonly of the <a href="/articles/fibrous-meningioma">fibrous meningiomas</a> <sup>5</sup>.</p><h5>Location</h5><p>They are most frequently (80%) seen at the <a href="/articles/trigone-of-the-lateral-ventricle">trigone</a> of the <a href="/articles/lateral-ventricle-1">lateral ventricles</a> and, for reasons that are not clear, slightly more frequently on the left. Considering the distribution of meningiomas, the intraventricular location is comparatively more<em> </em>common in children (20% of <a href="/articles/paediatric-meningiomas">paediatric meningiomas</a>).</p><ul>-<li>80% trigone of <a href="/articles/lateral-ventricle-1">lateral ventricle</a>- +<p><strong>Intraventricular meningiomas </strong>are rare tumours usually encountered in adults and are somewhat distinct from the far more common extra-ventricular meningioma.</p><p>On imaging, they classically present as vividly enhancing solid mass at the trigone of the lateral ventricles.</p><h4>Epidemiology</h4><p>Intraventricular meningiomas are rare, accounting for only 0.5-3% of all meningiomas <sup>7</sup>. Nonetheless, because of the overall rarity of intraventricular tumours after childhood, they account for 10-15% of all <a href="/articles/intraventricular-neoplasms-and-lesions">intraventricular neoplasm</a> in adults <sup>7</sup>.</p><p>Most intraventricular meningiomas present<sup> </sup>between the 3<sup>rd</sup> and 6<sup>th</sup> decades <sup>3,6</sup> with a recognised female predilection (M:F ratio of 1:2) <sup>4,6,7</sup>. They are rare in childhood <sup>7</sup>. </p><h4>Clinical presentation</h4><p>Intraventricular meningiomas present usually due to mass effect, either by direct compression of the adjacent brain or from obstruction to normal CSF drainage with resultant <a href="/articles/obstructive-hydrocephalus">hydrocephalus</a>.</p><h4>Pathology</h4><p>Intraventricular meningiomas are thought to arise from <a href="/articles/mengingothelial-inclusion-bodies">mengingothelial inclusion bodies</a> located in the <a href="/articles/tela-choroidea">tela choroidea</a> and/or <a href="/articles/mesenchymal-stroma">mesenchymal stroma</a> of the <a href="/articles/choroid-plexus">choroid plexus</a> <sup>5,6,7</sup>. In general, these meningiomas are most commonly of the <a href="/articles/fibrous-meningioma">fibrous meningiomas</a> <sup>5</sup>.</p><h5>Location</h5><ul>
- +<li>80% trigone of the <a href="/articles/lateral-ventricle-1">lateral ventricle</a>
-</ul><h4>Radiographic features</h4><p>Their signal and attenuation characteristics are the same as other meningiomas, demonstrating essentially isodensity and intensity to grey matter precontrast and vivid, usually homogeneous enhancement following administration of contrast. Compared to extra-axial meningiomas, a greater proportion is calcified (50% compared to 20% for standard meningioma).</p><p>For further discussion of the radiographic appearances of these tumours, refer to the general article: <a href="/articles/meningioma">meningioma</a>.</p><h4>Treatment and prognosis</h4><p>As is the case with other meningiomas, provided complete excision is possible, surgical excision is curative and therefore the treatment of choice.</p><h4>Differential diagnosis</h4><p>The differential somewhat depends on the location of the tumour and age of the patient, however, in general considerations should include:</p><ul>- +</ul><h4>Radiographic features</h4><p>Their signal and attenuation characteristics are the same as other meningiomas, demonstrating essentially isodensity and intensity to grey matter precontrast and vivid, usually homogeneous enhancement following administration of contrast. Compared to extra-axial meningiomas, a greater proportion is calcified (50% compared to 20% for standard meningioma).</p><p>The vascular supply depends on the location but generally is from the arterial supply of the adjacent choroid plexus <sup>7</sup>. </p><p>For further discussion of the radiographic appearances of these tumours, refer to the general article: <a href="/articles/meningioma">meningioma</a>.</p><h4>Treatment and prognosis</h4><p>As is the case with other meningiomas, provided complete excision is possible, surgical excision is curative and therefore the treatment of choice. Recurrence rate following resection is fairly low, ~5% <sup>7</sup>. </p><h4>Differential diagnosis</h4><p>The differential somewhat depends on the location of the tumour and age of the patient, however, in general considerations should include:</p><ul>
- +<li><a href="/articles/central-neurocytoma">central neurocytoma</a></li>
References changed:
- 7. Pereira B, de Almeida A, Paiva W et al. Natural history of intraventricular meningiomas: systematic review. (2020) Neurosurgical review. 43 (2): 513-523. <a href="https://doi.org/10.1007/s10143-018-1019-0">doi: 10.1007/s10143-018-1019-0</a>
Unable to process the form. Check for errors and try again.