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Crene EJD, Cockburn CJK, Cockburn WJ. Primary extradural meningioma with a history of traumatic head injury during infancy: A case report. Int J Surg Case Rep 2024; 119:109743. [PMID: 38728970 PMCID: PMC11101895 DOI: 10.1016/j.ijscr.2024.109743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 05/03/2024] [Accepted: 05/07/2024] [Indexed: 05/12/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Meningiomas are an extra-axial tumour arising from arachnoid cells and are typically benign and slow growing. Primary extradural meningiomas refer to meningiomas that arise outside the subdural compartment and are extremely rare (0.3 % of meningiomas). CASE PRESENTATION A 42-year-old female presented to her primary health care provider with a 2-year history of a painful mass on her left forehead with a past medical history of a traumatic brain injury and intracranial hematoma from a motor vehicle accident when she was 11 months old. An ultrasound reported as likely sebaceous cyst. The lesion was resected and sent for pathological examination. The diagnostic summary reported an ectopic subgaleal left frontal meningioma WHO Grade 1. CLINICAL DISCUSSION Extracranial meningiomas have been divided into two classifications; primary extracranial meningiomas and secondary extracranial meningiomas. In the female population group 88 % of extracranial meningiomas found on the scalp/skin are grade 1 meningiomas. Most extracranial meningiomas are diagnosed after histology examination, due to the rarity. They can arise via entrapment of arachnoid cells during embryologic development and from traumatic events displacing arachnoid cells. CONCLUSION The authors suggest that the patient's aetiology of her PEM is from the entrapment of arachnoid islet cells secondary to her traumatic brain injury during infancy. Interestingly, the patients' symptoms began 40 years post trauma. Other case studies of this rare tumour have correlated a shorter time period between the trauma and the diagnosis. We suggest that all patients should have radiographic and histologic investigations of scalp masses.
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Affiliation(s)
- Elliot J D Crene
- Neurosurgical Department, Gold Coast University Hospital, 1 Hospital Bld, Southport 4215, Queensland, Australia.
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2
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Echalier C, Chevrier B, Gros P, Teboul F, Goubier JN. Case report of a primary ectopic extradural and extraspinal meningioma of the brachial plexus. Neurochirurgie 2024; 70:101551. [PMID: 38508105 DOI: 10.1016/j.neuchi.2024.101551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 02/28/2024] [Accepted: 02/28/2024] [Indexed: 03/22/2024]
Abstract
Primary ectopic extradural and extraspinal meningiomas are rare. We present a unique case of this type of meningioma in the brachial plexus. A 25-year-old man consulted us because of neuropathic supraclavicular pain and the appearance of a supraclavicular mass whose volume had increased. Clinical examination found paresis of the deltoid, biceps brachii and brachialis muscles rated as M4 (MRC) and a strong Tinel sign at the supraclavicular fossa, over the palpable mass. There was no sign pointing towards central nervous system involvement or altered general condition. MRI revealed a mass measuring 53 × 24 mm invading the C5-C6 plexus roots and the primary upper trunk, but not the bone or spinal area. This lesion was hyperintense on DWI/ADC, hyperintense on T2 with hypointense spots, and hypointense on T1 with intense heterogeneous gadolinium enhancement. Excisional biopsy was done 6 months after symptoms started. The tumor had developed at the C5 root, which was fibrous and at the C6 root, which was grossly normal. Anatomical pathology confirmed the WHO grade 1 meningioma, meningothelial and psammomatous histological subtypes. At 6 months, a follow-up MRI found no postoperative tumor remnants or recurrence. During the postoperative course, persistent paralysis of the deltoid muscle at 5 months justified a nerve transfer. This is a rare case of ectopic extraspinal and extradural meningioma of the brachial plexus. The diagnosis of an ectopic meningioma must be considered when a patient presents with a brachial plexus tumor causing neurological deficits. The extradural nature is not sufficient to rule out this diagnosis.
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Affiliation(s)
- C Echalier
- Clinique Bizet, 22 bis rue Georges Bizet, 75116 Paris, France; Institut de Chirurgie Nerveuse et du Plexus Brachial, 92 bd de Courcelles, 75017 Paris, France; Clinique Nollet Paris, 23 rue Brochant, 75017 Paris, France
| | - B Chevrier
- Groupe Union Imagerie, 21 rue Oudinot, 75007 Paris, France
| | - P Gros
- Centre ACP, PRAXEA-UNILABS, 1 rue Galvani, 91300 Massy, France
| | - F Teboul
- Clinique Bizet, 22 bis rue Georges Bizet, 75116 Paris, France; Institut de Chirurgie Nerveuse et du Plexus Brachial, 92 bd de Courcelles, 75017 Paris, France
| | - J-N Goubier
- Clinique Bizet, 22 bis rue Georges Bizet, 75116 Paris, France; Institut de Chirurgie Nerveuse et du Plexus Brachial, 92 bd de Courcelles, 75017 Paris, France.
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3
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Ueno M, Shimato S. A Case of Recurrence of Benign Convexity Primary Intraosseous Meningioma. NMC Case Rep J 2024; 11:19-25. [PMID: 38410174 PMCID: PMC10895084 DOI: 10.2176/jns-nmc.2023-0171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 09/26/2023] [Indexed: 02/28/2024] Open
Abstract
Meningiomas originating within the bones of the skull are rare and have been reported as primary intraosseous meningiomas (PIOM). Moreover, PIOMs with a skull base location or malignant pathology are predisposed to recurrence; however, recurrence is quite rare among PIOMs characterized by a convexity location and benign pathology. Here, we present a case of extensive recurrence of a convex intraosseous meningioma with benign pathology. A 72-year-old woman presented with a headache to our hospital. Gd contrast-enhanced magnetic resonance imaging revealed an enhanced tumor in the left frontal to the parietal region extending through the calvarial bone and invading the subdural space and subcutaneous tissue. Skull radiograph and computed tomography identified a remarkable osteolytic change in the lesion. Macroscopic complete resection (MCR) of the tumor and the surrounding tissues was performed. The tumor was histopathologically diagnosed as a transitional meningioma (World Health Organization grade 1). Seven years after the surgery, the patient presented with dysarthria, and the recurrence of the tumor was identified as massive lesions extending through the calvarial bone to the orbital bone, partially protruding into the brain and scalp. MCR was performed again, with the reconstruction of the skull for an extensive calvarial area using a titanium plate. This case is unique due to the extensiveness of the recurrent tumor and its rarity. Here, we report the details of the clinical course and discuss the characteristics of this case.
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Affiliation(s)
- Masahiro Ueno
- Department of Neurosurgery, Handa City Hospital, Handa, Aichi, Japan
- Department of Neurosurgery, Kariya Toyota General Hospital, Kariya, Aichi, Japan
| | - Shinji Shimato
- Department of Neurosurgery, Handa City Hospital, Handa, Aichi, Japan
- Department of Neurosurgery, Kariya Toyota General Hospital, Kariya, Aichi, Japan
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Sato Y, Mitsuya K, Kakuda Y, Oishi T, Deguchi S, Sugino T, Akiyama Y, Nagashima T, Urakami K, Shimoda Y, Ohshima K, Hayashi N, Yamaguchi K. A Primary Intraosseous Meningioma: A Rare Case of Malignancy with High Proliferative Ability. J Neurol Surg Rep 2023; 84:e103-e108. [PMID: 37901278 PMCID: PMC10611535 DOI: 10.1055/a-2161-7710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 08/06/2023] [Indexed: 10/31/2023] Open
Abstract
Primary intraosseous meningioma (PIM) is a rare tumor that arises in the skull. Histopathologically, it is generally described as a slow-growing, benign lesion. However, on rare occasions, PIM presents as a malignancy with high proliferative ability, which requires maximal resection, adjuvant radiotherapy, and subsequent careful follow-up. Because of the rarity of such cases, they present a diagnostic challenge with unusual pathological findings. Herein, we report a case of a primary intraosseous anaplastic meningioma with extensive invasion inside and outside the skull, along with the results of whole-genome analysis. Histopathological diagnosis was a World Health Organization grade 3 anaplastic meningioma. In the literature, only two cases of anaplastic PIM have been reported, so its characteristics and treatment are poorly understood. Our patient was successfully treated with tumor resection, followed by intensity-modulated radiation therapy. Follow-up imaging studies revealed no recurrence or distant metastasis, including to lung, liver, and bone, at 8 months after the surgery.
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Affiliation(s)
- Yoshiki Sato
- Division of Neurosurgery, Shizuoka Cancer Center, Nagaizumi, Shizuoka, Japan
| | - Koichi Mitsuya
- Division of Neurosurgery, Shizuoka Cancer Center, Nagaizumi, Shizuoka, Japan
| | - Yuko Kakuda
- Division of Diagnostic Pathology, Shizuoka Cancer Center, Nagaizumi, Shizuoka, Japan
| | - Takuma Oishi
- Division of Diagnostic Pathology, Shizuoka Cancer Center, Nagaizumi, Shizuoka, Japan
| | - Shoichi Deguchi
- Division of Neurosurgery, Shizuoka Cancer Center, Nagaizumi, Shizuoka, Japan
| | - Takashi Sugino
- Division of Diagnostic Pathology, Shizuoka Cancer Center, Nagaizumi, Shizuoka, Japan
| | - Yasuto Akiyama
- Division of Immunotherapy, Shizuoka Cancer Center Research Institute, Nagaizumi, Shizuoka, Japan
| | - Takeshi Nagashima
- Cancer Diagnostics Research Division, Shizuoka Cancer Center Research Institute, Nagaizumi, Shizuoka, Japan
- SRL, Tokyo, Japan
| | - Kenichi Urakami
- Medical Genetics Division, Shizuoka Cancer Center Research Institute, Nagaizumi, Shizuoka, Japan
| | - Yuji Shimoda
- Division of Immunotherapy, Shizuoka Cancer Center Research Institute, Nagaizumi, Shizuoka, Japan
- SRL, Tokyo, Japan
| | - Keiichi Ohshima
- Division of Medical Genetics Division, Shizuoka Cancer Center Research Institute, Nagaizumi, Shizuoka, Japan
| | - Nakamasa Hayashi
- Division of Neurosurgery, Shizuoka Cancer Center, Nagaizumi, Shizuoka, Japan
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Bailo M, Gagliardi F, Boari N, Spina A, Piloni M, Castellano A, Mortini P. Meningioma and Other Meningeal Tumors. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1405:73-97. [PMID: 37452935 DOI: 10.1007/978-3-031-23705-8_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
Meningiomas develop from meningothelial cells and approximately account for more than 30 percent of central nervous system (CNS) tumors. They can occur anywhere in the dura, most often intracranially and at dural reflection sites. Half of the cases are usually at parasagittal/falcine and convexity locations; other common sites are sphenoid ridge, suprasellar, posterior fossa, and olfactory groove. The female-to-male ratio is approximately 2 or 3-1, and the median age at diagnosis is 65 years. Meningiomas are generally extremely slow-growing tumors; many are asymptomatic or paucisymptomatic at diagnosis and are discovered incidentally. Clinical manifestations, when present, are influenced by the tumor site and by the time course over which it develops. Meningiomas are divided into three grades. Grade I represents the vast majority of cases; they are considered typical or benign, although their CNS location can still lead to severe morbidity or mortality, resulting in a reported ten-year net survival of over 80%. Atypical (WHO grade II) meningiomas are considered "intermediate grade" malignancies and represent 5-7% of cases. They show a tendency for recurrence and malignant degeneration with a relevant increase in tumor cell migration and surrounding tissue infiltration; ten-year net survival is reported over 60%. The anaplastic subtype (WHO III) represents only 1-3% of cases, and it is characterized by a poor prognosis (ten-year net survival of 15%). The treatment of choice for these tumors stands on complete microsurgical resection in case the subsequent morbidities are assumed minimal. On the other hand, and in case the tumor is located in critical regions such as the skull base, or the patient may have accompanied comorbidities, or it is aimed to avoid intensive treatment, some other approaches, including stereotactic radiosurgery and radiotherapy, were recommended as safe and effective choices to be considered as a primary treatment option or complementary to surgery. Adjuvant radiosurgery/radiotherapy should be considered in the case of atypical and anaplastic histology, especially when a residual tumor is identifiable in postoperative imaging. A "watchful waiting" strategy appears reasonable for extremely old individuals and those with substantial comorbidities or low-performance status, while there is a reduced threshold for therapeutic intervention for relatively healthy younger individuals due to the expectation that tumor progression will inevitably necessitate proactive treatment. To treat and manage meningioma efficiently, the assessments of both neurosurgeons and radiation oncologists are essential. The possibility of other rarer tumors, including hemangiopericytomas, solitary fibrous tumors, lymphomas, metastases, melanocytic tumors, and fibrous histiocytoma, must be considered when a meningeal lesion is diagnosed, especially because the ideal diagnostic and therapeutic approaches might differ significantly in every tumor type.
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Affiliation(s)
- Michele Bailo
- Department of Neurosurgery and Gamma Knife Radiosurgery, I.R.C.C.S. Ospedale San Raffaele, Vita-Salute University, Via Olgettina 60, 20132, Milano, Italy.
| | - Filippo Gagliardi
- Department of Neurosurgery and Gamma Knife Radiosurgery, I.R.C.C.S. Ospedale San Raffaele, Vita-Salute University, Via Olgettina 60, 20132, Milano, Italy
| | - Nicola Boari
- Department of Neurosurgery and Gamma Knife Radiosurgery, I.R.C.C.S. Ospedale San Raffaele, Vita-Salute University, Via Olgettina 60, 20132, Milano, Italy
| | - Alfio Spina
- Department of Neurosurgery and Gamma Knife Radiosurgery, I.R.C.C.S. Ospedale San Raffaele, Vita-Salute University, Via Olgettina 60, 20132, Milano, Italy
| | - Martina Piloni
- Department of Neurosurgery and Gamma Knife Radiosurgery, I.R.C.C.S. Ospedale San Raffaele, Vita-Salute University, Via Olgettina 60, 20132, Milano, Italy
| | - Antonella Castellano
- Department of Neurosurgery and Gamma Knife Radiosurgery, I.R.C.C.S. Ospedale San Raffaele, Vita-Salute University, Via Olgettina 60, 20132, Milano, Italy
| | - Pietro Mortini
- Department of Neurosurgery and Gamma Knife Radiosurgery, I.R.C.C.S. Ospedale San Raffaele, Vita-Salute University, Via Olgettina 60, 20132, Milano, Italy
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6
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Tynan D, Ng J, Hardy TG. Primary Extradural Ectopic Orbital Meningioma in a Child. Ophthalmic Plast Reconstr Surg 2022; 38:e154-e158. [PMID: 35550454 DOI: 10.1097/iop.0000000000002200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The authors describe a rare case of primary extradural ectopic meningioma of the orbit in a 13-year-old female managed with surgical excision, adding to the very limited literature of this diagnosis in children. This is the second case to show a radiological abnormality in the gyrus rectus and olfactory bulb; however, in our case, there was no radiological evidence of connection seen.
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Affiliation(s)
- Dominique Tynan
- Royal Children's Hospital, Melbourne, Victoria, Australia
- Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
- The University of Sydney, Sydney, New South Wales, Australia
| | - Jessica Ng
- Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Thomas G Hardy
- Royal Children's Hospital, Melbourne, Victoria, Australia
- Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
- Department of Surgery, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia
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Ahmed N, Ferini G, Haque M, Umana GE, Scalia G, Chaurasia B, Vats A, Rahman A. Primary Intraosseous Osteolytic Meningioma with Aggressive Clinical Behaviour: Clinico-Pathologic Correlation and Proposed New Clinical Classification. Life (Basel) 2022; 12:life12040548. [PMID: 35455037 PMCID: PMC9025523 DOI: 10.3390/life12040548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 03/16/2022] [Accepted: 04/02/2022] [Indexed: 11/29/2022] Open
Abstract
(1) Introduction: Primary intraosseous osteolytic meningiomas (PIOM) are non-dural-based tumors predominantly presenting an osteolytic component with or without hyperostotic reactions. They are a subset of primary extradural meningiomas (PEM). In this study, we present a peculiar case with a systematic literature review and propose a new classification considering the limitations of previous classification systems. (2) Materials and Methods: Using a systematic search protocol in Google Scholar, PubMed, and Scopus databases, we extracted all case studies on PIOM published from inception to December 2020. A 46-year-old female patient form Dhaka, Bangladesh, was also described. The search protocol was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. (3) Results: Here, we present a 46-year-old female patient with PIOM who successfully underwent bifrontal craniotomy and gross total removal (GTR) of the tumor. At 6-month follow-up, no tumor recurrence was shown. Including our new case, 55 total cases from 47 articles were included in the analysis. PIOMs were in closer frequency among males (56.4%) and females (43.6%). The most common tumor location was the frontal and parietal calvarium, most commonly in the frontal bone (29.1%). Surgical resection was the predominant modality of treatment (87.3%); only 1.8% of patients were treated with radiotherapy, and 5.4% received a combination of surgery and radiotherapy. Gross total resection (GTR) was achieved in 80% of cases. Extracranial extension was reported in 41.8% of cases, dural invasion in 47.3%, and recurrence in 7.3%. Whole-body 68 Ga-DOTATOC PET/CT has also been reported as a useful tool both for differential diagnosis, radiotherapy contouring, and follow-up. Current treatments such as hydroxyurea and bevacizumab have variable success rates. We have also suggested a new classification which would provide a simple common ground for further research in this field. (4) Conclusions: Surgical resection, especially GTR, is the treatment of choice for PIOM, with a high GTR rate and low risk of complications and mortality. More research is needed on the differential diagnosis and specific treatment of PIOM.
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Affiliation(s)
- Nazmin Ahmed
- Department of Neurosurgery, Ibrahim Cardiac Hospital and Research Institute (A Centre for Cardiovascular, Neuroscience and Organ Transplant Units), Shahbag, Dhaka 1000, Bangladesh;
| | - Gianluca Ferini
- Department of Radiation Oncology, REM Radioterapia srl, 95029 Catania, Italy;
| | - Moududul Haque
- Department of Neurosurgery, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka 1000, Bangladesh; (M.H.); (A.R.)
| | - Giuseppe Emmanuele Umana
- Trauma Center, Gamma Knife Center, Department of Neurosurgery, Cannizzaro Hospital, 95100 Catania, Italy
- Correspondence:
| | - Gianluca Scalia
- Department of Neurosurgery, Highly Specialized Hospital and of National Importance “Garibaldi”, 95126 Catania, Italy;
| | - Bipin Chaurasia
- Department of Neurosurgery, Neurosurgery Clinic, Birgunj 44300, Nepal;
| | - Atul Vats
- Neurosurgery Department, James Cook University Hospital, Middlesbrough TS4 3BW, UK;
| | - Asifur Rahman
- Department of Neurosurgery, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka 1000, Bangladesh; (M.H.); (A.R.)
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Yokoya S, Hisaoka S, Fujiwara G, Oka H, Hino A. Posttraumatic rapid growing extradural meningioma: A case report on the effectiveness of echosonography. Surg Neurol Int 2022; 13:61. [PMID: 35242427 PMCID: PMC8888292 DOI: 10.25259/sni_1125_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 01/27/2022] [Indexed: 11/18/2022] Open
Abstract
Background: Most meningiomas related to head trauma have been reported to show intradural lesions; however, they can also occur as primary extradural meningiomas (PEMs) and have often been reported to histologically demonstrate atypical or malignant subtypes. Therefore, early detection and complete resection of related tissues are required; however, to date, only a few PEM cases related to trauma or injury have been reported. Herein, we present a patient with a rapidly growing posttraumatic PEM, in which echosonography is efficient not only for early diagnosis but also for intraoperative strategies. Case Description: A 62-year-old male presented to a nearby clinic with a complaint of a painless head bump that gradually grew larger in relation to trauma 6 weeks earlier. He underwent echosonography and pointed out the possibility of a cranial tumor and consulted our hospital. Although preoperative imaging studies, such as computed tomography or magnetic resonance imaging, did not provide reliable information on dura mater invasion, echosonography demonstrated dural invasion and intradural lesions in which large vessels passed the surface of the lesion. Based on these findings, we could safely resect the lesion within a sufficient range. Conclusion: Echosonography may not only be a cue for an early diagnosis but also provide important information for the treatment strategy of PEM that is related to head trauma.
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Kumar M, Joshi A, Meena RK, Nalin S. Atypical intradiploic meningioma: A case report and review of the literature. Surg Neurol Int 2022; 13:46. [PMID: 35242412 PMCID: PMC8888296 DOI: 10.25259/sni_774_2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 01/18/2022] [Indexed: 11/23/2022] Open
Abstract
Background: Intradiploic meningiomas with osteolytic bony changes are rarely reported in the literature. Intradiploic meningiomas are usually slow-growing benign lesions but atypical histopathology predicts aggressive behavior. Atypical intradiploic meningiomas (WHO Grade II) have some controversies in the management which are highlighted in this article. Case Description: A 40-year-old male, with a history of trauma to the head 12 years back, presented with a hard, slow-growing painless swelling exactly at the site of trauma. On imaging, lesion was intradiploic one with osteolytic margins and homogeneously enhancing on contrast magnetic resonance imaging. Biopsy was that of atypical meningioma (WHO Grade II). Conclusion: Atypical meningiomas with osteolytic changes are rarely reported in the literature. Because of potential aggressive behavior, they need a regular follow-up with radiological imaging.
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Affiliation(s)
- Mukesh Kumar
- Department of Neurosurgery, Dr. Rajendra Prasad Government Medical College, Tanda Medical College, Kangra, Himachal Pradesh, India
| | - Amit Joshi
- Department of Neurosurgery, Dr. Rajendra Prasad Government Medical College, Tanda Medical College, Kangra, Himachal Pradesh, India
| | - Rajesh Kumar Meena
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Shrish Nalin
- Department of Neurosurgery, Dr. Rajendra Prasad Government Medical College, Tanda Medical College, Kangra, Himachal Pradesh, India
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Liu PC, Lieu AS, Lin CJ, Tsai HP, Chai CY, Kwan AL. High Expression of Sp1 is Associated with Recurrence of Meningioma. World Neurosurg 2021; 149:e1056-e1060. [PMID: 33453428 DOI: 10.1016/j.wneu.2021.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 01/05/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Meningioma has the second highest incidence among primary intracranial tumors. There is no effective treatment or targeted therapy for meningioma except excision and radiotherapy. Sp1 (specificity protein 1) is a transcription factor that regulates tumor growth, but the literature describing the relationship between Sp1 and meningioma is scarce. The purpose of this study was to investigate the relationship between Sp1 expression and the clinicopathological parameters in meningioma by immunohistochemical staining. METHODS We collected samples from 74 patients from 2008-2012 in Kaohsiung Medical University Hospital, with staging and prognosis of the pathological section of the meningioma. RESULTS Our results show that Sp1 expression was significantly associated with World Health Organization grade, malignancy, and recurrence in patients with meningioma. CONCLUSIONS High expression of Sp1 in patients with meningioma was linked to poor prognosis of recurrence-free time. Therefore Sp1 may be a candidate biomarker of prognosis and therapy target in meningioma.
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Affiliation(s)
- Ping-Chuan Liu
- Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ann-Shung Lieu
- Division of Neurosurgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Surgery, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chien-Ju Lin
- School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hung-Pei Tsai
- Division of Neurosurgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chee-Yin Chai
- Department of Pathology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Pathology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Aij-Lie Kwan
- Division of Neurosurgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Surgery, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Neurosurgery, University of Virginia, Charlottesville, Virginia, USA.
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11
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Clifton BA, Abraham A, Ray A. A Case of Persistent Frontal Swelling. JAMA Otolaryngol Head Neck Surg 2021; 146:857-858. [PMID: 32729922 DOI: 10.1001/jamaoto.2020.1610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
| | - Anu Abraham
- Department of Pathology, University of Mississippi Medical Center, Jackson
| | - Amrita Ray
- Department of Otolaryngology-Head and Neck Surgery, University of Mississippi Medical Center, Jackson
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12
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Cho H, Kim S, Kang M, Kim D. Primary Extracranial Fibrous Meningioma of the Maxillary Sinus: A Case Report and Literature Review. TAEHAN YONGSANG UIHAKHOE CHI 2021; 82:231-236. [PMID: 36237455 PMCID: PMC9432393 DOI: 10.3348/jksr.2020.0072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/15/2020] [Accepted: 05/31/2020] [Indexed: 06/16/2023]
Abstract
Meningioma is a common neoplasm of the central nervous system; however, primary extracranial meningioma of the paranasal sinus, especially the maxillary sinus, is rare. We report a case of primary extracranial meningioma (fibrous type) of the maxillary sinus and present a literature review of the imaging features that correlate with fibrous meningioma.
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13
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Omofoye OA, Huynh T, Jhun R, Ashfaque H, Cronk K. Primary intraosseous meningioma of the calvarium: A systematic review. Clin Neurol Neurosurg 2020; 199:106283. [PMID: 33069929 DOI: 10.1016/j.clineuro.2020.106283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 09/23/2020] [Accepted: 10/04/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Primary intraosseous meningiomas (PIM) of calvarial origin are a small subset of meningiomas that arise from and occur within the calvarial bone. Its definition is often confused with other forms of non-dural based intracranial meningiomas, which has made previously published retrospective reviews heterogenous, non-specific and sometimes inaccurate. We present a systematic review of calvarial PIM. METHODS Using a systematic search protocol that included databases such as PubMed, Web of Science and Embase, we extracted all human studies on PIM published from inception to December 2017. This systematic review includes case reports and retrospective reviews that specifically described PIM. RESULTS On review of 166 articles identified with the systematic search protocol, 69 articles were analyzed. These comprised of 64 case reports, 1 case series and 4 retrospective reviews. 111 patients with PIM of calvarial origin were analyzed, 58 % of which were females and 42 % males. The mean patient age was 51 years and the frontal bone was the most common tumor location, occurring in 26.1 % of the cases. Surgical resection was the predominant modality of treatment in 97.2 % of the cases, and gross total resection was achieved in 84 % of cases that reported extent of resection. There were no recurrences for grade I meningiomas. However, all grade III meningiomas recurred and 33.3 % of grade II meningiomas showed recurrence with a mean postoperative follow-up interval of 20 months. Statistical analysis using Fisher's exact test showed the recurrence rate to be strongly associated with WHO tumor grade (p-value <0.001). CONCLUSION There is statistically significant increased recurrence rate for calvarial PIM of higher grades, and we recommend close follow-up in those cases. Surgical resection remains the overwhelming treatment of choice for calvarial PIM, and it has a high gross total resection rate and low risk of complications and mortality.
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Affiliation(s)
- Oluwaseun A Omofoye
- Boston Medical Center, Department of Neurosurgery, 725 Albany Street 7c, Boston, MA, 02118, USA.
| | - Trong Huynh
- Boston Medical Center, Department of Neurosurgery, 725 Albany Street 7c, Boston, MA, 02118, USA.
| | - Ray Jhun
- Boston University School of Medicine, 72 East Concord Street, Boston, MA, 02118, USA.
| | - Hasan Ashfaque
- Boston Medical Center, Department of Neurosurgery, 725 Albany Street 7c, Boston, MA, 02118, USA.
| | - Katharine Cronk
- Boston Medical Center, Department of Neurosurgery, 725 Albany Street 7c, Boston, MA, 02118, USA.
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Type III Intraosseous Meningioma Invading Superior Sagittal Sinus and Skull Periosteum. J Craniofac Surg 2020; 30:e561-e563. [PMID: 30939563 DOI: 10.1097/scs.0000000000005525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Type III intraosseous meningioma is a very rare type of meningioma with extracranial extension. Herein, the author reported a case of type IIIC intraosseous meningioma with invasion of the superior sagittal sinus and skull periosteum. A 67-year-old woman was admitted to our hospital due to a mass on the left frontoparietal region for 4 years. Magnetic resonance imaging showed a skull tumor with invasion of the superior sagittal sinus. After partial resection of the tumor, pathological and immunohistochemical staining revealed that the epithelial meningioma derived from skull involved the skull periosteum. There was no enlargement of residual parasagittal tumor after 1 year of follow-up. The intraosseous meningioma in the present case was a rare benign tumor with good prognosis after surgery.
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Aydin Ozturk P, Yilmaz T, Ozturk U, Aydin K. Pediatric Orbital Roof Intradiploic Meningioma Operated by Eyebrow Incision. Pediatr Neurosurg 2020; 55:309-312. [PMID: 33207345 DOI: 10.1159/000511282] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 08/28/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Primary intradiploic meningiomas account for <1% of all osseous calvarial lesions and are categorized as bone tumors. They are frequently observed in the frontotemporal region of the calvarium, anterior cranial fossa, and orbit. We present a case of intradiploic meningioma of the orbital roof, which is rarely observed in the pediatric age-group; it was surgically treated with a unique minimally invasive approach. CASE PRESENTATION A 16-year-old male with chief complaints of headache on the right side for approximately 1 year was presented to our clinic. Cranial MRI revealed an intradiploic mass with homogeneous, hypointense contrast patterns on the T1W and T2W images of the right orbital roof. A skin incision was made through the right eyebrow, and the frontal sinus anterior wall was opened by craniotomy. Gross total resection was achieved by reaching the tumor present in the orbital roof. The mass was characterized as psammomatous meningioma by a pathological examination. DISCUSSION/CONCLUSION In cranial oncologic surgery, lesion localization and possible pathological diagnosis are essential for the determination of the correct surgical technique. In particular, in pediatric cases, selecting a method that will reduce the need for transfusion, shorten the surgical time, minimize the chances of facial deformity, and facilitate postoperative care will ensure compliance with the correct and appropriate treatment process.
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Affiliation(s)
- Pinar Aydin Ozturk
- Department of Neurosurgery, Health Science University Gazi Yasargil Education Research Hospital, Diyarbakir, Turkey,
| | - Tevfik Yilmaz
- Department of Neurosurgery, Dicle University Medical Faculty, Diyarbakir, Turkey
| | - Unal Ozturk
- Department of Neurology, Health Science University Gazi Yasargil Education Research Hospital, Diyarbakir, Turkey
| | - Kamuran Aydin
- Department of Neurosurgery, Dicle University Medical Faculty, Diyarbakir, Turkey
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Verhoeven V, Vrints I, De Keyser J, Menovsky T, Thiessen F, Tondu T. A contemporary and a historical patient with an ectopic meningioma. Acta Chir Belg 2019; 119:254-258. [PMID: 29490576 DOI: 10.1080/00015458.2018.1438561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 02/04/2018] [Indexed: 10/17/2022]
Abstract
Introduction: Ectopic meningiomas are rare tumors which can be encountered by all surgical specialties. Patients and methods: We report on two different cases, a contemporary one and a historical one, highlighting the diversity of clinical presentations and prognoses of these lesions. Furthermore epidemiological aspects, clinical features, and diagnostic and therapeutic work-up in patients with an ectopic meningioma are reviewed. Results: Typically, ectopic meningiomas present as gradually expanding lesions, causing a variety of symptoms by their mass effect. Diagnosis is based on histological characteristics, which are similar to those of intracranial meningiomas. Treatment is primarily surgical. Conclusions: The cases we report are at different ends of the clinical and prognostic spectrum. Therapeutic options for different clinical scenarios are discussed.
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Affiliation(s)
- Veronique Verhoeven
- a Department of Primary and Interdisciplinary Care (ELIZA) - Faculty of Medicine and Health Sciences , University of Antwerp , Belgium
| | - Ina Vrints
- b Department of Plastic and Reconstructive Surgery , Antwerp University Hospital , Antwerp , Belgium
| | | | - Tomas Menovsky
- d Department of Neurosurgery , Antwerp University Hospital , Antwerp , Belgium - Faculty of Medicine and Health Sciences , University of Antwerp , Belgium
| | - Filip Thiessen
- b Department of Plastic and Reconstructive Surgery , Antwerp University Hospital , Antwerp , Belgium
| | - Thierry Tondu
- b Department of Plastic and Reconstructive Surgery , Antwerp University Hospital , Antwerp , Belgium
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Kwon SM, Ko Y, Bang SS. Primary intraosseous osteolytic meningioma: a case report and review of the literature. BMC Neurol 2019; 19:176. [PMID: 31337352 PMCID: PMC6647308 DOI: 10.1186/s12883-019-1392-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 07/03/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Primary intraosseous meningioma is a subset of extradural meningioma that arises in the bone, and only a few cases have been reported to date. CASE PRESENTATION An 80-year-old man presented with decreased hearing on the right side accompanied by a disturbance of balance 10 months prior to admission. Magnetic resonance imaging revealed an 8 × 7 cm osteolytic mass in the right posterior fossa related to the petrous bone, with extension to the cervical region. During surgery, the tumor was found to be located extradurally, with no invasion of the dura. The tumor was removed entirely, apart from a small portion around the jugular foramen to avoid lower cranial nerve injury. CONCLUSION The final diagnosis was primary intraosseous osteolytic meningioma with atypical pathology. Here, we report a rare case of an osteolytic skull lesion in the skull base not invading the dura and with extensive bone destruction.
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Affiliation(s)
- Sae Min Kwon
- Departments of Neurosurgery, College of Medicine, Hanyang University, 17 Haengdang-dong, Seongdong-gu, 133-792, Seoul, Republic of Korea.,Department of Neurosurgery, Keimyung University School of Medicine, 1095 Dalgubeol-daero, Dalseo-gu, Daegu, 42601, Republic of Korea
| | - Yong Ko
- Departments of Neurosurgery, College of Medicine, Hanyang University, 17 Haengdang-dong, Seongdong-gu, 133-792, Seoul, Republic of Korea.
| | - Seong Sik Bang
- Departments of Pathology, College of Medicine, Hanyang University, 17 Haengdang-dong, Seongdong-gu, 133-792, Seoul, Republic of Korea
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Shankar JJS, Hodgson L, Sinha N. Diffusion weighted imaging may help differentiate intracranial hemangiopericytoma from meningioma. J Neuroradiol 2019; 46:263-267. [DOI: 10.1016/j.neurad.2018.11.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 10/29/2018] [Accepted: 11/15/2018] [Indexed: 11/25/2022]
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Rami A, Suzan E, Rafeed A, Nooruddeen AM, Lamees A, Duaa A, Hussam AN, Amer AS. The Sovereignty of Primary Cranial Tumors-Meningiomas: Vetting the Cardinal Epidemiological Features. Med Arch 2019; 72:434-438. [PMID: 30814776 PMCID: PMC6340618 DOI: 10.5455/medarh.2018.72.434-438] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Introduction: Cranial meningiomas considered one of most frequently encountered primary intracranial tumors in our daily neurosurgical practice, represent about 36% of brain neoplasms. Aim: In this cohort analysis, we investigated epidemiological features of brain meningiomas diagnosed at a single institution. Special highlighting has been dedicated to demographic features, foretelling radiological signs, and concomitant factors predictive of tumor atypia. Material and Methods: This retrospective analysis was conducted by revising all medical registries of patients aged ≥18 years, with a diagnosis of brain meningioma treated at King Hussein Medical Center, patients were retrieved from the electronic hospital database during a 12-year period (2004 to 2015). Preoperative radiology reports were examined to confirm tumor site and size based on largest measured dimension. Level of resection was based on surgical operative reports and post-operative radiological imaging. Results: A total of 665-patients operated for intracranial meningiomas were analyzed out of total 2047-patients operated for intracranial neoplasm during the same period. Demographic analysis showed; female to male ratio 2.4:1. Mean age 49.6-years. Average follow-up of 8.7 years. Tumor locations were classified as parasagittal (39.55%), convexity (27.52%), tentorial/ falx (6.17%), intraventricular (2.04%). Mean tumor size was 3,86 cm and tumor size was >4.5cm in (28. 07%) of cases. In this study we achieved gross total resection in (73.1%) of cases, subtotal resection in (22.6%). The majority of patients evolved favorably with respect to their neurological examination post-operatively, though a neurological deficit persisted in 64-cases and 16-cases developed a new neurological deficit. Ninety five cases developed recurrence during the observation period. Surgical mortality was reported in 11-cases in the immediate post-operative period and in 42-cases further cases during the observation period related to other causes. Conclusion: Neurosurgery faces a large number of intracranial meningioma patients in daily practice. Because of its “benign” nature; the variability in management strategy, Neurosurgery is more and more challenged with the concern of intracranial meningioma treatment in the daily practice. Because of its “benign” nature; the variability in management strategy, research regarding the meningioma etiology and epidemiology has lagged behind that for more malignant intracranial neoplasms. These risk factors piloted a revitalization in the study of meningiomas.
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Affiliation(s)
- Alqroom Rami
- Neurosurgery Department, King Hussein Medical Center, Royal Medical Services, Amman, Jordan
| | - Eteiwi Suzan
- Endocrinology Department, King Hussein Medical Center, Royal Medical Services, Amman, Jordan
| | - Aldrous Rafeed
- Neurosurgery Department, King Hussein Medical Center, Royal Medical Services, Amman, Jordan
| | | | - Arabiyat Lamees
- Plastic Surgery Department at Farah Center, Royal Medical Services, Amman, Jordan
| | - Alshurbaji Duaa
- Pathology Department at Princess Iman Research and Laboratory Sciences Center, Amman, Jordan
| | - Abu Nowar Hussam
- Neurosurgery Department, King Hussein Medical Center, Royal Medical Services, Amman, Jordan
| | - Al Shurbaji Amer
- Neurosurgery Department, King Hussein Medical Center, Royal Medical Services, Amman, Jordan
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Slentz DH, Bellur S, Taheri MR, Almira-Suarez MI, Sherman JH, Mansour TN. Orbital malignant meningioma: a unique presentation of a rare entity. Orbit 2018; 37:457-462. [PMID: 29485367 DOI: 10.1080/01676830.2018.1437189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 01/05/2018] [Accepted: 01/28/2018] [Indexed: 06/08/2023]
Abstract
An elderly female with progressive proptosis was found to have an aggressive retrobulbar solid orbital mass. The mass was distinct from the optic nerve sheath and intracranial meninges, and produced concave erosion of the sphenoid wing. Operative findings demonstrated an orbital mass adherent to the dura of the superior orbital fissure. The mass did not demonstrate meningeal violation, infiltrate the superior orbital fissure, or display intracranial spread. The dura remained intact after gross total resection. Histopathology revealed a malignant meningioma with papillary and focal rhabdoid morphology and bony invasion (WHO grade III). The patient received 2500cGy of stereotactic radiotherapy in addition to gross total resection. Postoperatively, the signs and symptoms of orbital mass effect resolved (proptosis, relative afferent papillary defect, and periorbital edema) and the vision improved. There was no orbital recurrence or intracranial extension. The follow-up time was limited to eight months secondary to the patient succumbing to metastatic lung adenocarcinoma, which was demonstrated to be a separate process from the orbital meningioma. We propose the etiology of this tumor to be most consistent with an orbital malignant primary extradural meningioma - the first case reported in the literature.
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Affiliation(s)
- Dane H Slentz
- a Department of Ophthalmology , The George Washington University School of Medicine and Health Sciences , Washington , DC , USA
| | - Sunil Bellur
- b The McGovern Medical School at the University of Texas Health Science Center at Houston , Houston , TX , USA
| | - M Reza Taheri
- c Department of Radiology , The George Washington University School of Medicine and Health Sciences , Washington , DC , USA
| | - M Isabel Almira-Suarez
- d Department of Pathology , The George Washington University School of Medicine and Health Sciences , Washington , DC , USA
| | - Jonathan H Sherman
- e Department of Neurosurgery , The George Washington University School of Medicine and Health Sciences , Washington , DC , USA
| | - Tamer N Mansour
- a Department of Ophthalmology , The George Washington University School of Medicine and Health Sciences , Washington , DC , USA
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Satyarthee GD. Primary Extradural Meningioma of Posterior Fossa Associated with Acquired Chiari Malformation: A Short Review. Asian J Neurosurg 2018; 13:421-424. [PMID: 29682049 PMCID: PMC5898120 DOI: 10.4103/ajns.ajns_28_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Generally, meningioma is considered intracranial lesion occurring in the intradural compartment. However, meningioma can also occur and usually confined in the extradural compartment called as primary extradural meningioma (PEM). PEM represents a special subgroup of meningioma constitute about 1% of all meningioma. PEM arises outside the subdural compartment and usually contains neither connection underlying subdural structures nor extends into with subdural compartment. It is commonly located in the paranasal sinus, middle ear, rarely in the intradiploic spaces of calvarial bone such as temporal, frontal, and parietal bone and orbit but extremely uncommonly in the occipital and sphenoid bones. Authors did detailed Pubmed search for posterior fossa, occipital bone extradural, ectopic intraosseous meningioma which yielded only four publications in the form of isolated case report analyzing only five case of PEM. Authors report a rare case extradural meningioma in a 40-year-old male, who presented with progressive headache and gait imbalance. Magnetic resonance imaging study of brain revealed the presence of PEM of posterior fossa associated with acquired Chiari malformation. The patient was managed successfully surgically with excision of meningioma and release of associated acquired tonsiallar descent was carried out. Authors are analyzing total of five cases including four cases from published literature and one our current case. PEM of the posterior fossa tends to have equal predilection in male and female (3:3), with a mean age of 48 years (range 25-64 years). All cases were surgically and underwent gross total surgical excision. The clinical features, imagings, and management of this rare entity along with the pertinent literature are briefly discussed.
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22
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Wang Y, Teng Y, Xu H, Li Y. Primary Intraosseous Lymphoplasmacyte-Rich Meningioma. World Neurosurg 2017; 109:291-293. [PMID: 28962957 DOI: 10.1016/j.wneu.2017.09.133] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 09/18/2017] [Accepted: 09/19/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND Lymphoplasmacyte-rich meningioma is an uncommon variant of meningioma, and that arising in the extradural site is extremely rare. CASE DESCRIPTION We report a case of primary intraosseous lymphoplasmacyte-rich meningioma. A 51-year-old woman presented with left frontal scalp swelling lasting longer than 1 year. Magnetic resonance imaging revealed an intraosseous extradural mass in the left frontal region with bone destruction. Surgical resection of the mass with a cranioplasty was performed. The postoperative course was uneventful, and histopathologic findings were consistent with a lymphoplasmacyte-rich meningioma. After a follow-up period of 2 years, no residual tumor or in situ recurrence was noted. CONCLUSIONS Lymphoplasmacyte-rich meningioma occurring in the intraosseous extradural region is extremely rare. It is crucial for clinicians to be aware of this entity as it can be easily mistaken for more common osteogenic neoplasms occurring at this site.
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Affiliation(s)
- Yubo Wang
- Department of Neurosurgery, First Hospital of Jilin University, Changchun, China
| | - Yongliang Teng
- Department of Pathology, First Hospital of Jilin University, Changchun, China
| | - Haiyang Xu
- Department of Neurosurgery, First Hospital of Jilin University, Changchun, China
| | - Yunqian Li
- Department of Neurosurgery, First Hospital of Jilin University, Changchun, China.
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Zhang S, Zhang J, Chen J, Ai X, He X. Frontal intradiploic meningioma with progressive intracranial invasion: A rare case report. Medicine (Baltimore) 2017; 96:e7903. [PMID: 28834912 PMCID: PMC5572034 DOI: 10.1097/md.0000000000007903] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
RATIONALE Intradiploic meningiomas are a subset of extradural meningiomas that arise in the skull. They are mostly localized in the frontoparietal and orbital regions, and they are often mistaken for primary bone tumors. PATIENT CONCERNS The patient was a 48-year-old man with headache and a 12-year history of frontal cranium occupation, which was first discovered in 2005 and enlarged in 2009. The patient had a history of fracture in his frontal cranium 12 years ago. The computed tomography and magnetic resonance imaging revealed an occupation and intracranial invasion in frontal cranium. And the angiography showed an occlusion at the anterior part of sagittal sinus. INTERVENTIONS Bilateral frontal craniotomy, intracranial tumor resection, and cranioplasty were performed. DIAGNOSIS Histologic examination confirmed an intradiploic ectopic meningioma (World Health Organization Grade I). OUTCOMES He was discharged with no neurological deficits 3 days after surgery. At the 6-month clinical follow-up, there was no tumor recurrence or other complaints. LESSONS In this study, we present the case of a frontal intradiploic meningioma with progressive intracranial invasion and review the radiographic and clinical findings of patients with primary intraosseous meningioma.
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Affiliation(s)
- Sunfu Zhang
- The First People's Hospital of Yibin, Sichuan 81 Rehabilitation Center/Sichuan provincial Rehabilitation Hospital
- West China School of Medicine, West China Hospital, Sichuan University, Sichuan, China
| | - Jing Zhang
- West China School of Medicine, West China Hospital, Sichuan University, Sichuan, China
| | - Junchen Chen
- The First People's Hospital of Yibin, Sichuan 81 Rehabilitation Center/Sichuan provincial Rehabilitation Hospital
| | - Xiaolin Ai
- West China School of Medicine, West China Hospital, Sichuan University, Sichuan, China
| | - Xia He
- The First People's Hospital of Yibin, Sichuan 81 Rehabilitation Center/Sichuan provincial Rehabilitation Hospital
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Orbital Recurrence of Ethmoid Sinus Malignant Meningioma: Case Study and Literature Review. Ophthalmic Plast Reconstr Surg 2017; 33:e49-e51. [PMID: 27333450 DOI: 10.1097/iop.0000000000000728] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The authors describe a case of a recurrent World Health Organization grade III extradural, sinonasal meningioma that presented with epiphoria. Primary extradural meningiomas are rare, comprising only 1% to 2% of all meningiomas. These tumors are diagnosed and graded histologically according to the World Health Organization criteria. Grade III tumors are very malignant with high recurrence and death rates. This case highlights the rarity of sinonasal tract meningiomas involving the orbit. In addition, it shows the poor prognosis of such malignant disease and the need for a multidisciplinary approach. Collection and evaluation of protected patient health information for this report was in compliance with the Health Insurance Portability and Accountability Act and approved by the Institutional Review Board of Northwestern University Feinberg School of Medicine. Research adhered to the tenets of the Declaration of Helsinki.
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25
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Laarakker AS, Nakhla J, Lasala P. Surprising skull lesion. J Clin Neurosci 2016. [DOI: 10.1016/j.jocn.2016.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Mourad M, Chan D, Ducic Y. Surgical Management of Extracranial Meningiomas Arising in the Head and Neck. J Oral Maxillofac Surg 2016; 74:1872-8. [PMID: 27087283 DOI: 10.1016/j.joms.2016.03.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 03/13/2016] [Accepted: 03/15/2016] [Indexed: 11/28/2022]
Abstract
PURPOSE To determine outcomes in the management of extracranial meningiomas of the head and neck. PATIENTS AND METHODS This is a retrospective single-surgeon series performed at a tertiary-care referral center. In all, 23 patients met the inclusion criteria, consisting of 12 men and 11 women. The mean age of patients treated was 60.5 years (range, 32 to 71 years). Subsite involvement included the infratemporal fossa (n = 8), greater wing of the sphenoid and orbit (n = 7), clivus (n = 2), and parapharyngeal space (n = 6). RESULTS In all, recurrence occurred in 21% of patients (n = 5) who underwent gross tumor resection. Two patients underwent subtotal resection because of the tumor's location within the clivus with adjuvant CyberKnife therapy (Accuray, Sunnyvale, CA). Both patients had persistent disease with no new neurologic symptoms. Examination showed that 100% of patients (N = 23) had dural involvement. Post-ablative complications occurred in 43% of patients (n = 10). CONCLUSIONS We presently report the largest series of surgical treatment for extracranial meningiomas. Gross tumor resection should be the mainstay of therapy, except in anatomically restricted regions such as the petrous apex and clivus. Adjuvant therapy including CyberKnife therapy may be used in such lesions. All lesions showed dural involvement. A more unified nomenclature is required for the characterization of these lesions.
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Affiliation(s)
- Moustafa Mourad
- Resident Physician, Division of Facial Plastic Surgery, Department of Otolaryngology-Head & Neck Surgery, The New York Eye & Ear Infirmary, New York, NY
| | - David Chan
- Fellow Physician, Department of Otolaryngology Head and Neck Surgery, Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, TX
| | - Yadranko Ducic
- Professor, Department of Otolaryngology Head and Neck Surgery, Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, TX.
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Malignant Primary Extradural Meningioma in Elderly Patients: Report of Two Cases and Literature Review. INT J GERONTOL 2015. [DOI: 10.1016/j.ijge.2014.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Saade R, Hessel A, Ginsberg L, Fuller G, Bell D. Primary extradural meningioma presenting as a neck mass: Case report and review of the literature. Head Neck 2015; 37:E92-5. [DOI: 10.1002/hed.23874] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2014] [Indexed: 12/15/2022] Open
Affiliation(s)
- Rami Saade
- Department of Head and Neck Surgery; The University of Texas MD Anderson Cancer Center; Houston Texas
| | - Amy Hessel
- Department of Head and Neck Surgery; The University of Texas MD Anderson Cancer Center; Houston Texas
| | - Lawrence Ginsberg
- Department of Radiology; The University of Texas MD Anderson Cancer Center; Houston Texas
| | - Greg Fuller
- Department of Pathology; The University of Texas MD Anderson Cancer Center; Houston Texas
| | - Diana Bell
- Department of Pathology; The University of Texas MD Anderson Cancer Center; Houston Texas
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Primary intraosseous meningioma in the calvaria: morphological feature changes on magnetic resonance images over several years. Jpn J Radiol 2015; 33:437-40. [PMID: 25985957 DOI: 10.1007/s11604-015-0437-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 05/12/2015] [Indexed: 11/27/2022]
Abstract
Primary intraosseous meningiomas (PIMs) are rare, and their pathogenesis remains unclear. We report the case of a sizable PIM in the calvaria that progressively enlarged over several years and presented temporal changes in the morphological features on magnetic resonance images. Along with discussing the case, we further emphasize the potential pitfalls of diagnosing a PIM in the calvaria.
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Microcystic meningioma of the calvarium: a series of 9 cases and review of the literature. Am J Surg Pathol 2015; 39:505-11. [PMID: 25517950 DOI: 10.1097/pas.0000000000000347] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Meningiomas are one of the most common tumors that arise within the central nervous system; they represent up to 30% of all primary intracranial tumors. Extradural meningiomas are rare (<2% of all meningiomas), and most arise within the calvarium. Intraosseous calvarial meningiomas are usually easy to diagnose histologically if they are of the meningothelial type; however, they may cause diagnostic challenges when they manifest as unusual morphologic variants, such as the microcystic type. To address this issue we present a series of 9 cases of calvarial microcystic meningiomas arising in 7 female and 2 male patients; all patients were adults. The tumors had heterogenous findings on imaging studies and ranged in size from 1.1 to 4.3 cm in greatest dimension. The neoplasms were composed predominantly of stellate and spindle cells with long, thin interconnecting cytoplasmic processes arranged in a complex network. The resulting cellular architecture was "sieve-like" in appearance because of the formation of numerous small "cyst-like" spaces interposed between the cytoplasmic processes of the tumor cells. All of the neoplasms expressed the characteristic immunophenotype of meningiomas (EMA, PR positive). Most tumors were resected, and none of these have recurred during a follow-up period of 1 to 83 months (average 17 mo). The morphology of the tumors and their anatomic location generated problems in diagnosis, especially in 6 patients with a history of malignancy and for whom metastatic disease was suspected clinically. Intraosseous microcystic meningioma is uncommon, and this series, the largest reported to date, describes their clinicopathologic findings, biological behavior, and features that facilitate their accurate diagnosis.
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Yun JH, Lee SK. Primary osteolytic intraosseous atypical meningioma with soft tissue and dural invasion: report of a case and review of literatures. J Korean Neurosurg Soc 2015; 56:509-12. [PMID: 25628813 PMCID: PMC4303729 DOI: 10.3340/jkns.2014.56.6.509] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Revised: 07/01/2014] [Accepted: 10/28/2014] [Indexed: 11/27/2022] Open
Abstract
Primary intraosseous meningioma is a rare tumor, and atypical pathologic components both osteolytic lesion and dura and soft tissue invasion is extremely rare. A 65-year-old woman presented with a 5-month history of a soft mass on the right frontal area. MR imaging revealed a 4 cm sized, multilobulated, strongly-enhancing lesion on the right frontal bone, and CT showed a destructive skull lesion. The mass was adhered tightly to the scalp and dura mater, and it extended to some part of the outer and inner dural layers without brain invasion. The extradural mass and soft tissue mass were totally removed simultaneously and we reconstructed the calvarial defect with artificial bone material. The pathological study revealed an atypical meningioma as World Health Organization grade II. Six months after the operation, brain MR imaging showed that not found recurrence in both cranial and spinal lesion. Here, we report a case of primary osteolytic intraosseous atypical meningioma with soft tissue and dural invasion.
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Affiliation(s)
- Jung-Ho Yun
- Department of Neurosurgery, Dankook University College of Medicine, Cheonan, Korea
| | - Sang-Koo Lee
- Department of Neurosurgery, Dankook University College of Medicine, Cheonan, Korea
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Kariyattil R, Govindaraju V, Hamid RS, Unnikrishnan M. Primary Extradural Meningioma Presenting as Frontal Sinusitis with Extensive Bony Changes: Case report. Sultan Qaboos Univ Med J 2014; 14:e566-e570. [PMID: 25364563 PMCID: PMC4205072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Revised: 05/18/2014] [Accepted: 06/04/2014] [Indexed: 06/04/2023] Open
Abstract
Primary extradural meningiomas are rare tumours and calvarial meningiomas with extensive bony changes and frontal sinusitis are rarer still. We report a 40-year-old female patient who presented to the otorhinolaryngologist at the Sultan Qaboos University Hospital in Muscat, Oman, in October 2013 with headaches and frontal swelling. She was diagnosed with frontal sinusitis complicated by osteomyelitis. Further clinical examination and imaging revealed a left frontal calvarial meningioma with extensive bony changes and extracalvarial extension into the frontal sinus. She underwent a left frontal craniotomy during which the tumour was removed. The postoperative period was uneventful and a follow-up computed tomography scan after three months showed only postoperative changes. This report discusses the radiological differential diagnosis and management of this type of lesion.
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Affiliation(s)
- Rajeev Kariyattil
- Departments of Surgery, Sultan Qaboos University Hospital, Muscat, Oman
| | | | - Rana S. Hamid
- Radiology & Molecular Imaging, Sultan Qaboos University Hospital, Muscat, Oman
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Hyperplastic intradiploic meningothelial tissue in the orbital roof mimicking metastatic disease. Ophthalmic Plast Reconstr Surg 2012; 29:e22-3. [PMID: 22836795 DOI: 10.1097/iop.0b013e31825ca89b] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Osteolytic lesions are highly suggestive of metastatic disease or in rare instances may result from primary extradural meningiomas. Herein, we describe a rare case of a patient who presented with a large area of osteolysis on the right orbital roof. An excisional biopsy revealed that the lesion was associated with the presence of hyperplastic intra-osseous meningothelial tissue. To our best knowledge, this is the first evidence that ectopic nonneoplastic meningothelial cells may induce osteolysis on the orbital walls.
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Baek BJ, Shin JM, Lee CK, Lee JH, Lee KH. Atypical primary meningioma in the nasal septum with malignant transformation and distant metastasis. BMC Cancer 2012; 12:275. [PMID: 22759338 PMCID: PMC3420263 DOI: 10.1186/1471-2407-12-275] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Accepted: 07/03/2012] [Indexed: 01/27/2023] Open
Abstract
Background Primary extracranial meningiomas (PEMs) originating from the nasal septum are extremely rare, as are extracranial metastases of meningiomas. Case presentation A 44-year-old male presented with a 2-month history of left-side nasal obstruction and frequent episodes of epistaxis. A friable mass originating from the nasal septum was resected completely via an endoscopic endonasal approach. According to WHO criteria, the tumor was diagnosed as an atypical meningioma radiologically and histopathologically. Two years later, a tumor recurred at the primary site with the same histopathological findings, and the patient was given local external radiotherapy (6840 cGy in 38 fractions). Two months after this local recurrence, a left anterior chest wall mass and a left parietal area scalp mass were observed. The subcutaneous mass was resected and showed histological evidence of malignant transformation. Several months after the last operation, the patient died. Conclusions We describe the clinical, radiological, and bio-pathological features of this unique case and review the literature on atypical PEMs originating in the nasal septum. To our knowledge, this is the first reported case of an atypical PEM originating from the nasal septum that recurred with malignant transformation and extracranial metastasis.
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Affiliation(s)
- Byoung Joon Baek
- Department of Otolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Cheonan Hospital, 23-20 Bongmyung-Dong, Cheonan 330-721, Chungcheongnam-do, South Korea.
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