CNS & pituitary tumors

Meningeal tumors

Clear cell meningioma

Last author update: 1 March 2015
Last staff update: 18 May 2022

Copyright: 2002-2023,, Inc.

PubMed Search: Clear cell meningioma [title]

Jesse L. Kresak, M.D.
Anthony T. Yachnis, M.D.
Page views in 2022: 5,066
Page views in 2023 to date: 2,205
Cite this page: Kresak J, Yachnis A. Clear cell meningioma. website. Accessed June 2nd, 2023.
Definition / general
  • Rare variant, 0.2 - 0.8% of all meningiomas (J Neurooncol 2007;81:315)
  • WHO grade II due to aggressiveness
  • 20 - 60% chance of recurrence even with gross total resection
  • More common in younger patients (mean age 29 years)
  • Predilection for cauda equina and cerebellopontine areas
  • Predilection for CP angle and cauda equina
Radiology description
  • Indistinguishable from classic meningioma
  • Dural based, homogenously enhancing
Radiology images

Contributed by Chunyu Cai, M.D., Ph.D. (Case #514)


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Various images

Case reports
  • Gross total resection
  • Postsurgical radiation
Microscopic (histologic) description
  • Patternless arrangement of clear cells with sometimes distinct cell borders
  • Prominent perivascular and interstitial collagen
  • Little to no mitotic activity
  • May not display any characteristic meningioma features (whorls, psamomma bodies, intranuclear inclusions)
Microscopic (histologic) images

Contributed by Chunyu Cai, M.D., Ph.D. (Case #514)
H&E clear cell

H&E clear cell

H&E blocky collagen

H&E blocky collagen





Cytology description
  • Whorled, syncytial architecture composed of spindle to polygonal cells with vacuolated cytoplasm and bland nuclei (Diagn Cytopathol 1998;18:131)
Positive stains
Negative stains
Electron microscopy description
  • Abundant cytoplasmic glycogen
  • Intermediate filaments
  • Interdigitation of cell membranes, desmosomes
  • Occasional cytoplasmic lumina (Ultrastruct Pathol 1999;23:51)
Differential diagnosis
Board review style question #1
Which of the following genetic alterations is characteristic of clear cell meningioma?

  1. AKT1 mutation
  2. BAP1 mutation
  3. NF2 mutation
  4. SMARCE1 mutation
  5. TRAF7 and KLF4 co-mutations
Board review style answer #1
D. SMARCE1 mutation. Clear cell meningioma is a rare variant characterized by loss of nuclear SMARCE1 protein expression.

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Reference: Clear cell meningioma
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