Primary meningioma of the mandible

Mandibular meningioma-a rare case report of a second extracranial meningioma and a systematic literature review

Meningiomas are benign tumours common in the central nervous system. Primary extracranial meningiomas in the jaws are extremely rare. We performed a systematic review of all the primary extracranial meningioma arising in the jawbones reported in the English-language literature including indexed and non-indexed journals and we report a unique case in our hospital of a man with two primary extracranial meningiomas, the first frontal intradiploic and 16 years later, a second located in the mandible. We found 14 cases with primary jaws meningioma and we report another one. A mandibular predominance was observed with only four cases in the maxilla. Most of them occurred in women, with a mean age of 35.9 years. It is the first published case of a patient with two primary extracranial meningiomas one of them in the mandible, which the gender, age and laterality of the lesion are less frequent.

Case Report: Rare site for intraoral meningioma

Extracranial meningioma is very rare with few cases reported, especially in the oral cavity. Its diagnosis is considered a challenge owing to the unusual site of occurrence.  We report, to the best of our knowledge, the first case of extra-cranial meningioma as a primary tumor in the hard palate with no detected intracranial extension. A 59-year-old Egyptian female patient presented with a 22-year history of a large painless swelling at the right side of the hard palate, which could not be seen on radiographs.  An incisional biopsy was taken and, after assessment with a panel of immunohistochemical markers, the lesion was diagnosed as extracranical grade I mengiothelial meningioma. The patient did not show up for surgical excision and follow-up was not performed because of the lose of contact with the patient. Intraoral meningioma is a rare tumor. Immuohistochemical markers are important for confirming this diagnosis.

Primary Extracranial Meningioma: A Rare Location

Meningiomas are benign extraaxial tumors of the central nervous system (CNS). Extracranial meningiomas are extremely rare (2%) and can develop as a direct extension from a primary intracranial meningioma or as true primary extracranial meningioma originating from ectopic arachnoid cells. Only eight cases of primary meningioma in the jaw have been reported to date. Extracranial meningiomas are frequently misdiagnosed, resulting in inappropriate clinical management. The aim of this article was to describe the case of a man with an asymptomatic swelling in the right retromolar area over a period of 2 months. Cone beam computed tomography was performed to determine the extension and involvement of the adjacent structures. Histopathological findings and immunohistochemical analysis aided in the diagnosis of primary extracranial meningioma in the mandible and several aspects of this unusual neoplasm are reviewed. The treatment of choice was a partial resection of the mandible and reconstruction with autogenous iliac tricortical bone. Five years after surgery, the patient remains free of disease.

The Meningioma that Got Cheeky

Extracranial meningiomas are rare with a reported incidence of 1-2 %. Diagnosis is a challenge due to the unusual site of occurrence. The treatment of choice is surgical excision. A case that presented with primary lesion in the cheek with no detected intracranial extension is being reported.

Extracranial meningioma in the vicinity of the temporal bone: a difficult preoperative diagnosis

BACKGROUND

Extracranial meningioma is a rare tumor, and most of the time only after histopathologic examination is diagnosis possible.

CASE DESCRIPTION

A 40-year-old right-handed woman presented with progressive swelling over the right side of the forehead and temporal region associated with proptosis and visual loss. Incisional biopsy of the lesion was reported as spindle cell tumor. Computed tomography scan showed large enhancing predominantly extracranial lesion located in the right anterior frontotemporal region extending into the infratemporal fossa and a relatively thin sheet of tumor on the intracranial aspect of the thickened temporal. Intraoperative impression was malignant tumor involving the temporalis muscle, and a near total excision of the lesion was performed. Histopathologic features were suggestive of meningothelial meningioma arising from the temporal bone with predominant extracranial extension.

CONCLUSION

Preoperative suspicion of a meningioma in this patient would have resulted in a more aggressive surgical approach as these lesions are relatively benign with indolent course.