Lymphoplasmacyte-rich meningioma with atypical cystic-solid feature: A case report

Background: Lymphoplasmacyte-rich meningioma (LPRM) is one of the rarest variants of meningioma and is classified as grade I (benign) tumor. It is characterized by abundant infiltrates of lymphocytes and plasma cells. Here, we report an extremely rare case of LPRM with an atypical imaging finding of multiple cysts around a solid mass.

Case summary: The patient was a 36-year-old man with intermittent headache, dizziness, and vomiting for 2 years. Computed tomography and magnetic resonance imaging presented a cystic solid mass in the right frontal lobe with heavy peritumoral edema and obvious contrast enhancement. The patient was treated with right frontotemporal craniotomy, and gross total resection of the tumor was achieved without adjuvant therapy. There was no clinical or neuroradiological evidence of recurrent or residual tumor for 3 years after initial surgery.

Conclusion: LPRM is one of the rarest variants of meningioma. Although, the mass of this case had common features, multiple cysts with nonuniform size and thin wall around the solid part are uncommon imaging finding, increasing the rate of misdiagnosis. The definitive diagnosis of LPRM relies on histopathological findings.