Meningiomas most often occur near the surfaces of the brain, especially the parasaggital regions. They are often asymptomatic, and grossly it appears as a round mass attached to dura. It will compress the cortex (explaining the headaches), but it will not invade. They are also the most common primary benign CNS tumor. Women are more commonly affected, which is supported by the vignette.
Other answers:
A: Astrocytomas are usually found in the posterior fossa, and are the most common primary CNS tumor in children
B: Glioblastoma multiforme is usually seen within the cerebral hemispheres, and shows signs of necrosis and hemorrhage.
C: Melanoma can metastasize to the brain, but this would likely form in multiple spots, and they would not be outside of the parenchyma
E: Squamous epithelial would similarly be metastasis and therefore also be multiple lesions inside the parenchyma
Clinical vignette is leading to GBM(astrocyte origin)....not sure about the gross picture.....
Don't know what if such questions appear on real exam๐๐๐
In case anyone was wondering, meningiomas are more common in women (perhaps due to an estrogenic effect, but this is still hotly debated).
Also, GBM's would show up as butterfly-shaped and intraparenchymal. They have a 60% higher incidence in males than females. Historical aside - Ted Kennedy died from a GBM
Answer is Astrocyte. Patient has glioblastoma multiforme. Although meningiomas may occur at convexities, meningiomas are benign and often asymptomatic. They may cause h/a seizures, but would be unlikely to cause death w/in 6m of onset of h/a. The size of tumor and course of illness is consistent with the course of GBM
Astrocytes proliferate to form glial tumors in adults, for example, glioblastoma. These highly malignant tumors appear as intra-axial masses in the cerebral hemispheres, which typically demonstrate areas of necrosis and can spread to the opposite hemisphere across the corpus callosum.
Meningiomas are the most common primary brain tumors in adults. Malignant meningiomas may grow rapidly and cause symptoms of increased intracranial pressure such as headache. Meningiomas appear as well-circumscribed, extraaxial masses that compress the adjacent brain parenchyma.***Parasaggital regions.
submitted by โjohnthurtjr(168)
I'm not a fan of gross path images and questions that say "look, what is this thing?" - that said meningiomas are the most common brain tumor and this picture is is a good example of one. I had no idea what these things looked like and got it wrong, too. Take a look at this one