Two distinct case reports with foamy cell and differential diagnosis: Xanthomatous meningioma and review of literature


Cukurova Medical Journal, vol.46, 2021 (ESCI) identifier

  • Publication Type: Article / Case Report
  • Volume: 46
  • Publication Date: 2021
  • Doi Number: 10.17826/cumj.839932
  • Journal Name: Cukurova Medical Journal
  • Journal Indexes: Emerging Sources Citation Index (ESCI), Academic Search Premier, Directory of Open Access Journals, TR DİZİN (ULAKBİM)
  • Keywords: Foamy cell, xanthomatous, metaplastic, histiocytic, meningioma
  • Karadeniz Technical University Affiliated: Yes


Meningiomas are the most common primary intracranial 

tumor thought to derived from arachnoidal cap cells in the 

meningeal coverings of the spinal cord and brain. The 

current WHO classification, published in 2016, includes 

nine different subtypes of grade 1 meningiomas, three 

different subtypes of grade 2 meningiomas, and three 

different subtypes of grade 3 meningiomas. Metaplastic 

meningioma is a rare variant which shows focal or diffuse 

mesenchymal tissue component. Xanthomatous 

meningioma which has foamy cell changes is a quite rare 

variant of metaplastic meningioma. Two patients, 54 and 

59 years old, who applied to our clinic with similar 

symptoms, were operated for meningioma. 

Histopathological examination of their biopsy showed that 

neoplastic cells had oval-round nuclei and eosinophilic 

cytoplasm. In xanthomatous meningioma, some 

neoplastic cells had clear vacuolated cytoplasm (foamy 

cells). In microscopic examination of resection material in 

one of these patients, cells in some areas of the tumor had 

clear vacuolated cytoplasm (foamy cells). These neoplastic 

cells were scattered among other meningothelial cells and 

they were positive for EMA. To the best of our knowledge, 

until today there have been only 14 reported xanthomatous 

meningioma cases in English literature. Here, we aimed to 

discuss the pathogenesis and differential diagnosis of 

xanthomatous meningioma in two different cases.