We reported a case of meningioma with rhabdoid morphology but lacking histological top features of malignancy in due to the spinal-cord within a 28-year-old man. number of instances, the rhabdoid cells show up after preliminary recurrence. We record an instance of vertebral meningoma within a 28-year-old male that demonstrated rhabdoid morphology at the original presentation. Case Record A 28-year-old man offered a history background of progressive weakness and decreased feeling in both reduced limbs. He complained of weakness and numbness up to the nipple also. There is no bladder participation. On examination, there is Quality I to II weakness in both lower limbs and sensory reduction (touch, pain, temperature) below T3 and T4. Magnetic resonance imaging uncovered the intradural extramedullary tumor at C7-T1 level [Body 1]. Laminectomy C7-T1 was finished with full excision of intradural, well circumscribed extramedullary, firm, vascular tumor due to dura compressing and C7-T1 the cord significantly. On microscopic evaluation, from the resected tumor, a lot of the tumor cells exhibited regular rhabdoid morphology with huge, vesicular, frequently eccentrically located nuclei with specific nucleoli and abundant cytoplasm formulated with eosinophilic hyaline inclusions [Body 2]. Many psammoma bodies were seen. Traditional meningothelial features with focal whorl formation were seen and scarce just in a few foci. Immunohistochemically, these rhabdoid cells showed epithelial membrane antigen (EMA) as well as vimentin positivity. By 7th postoperative day, significant improvement was observed, and patient got Grade III power. Sensory loss also started improving. The postoperative period of this individual was uneventful and after surgery was planned for radiotherapy and chemotherapy. Patient has not so far presented with recurrences, 6 months after radiotherapy and chemotherapy. Open in a separate window Physique 1 Magnetic resonance imaging exposing intradural extrarmedullary tumor at C7-T1 level Open in a separate window Physique 2 Photomicrograph showing cells with rhabdoid morphology. A psammoma body is also seen at the periphery (H and E, 40) Conversation Although meningiomas are well-known entities with frequent histological variants, LY3009104 supplier Rhabdoid meningioma is usually a rare subtype of meningiomas accounting for 1C3% of all intracranial meningiomas.[2] Rhabdoid meningiomas were described LY3009104 supplier for the first time in 1998 as an unusual variant with increased proliferative activity.[1,3,4] In 2000, they included in the revised WHO classification of tumors of the CNS as a subtype of meningiomas with increased risk of recurrence and more aggressive growth, corresponding to WHO Grade III. Meningiomas with focal rhabdoid differentiation are considered WHO Grade I. Rhabdoid features should constitute over 50% of tumor to call a meningiomas as the rhabdoid meningioma (WHO Grade III).[1] Rhabdoid morphology in tumors refers to the resemblance of the cells to rhabdomyoblasts, without true skeletal muscle mass differentiation. The cytologic features include abundant eosinophilic cytoplasm, eccentric nuclei, and intracytoplasmic hyaline inclusions. Ultrastructurally, the latter represents whorls of intermediate filaments expressing vimentin and sometimes cytokeratin. The term malignant rhabdoid tumor (MRT) was first used to describe a distinctive pediatric renal tumor.[5] The term was then extended to similar extrarenal pediatric tumors (extrarenal MRT), including atypical teratoid/rhabdoid tumor of the CNS.[6] A rhabdoid phenotype has also been explained in a variety of tumors with a different histogenesis, including carcinomas, sarcomas, gliomas, and melanomas.[7] In 1998, Kepes em et al /em .[8] and Perry em et al /em .[9] explained the first two series of meningiomas with rhabdoid transformation. These meningiomas often recur, and the rhabdoid features become more apparent in subsequent biopsies. Brain invasion, anaplasia, and extracranial metastasis have been reported in rhabdoid meningiomas. Besides the rhabdoid morphology, cytoarchitectural features of atypical meningioma (four or more mitoses per 10 high-power fields, high cellularity, sheeting architecture, nuclear atypia, and necrosis) were seen in most cases. Expression of cytokeratin is usually common. The wide histological differential diagnosis includes metastatic carcinoma, metastatic melanoma, glioma, and sarcoma. Diagnosis depends LY3009104 supplier on obtaining evidence of meningothelial differentiation either by light microscopy (whorls, intranuclear pseudoinclusions), immunohistochemistry (expression of vimentin, EMA, and progesteroneCreceptor positivity), or by electron microscopy (interdigitating cytoplasmic membranes, intercellular junctions). Perry em et al /em .[9] analyzed a series of 15 meningiomas with rhabdoid Vegfa features. Histological features of malignancy (brain invasion LY3009104 supplier or anaplasia) were observed in nine cases, and another two tumors getting considered malignant based on extracranial metastasis. In almost all, elevated cell proliferation was evidenced by a higher mitotic price or.