Background: Giant meningioma stemming from intraventricular zone has been reported to be extremely few. Two cases of supersize (>8 cm) intraventricular meningiomas presenting with cystic lesions and their clinical characteristics were collected in our study.
Case description: One patient was a 56-year-old man who hospitalized for blunt headache and weakness of right lower limb along with defect of right visual field for 12 months. The other patient is a 22-year-old lady presented with slight headache accompanied with right facial numbness for one week. Computed tomography and magnetic resonance imaging of both patients revealed a giant heterogeneous, enhancing tumor mainly in the left trigonum with a low-density or hypointense cystic lesions located within or around the tumor. Total resection was performed via a transcortical approach in both cases. The pathological and immunohistochemical staining indicated fibroblastic meningioma (case one) and atypical meningioma (case two) respectively. Postoperatively, both of patients recovered free from episodes of symptoms and imaging examinations confirmed no evidence of regrowth of the meningioma during an average 24 months follow-up.
Conclusions: Cystic lesions may indicate the histopathologic malignancy of intraventricular meningioma. Transcortical approach through the posterior temporal lobe or the parieto-occipital lobe is an effective technology for giant intraventricular meningiomas.