Meningeal Sarcomas

These rare and malignant tumors arise either from the dura or from the leptomeninges; seldom from pial or adventitial cells within the brain parenchyma. They may occur at any age.

Dural fibrosarcoma has a firm consistency and is composed of interlacing fascicles of fibroblasts.

Leptomeningeal sarcoma grossly appears demarcated, but not encapsulated, soft, grayish-pink with granular cut surfaces. It often contains hemorrhages, necrosis, and cysts. Histologically, the tumor invades the adjacent brain tissue and shows fascicles of fibro-blasts separated by a rich reticulin stroma.

Primary meningeal sarcomatosis is more common in infants and children. Dense tumorous infiltrations with round or fusiform cells fill the subarachnoid space.

figure 1 1.30

Primary meningeal sarcomatosis in a 15-year-old girl diffusely spreads into the subarachnoid space and invades the cerebral cortex (Cresyl violet).

figure 1 1.30

Primary meningeal sarcomatosis in a 15-year-old girl diffusely spreads into the subarachnoid space and invades the cerebral cortex (Cresyl violet).

The tumor may arise in multiple foci and spread diffusely. It may infiltrate the cranial nerve roots and brain parenchyma and, with time, can lead to hydrocephalus (Fig. 11.30).

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