A 66-year-old woman presented with a seizure

A 66-year-old woman presented with a seizure, 1 year of headaches with increasing frequency and intensity, visual deficits, and behavioral changes. Her MRI shows a space-occupying lesion, which on pathology shows whorls of fibrous tissue and concentric calcifications. A homogenous, avidly enhancing mass with dural attachment (ie, “dural tailing”) is virtually diagnostic of meningioma.

The histology of meningiomas is significant for whorls of fibrous tissue and psammoma bodies (calcified laminated concentric rings), indicated in the image by the yellow square. Tumors with psammoma bodies can be remembered by the mnemonic PSaMMoma: Papillary adenocarcinoma of the thyroid, Serous papillary cystadenocarcinoma of the ovary, Mesothelioma, and Meningioma.

Meningiomas arise from the meningothelial cells of the arachnoid and are most often located in the convexities of the hemispheres and parasagittal regions, but may also arise in the lining of the ventricles.
They are the second most common primary brain tumor in adults and are typically benign and slow-growing. Meningiomas are typically resectable and have an excellent prognosis

Astrocytes give rise to astrocytomas and glioblastomas, which constitute the largest group of primary brain tumors. Low-grade astrocytomas are slow-growing malignant tumors that are typically found in the posterior fossa as an enhancing irregular cerebellar mass. Low-grade astrocytomas are more common in children while high-grade astrocytomas and glioblastomas are more common in adults and carry grave prognoses. Glioblastomas typically appear as irregular enhancing lesions and may be associated with necrosis, edema, and local mass effect.

Ependymal cells give rise to ependymomas, which are also more common in children than adults and have perivascular psuedorosettes on microscopic examination. Ependymomas are commonly found in the fourth ventricle and may result in non-communicating hydrocephalus. Oligodendrogliomas arise from oligodendrocytes. They are benign, slow growing, and rare tumors. They typically appear as large frontal lobe masses with focal nodular calcifications. Schwann cells are responsible for myelinating peripheral nerves and could cause a tumor of a cranial nerve sheath. Schwannomas typically localize to cranial nerve VIII and present with hearing loss and vertigo.