Dural angioleiomyoma of the middle cranial fossa: a case report and review of the literature.

We describe a case of dural angioleiomyoma (ALM) of the middle cranial fossa. A 62-year-old man was referred to our center for fracture of the left clavicle because of a fall, and he had a sudden seizure during admission. The mass was completely resected. The tumor base was located at the bottom of the temporal lobe in the front of the petrous apex and near the cavernous sinus. After 7 months, the postoperative course demonstrated no tumor recurrence. The lesion had the typical appearance of ALM. Mitoses and necrosis were not identified. The lesion contained multifocality of fat in some areas of spindle-shaped cells, and markedly myxoid change was present. The spindle cells were positive for SMA and DES and negative for EMA, HMB-45, p53 and p16. A small focus of fat was positive for S-100. Less than 1% of the tumor cells showed immunoreactivity for Ki-67. EBV-encoded RNA was negative for tumor cells. Stainings for p53, p16, Ki-67 and EBV infection need to be carried out in cases of intracranial ALM because they are correlated with the biological behavior and prognosis of the tumor.