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Liu YJ, Han L, Cao J, Zheng HW, Yu LS. Primary Middle Ear Meningioma with Intact Tympanic Membrane: A Case Report and Literature Review. EAR, NOSE & THROAT JOURNAL 2024; 103:364-369. [PMID: 34784773 DOI: 10.1177/01455613211058100] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Primary ectopic meningioma of the middle ear is relatively rare in clinical practice. It is often difficult to distinguish it from chronic otitis media or otitis media with effusion due to its similar and atypical clinical symptoms. We report a case of epithelial tympanic ectopic meningioma with the main complaints of otalgia, aural fullness, and hearing loss. It was accidentally discovered during tympanotomy due to the symptoms of recurring refractory secretory otitis media. This article briefly reviews the relevant literature in recent years, summarizes the characteristics of primary ectopic tympanic meningioma with intact tympanic membrane, and emphasizes the diagnosis and treatment strategy of the middle ear mass.
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Affiliation(s)
- Yuan-Jun Liu
- Department of Otorhinolaryngology, Head and Neck Surgery, Peking University People's Hospital, Peking University, Beijing, China
| | - Lin Han
- Department of Otorhinolaryngology, Head and Neck Surgery, Peking University People's Hospital, Peking University, Beijing, China
| | - Jie Cao
- Department of Otorhinolaryngology, Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Hong-Wei Zheng
- Department of Otorhinolaryngology, Head and Neck Surgery, Peking University People's Hospital, Peking University, Beijing, China
| | - Li-Sheng Yu
- Department of Otorhinolaryngology, Head and Neck Surgery, Peking University People's Hospital, Peking University, Beijing, China
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2
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Nozzoli F, Buccoliero AM, Massi D, Santoro R, Pecci R. External auditory canal ectopic atypical meningioma: A case report and brief literature review. Pathol Res Pract 2024; 253:154963. [PMID: 38029716 DOI: 10.1016/j.prp.2023.154963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 11/16/2023] [Accepted: 11/18/2023] [Indexed: 12/01/2023]
Abstract
Meningiomas are tumours typically derived from the meningothelial cells of the arachnoid mater. They most often arise in intracranial, intraspinal, or orbital locations. Ectopic meningiomas, described as primary meningiomas with no intracranial involvement, are definitely unconventional. In fact, most of the extracranial meningiomas described in the literature, particularly in the outer ear, are effectively spreads of disease with primary intracranial localization. We describe a case of a primary external auditory canal meningioma with demonstrated absence of intracranial involvement, and we provide a full radiological, histological, immunohistochemical and molecular characterization of the lesion.
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Affiliation(s)
- Filippo Nozzoli
- Section of Anatomic Pathology, Department of Health Sciences, University of Florence, Florence, Italy.
| | | | - Daniela Massi
- Section of Anatomic Pathology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Roberto Santoro
- Audiology and Robotic Oncologic Head and Neck Surgery, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Rudi Pecci
- Audiology and Robotic Oncologic Head and Neck Surgery, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
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3
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Moezzi C, Pickett B. Mastoiditis in a Patient With Seizures. JAMA Otolaryngol Head Neck Surg 2023; 149:938-939. [PMID: 37561497 DOI: 10.1001/jamaoto.2023.2102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
A 64-year-old man with a 2-year history of seizure disorder presented to the emergency department at an outside hospital with breakthrough seizures. What is your diagnosis?
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Affiliation(s)
- Cody Moezzi
- University of New Mexico School of Medicine, Albuquerque
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4
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Lott Limbach A, Chute DJ. Top 10 Nested Pattern Head and Neck Lesions to Notice. Head Neck Pathol 2023; 17:119-131. [PMID: 36928740 PMCID: PMC10063737 DOI: 10.1007/s12105-023-01534-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 01/13/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND Nested is defined as "cellular clusters arranged in small groupings with intervening vascular or stromal networks, lacking lumens or glandular formation." Using this definition, multiple neoplastic and non-neoplastic lesions of the head and neck come into the differential. We have broadly organized the differential diagnosis of "nested" tumors into entities with neuroendocrine differentiation, squamous differentiation, thyroid follicular cell differentiation, and other lesions. METHODS Review. RESULTS Many different entities have a nested appearance and the morphologic, immunohistochemical, clinical, and radiographic features contribute to the differential diagnosis. The different tumors covered in this review include neuroendocrine neoplasms, paraganglioma, middle ear neuroendocrine tumor (formerly known as middle ear adenoma), medullary thyroid carcinoma, poorly differentiated thyroid carcinoma, olfactory neuroblastoma, ectopic pituitary neuroendocrine tumor, hyalinizing trabecular tumor, solid subtype of papillary thyroid carcinoma, solid cell nests/C-cell hyperplasia, necrotizing sialometaplasia, and meningioma. CONCLUSION In this review, we discuss the morphologic and immunohistochemical features of the covered entities as a guide to differential diagnosis when nested-patterned head and neck lesions are encountered.
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Affiliation(s)
- Abberly Lott Limbach
- Department of Pathology, The Ohio State University Wexner Medical Center, E422 Doan Hall, 410 W 10th Ave, Columbus, OH 43210 USA
| | - Deborah J. Chute
- Department of Pathology, Cleveland Clinic, 9500 Euclid Ave L25, Cleveland, OH 44195 USA
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GENÇ A, AKYUVA Y, KABATAŞ S. Surgical Challenges of Meningiomas with Extracranial Invasion: A Clinical Study. MUSTAFA KEMAL ÜNIVERSITESI TIP DERGISI 2022. [DOI: 10.17944/mkutfd.1060518] [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
Objective: Meningiomas are mostly benign tumors located intracranially and intradurally, but they can rarely show extradural and extracranial growth. Surgical treatment of extracranial meningiomas is specifically challenging. In this study, we present an illustrated surgical series to convey our experience in treating meningiomas with extracranial extension.
Methods: We retrospectively reviewed 11 patients with meningioma who underwent surgery between 2008 and 2020. In these patients, both intracranial and extracranial components were confirmed both radiologically and intraoperatively.
Results: The patients were 7 males and 4 females with a mean age of 55.4 years. Most presented with facial disfigurement or asymmetrical growth of their skull. The most common symptom at presentation was headache. The most common location of meningiomas was the frontal region and that of extracranial growth was the paranasal sinuses and parietal bone invasion. We recognized two distinct modalities of bone destruction: hyperostosis (n=3) and osteolysis (n=8). Pathological study revealed atypical features in 6 patients. Preop embolization was attempted in 4 patients and proved difficult. Proper embolization was achieved only in one patient. The most commonly encountered surgical challenges were large calvarial and cranial base defects due to bone erosion, dural defects, and managing the superior sagittal sinus with parietal tumors. Excessive blood was of a particular concern and was managed by simple scalp clips, intraoperative transfusion, and conservative approach for tumor extensions into paranasal sinuses. No perioperative mortality occurred. Postoperative CSF fistulas beneath the scalp were common complications but conservatively managed with pressure wrapping. No cranial base CSF fistula developed. Calvarial reconstruction was performed with PMMA cement where needed.
Conclusions: Meningiomas with extracranial extension are surgically challenging but treatable tumors. It contains fine neurosurgical trics in its treatment and follow-up.
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Affiliation(s)
| | - Yener AKYUVA
- MUSTAFA KEMAL ÜNİVERSİTESİ HATAY SAĞLIK YÜKSEKOKULU
| | - Serdar KABATAŞ
- SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, İSTANBUL TAKSİM SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ
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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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Singh J, Patel U, Backous D. Primary external auditory canal meningioma: Case report and review of the literature. Am J Otolaryngol 2022; 43:103215. [PMID: 34536924 DOI: 10.1016/j.amjoto.2021.103215] [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: 07/02/2021] [Accepted: 09/05/2021] [Indexed: 11/17/2022]
Abstract
Meningiomas are tumors that arise from arachnoid cells attached to both the pia mater and the inner portion of the arachnoid. They are common intracranial tumors, representing 12-25% of intracranial neoplasms. Intracranial meningiomas can spread extracranially to involve surrounding structures, including the ear and temporal bone. Ectopic meningiomas, described as primary meningiomas with no intracranial involvement, are rare. We describe a case of a primary external auditory canal meningioma with no evidence of intracranial involvement. We present pre-operative imaging findings proving no intracranial involvement prior to surgical intervention. A literature review of this uncommon clinical entity is presented and a discussion regarding its prognosis and treatment is reviewed.
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Affiliation(s)
- Jeffrey Singh
- Puget Sound Ear, Nose and Throat, 21911 76th Ave W, Edmonds, WA, 98026, United States of America.
| | - Uresh Patel
- Swedish Neuroscience Institute, 747 Broadway, Seattle, WA 98122, United States of America
| | - Douglas Backous
- Puget Sound Ear, Nose and Throat, 21911 76th Ave W, Edmonds, WA, 98026, United States of America
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8
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Umana GE, Scalia G, Vats A, Pompili G, Barone F, Passanisi M, Graziano F, Maugeri R, Tranchina MG, Cosentino S, Ippolito M, Tomasi SO, Raudino G, Chaurasia B, Iacopino DG, Nicoletti GF, Cicero S, Strigari L, Perrotta RE. Primary Extracranial Meningiomas of the Head and Neck. Life (Basel) 2021; 11:life11090942. [PMID: 34575090 PMCID: PMC8468587 DOI: 10.3390/life11090942] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 09/02/2021] [Accepted: 09/07/2021] [Indexed: 12/29/2022] Open
Abstract
Meningiomas represent the most common benign histological tumor of the central nervous system. Usually, meningiomas are intracranial, showing a typical dural tail sign on brain MRI with Gadolinium, but occasionally they can infiltrate the skull or be sited extracranially. We present a systematic review of the literature on extracranial meningiomas of the head and neck, along with an emblematic case of primary extracranial meningioma (PEM), which provides further insights into PEM management. A literature search according to the PRISMA statement was conducted from 1979 to June 2021 using PubMed, Web of Science, Google Scholar, and Scopus databases, searching for relevant Mesh terms (primary extracranial meningioma) AND (head OR neck). Data for all patients were recorded when available, including age, sex, localization, histological grading, treatment, possible recurrence, and outcome. A total of 83 published studies were identified through PubMed, Google Scholar, and Scopus databases, together with additional references list searches from 1979 to date. A total of 49 papers were excluded, and 34 manuscripts were considered for this systematic review, including 213 patients. We also reported a case of a 45-year-old male with an extracranial neck psammomatous meningioma with sizes of 4 cm × 3 cm × 2 cm. Furthermore, whole-body 68Ga-DOTATOC PET/CT was performed, excluding tumor spread to other areas. Surgical resection of the tumor was accomplished, as well as skin flap reconstruction, obtaining radical removal and satisfying wound healing. PEMs could suggest an infiltrative and aggressive behavior, which has never found a histopathological correlation with a malignancy (low Ki-67, <5%). Whole-body 68Ga-DOTATOC PET/CT should be considered in the patient’s global assessment. Surgical removal is a resolutive treatment, and the examination of frozen sections can confirm the benignity of the lesion, reducing the extension of the removal of healthy tissue surrounding the tumor.
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Affiliation(s)
- Giuseppe Emmanuele Umana
- Trauma Center, Gamma Knife Center, Department of Neurosurgery, Cannizzaro Hospital, 95125 Catania, Italy; (F.B.); (M.P.); (S.C.)
- Correspondence:
| | - Gianluca Scalia
- Department of Neurosurgery, Highly Specialized Hospital and of National Importance “Garibaldi”, 95125 Catania, Italy; (G.S.); (F.G.); (G.F.N.)
| | - Atul Vats
- Neurosurgery Department, James Cook University Hospital, Middlesbrough TS1, UK;
| | - Gianluca Pompili
- Department of General Surgery and Medical and Surgery Specialities, Section of Plastic Surgery, University of Catania—“Cannizzaro” Hospital, 95125 Catania, Italy; (G.P.); (R.E.P.)
| | - Fabio Barone
- Trauma Center, Gamma Knife Center, Department of Neurosurgery, Cannizzaro Hospital, 95125 Catania, Italy; (F.B.); (M.P.); (S.C.)
| | - Maurizio Passanisi
- Trauma Center, Gamma Knife Center, Department of Neurosurgery, Cannizzaro Hospital, 95125 Catania, Italy; (F.B.); (M.P.); (S.C.)
| | - Francesca Graziano
- Department of Neurosurgery, Highly Specialized Hospital and of National Importance “Garibaldi”, 95125 Catania, Italy; (G.S.); (F.G.); (G.F.N.)
- Neurosurgical Clinic, AOUP “Paolo Giaccone”, Postgraduate Residency Program in Neurological Surgery, Department of Experimental Biomedicine and Clinical Neurosciences, School of Medicine, 90128 Palermo, Italy; (R.M.); (D.G.I.)
| | - Rosario Maugeri
- Neurosurgical Clinic, AOUP “Paolo Giaccone”, Postgraduate Residency Program in Neurological Surgery, Department of Experimental Biomedicine and Clinical Neurosciences, School of Medicine, 90128 Palermo, Italy; (R.M.); (D.G.I.)
| | | | - Sebastiano Cosentino
- Trauma Center, Gamma Knife Center, Nuclear Medicine Unit, Department of Advanced Technologies, Cannizzaro Hospital, 95125 Catania, Italy; (S.C.); (M.I.)
| | - Massimo Ippolito
- Trauma Center, Gamma Knife Center, Nuclear Medicine Unit, Department of Advanced Technologies, Cannizzaro Hospital, 95125 Catania, Italy; (S.C.); (M.I.)
| | - Santino Ottavio Tomasi
- Department of Neurological Surgery, Christian Doppler Klinik Paracelsus Medical University, 5020 Salzburg, Austria;
- Laboratory for Microsurgical Neuroanatomy, Christian Doppler Klinik, 5020 Salzburg, Austria
| | - Giuseppe Raudino
- Center Humanitas ICC, Misterbianco, Ortho-Neuro, 95125 Catania, Italy;
| | - Bipin Chaurasia
- Department of Neurosurgery, Neurosurgery Clinic, Birgunj 44300, Nepal;
| | - Domenico Gerardo Iacopino
- Neurosurgical Clinic, AOUP “Paolo Giaccone”, Postgraduate Residency Program in Neurological Surgery, Department of Experimental Biomedicine and Clinical Neurosciences, School of Medicine, 90128 Palermo, Italy; (R.M.); (D.G.I.)
| | - Giovanni Federico Nicoletti
- Department of Neurosurgery, Highly Specialized Hospital and of National Importance “Garibaldi”, 95125 Catania, Italy; (G.S.); (F.G.); (G.F.N.)
| | - Salvatore Cicero
- Trauma Center, Gamma Knife Center, Department of Neurosurgery, Cannizzaro Hospital, 95125 Catania, Italy; (F.B.); (M.P.); (S.C.)
| | - Lidia Strigari
- Department of Medical Physics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40122 Bologna, Italy;
| | - Rosario Emanuele Perrotta
- Department of General Surgery and Medical and Surgery Specialities, Section of Plastic Surgery, University of Catania—“Cannizzaro” Hospital, 95125 Catania, Italy; (G.P.); (R.E.P.)
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Abstract
The anatomy of the petrous face of the temporal bone, also known as the petrous pyramid, should be carefully examined to understand the location of, blood supply to, and venous drainage of meningiomas in this area (42%-59% of posterior fossa meningiomas). The petrous face is located in the skull base between the sphenoid and occipital bones. It consists of a base that joins the mastoid laterally and an apex that extends anteromedially to form the foramen lacerum. The anatomy can be divided into three surfaces: anterior/superior, posterior, and inferior. The anterior/superior surface is a continuation of the posteromedial portion of the middle cranial fossa with boundaries extending from the arcuate eminence to the petrous apex. The posterior surface is a continuation of the front part of the posterior cranial fossa with the internal auditory meatus at its center. The inferior surface contains foramina that transmit important vessels and cranial nerves. The vascular anatomy of the petrous face is also described, including branches of the carotid artery and vertebrobasilar systems. It is imperative to understand potential anastomotic routes between extracranial and intracranial arteries, as well as arterial supply to cranial nerves, to facilitate preoperative transarterial embolization of meningiomas and avoid neurologic complications during surgery.
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Affiliation(s)
- Ricky Chae
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, United States
| | - Roberto Rodriguez Rubio
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, United States.
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10
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An Unusual Cause of Cranial Dural Thickening. Case Rep Neurol Med 2020; 2020:8877738. [PMID: 33178470 PMCID: PMC7644338 DOI: 10.1155/2020/8877738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 09/17/2020] [Accepted: 10/06/2020] [Indexed: 11/30/2022] Open
Abstract
We describe an unusual cause of cranial dural thickening in an elderly female with a chronic meningeal inflammatory process. A 70-year-old ethnically Chinese, Singaporean female presented with a history of chronic daily headache with no other meningeal signs. Serial MRI brains showed progressive pachymeningeal and leptomeningeal enhancement in the left frontal region with underlying vasogenic oedema, similar appearances in the right frontal region to a lesser extent, and persistent inflammatory changes in her bilateral paranasal sinuses. Investigative work-up showed a chronically raised ESR with a normal CRP, negative ANCA, and a chronically raised serum IgA kappa paraprotein. Bone marrow trephine biopsy was suggestive of a low level plasma cell disorder. Olfactory cleft biopsy showed no evidence of IgG4-related disease or vasculitis and no significant plasma cell infiltrate. Histopathological examination from a meningeal biopsy revealed a diagnosis of an en-plaque meningioma (the WHO, 2016; Grade I) causing an unusual granulomatous reaction. We discuss the radiological and histological relations of this rare form of meningioma. Clinicians can consider en-plaque meningioma in the differential diagnosis of linear dural thickening and enhancement.
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11
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Han JJ, Lee DY, Kong SK, Chang KH, Yoon YJ, Kim HJ, Lee HJ, Park MH, Koo JW, Kim YH. Clinicoradiologic Characteristics of Temporal Bone Meningioma: Multicenter Retrospective Analysis. Laryngoscope 2020; 131:173-178. [PMID: 32011010 DOI: 10.1002/lary.28534] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 12/29/2019] [Accepted: 01/07/2020] [Indexed: 11/08/2022]
Abstract
OBJECTIVES/HYPOTHESIS Meningioma is a neoplasm arising from cells related to the arachnoid villi. The aim of the present study was to explore the clinical and radiological characteristics of temporal bone meningioma (TBM) in a multicenter cohort. STUDY DESIGN Retrospective cohort study. METHODS Thirteen patients diagnosed with TBM at eight medical institutes between 1998 and 2018 were retrospectively enrolled. The clinical procedures, symptoms, signs, and images that led to the diagnosis of TBM were investigated for all patients. RESULTS The most common symptom at the initial visit was hearing loss (n = 12/13, 92.3%). All patients exhibited unilateral TBMs with varied symptom durations (1-60 months). Four patients presented masses occupying the external auditory canal; the tympanic membrane (TM) could not be evaluated. The other nine patients did not show TM perforation despite the presence of inflammatory signs. The majority of patients exhibited unilateral conductive or mixed hearing loss. A retrospective review of temporal bone computed tomography (TBCT) images revealed findings suggestive of a tumor in all patients. However, three patients had been misdiagnosed with chronic otitis media and were subjected to tympanomastoidectomy (n = 3/7, 42.9%). TBCT findings that suggested TBM included diffuse trabecular hyperostosis in the middle and posterior cranial fossae and widening and destruction of the temporal bone in the jugular bulb area. CONCLUSIONS TBM should be suspected if patients exhibit persistent inflammatory symptoms or signs involving intact TM or unilateral conductive or mixed hearing loss with trabecular hyperostosis or destruction of the temporal bone on computed tomography images. LEVEL OF EVIDENCE 4 Laryngoscope, 131:173-178, 2021.
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Affiliation(s)
- Jae Joon Han
- Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Seoul Hospital, Seoul, South Korea
| | - Doh Young Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Soo-Keun Kong
- Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University Hospital, Pusan, South Korea
| | - Ki-Hong Chang
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Yong Joo Yoon
- Department of Otolaryngology-Head and Neck Surgery, Chonbuk National University College of Medicine, Chonbuk, South Korea
| | - Hyung-Jong Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Chuncheon, South Korea
| | - Hyo-Jeong Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Chuncheon, South Korea
| | - Min-Hyun Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Ja-Won Koo
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Young Ho Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul National University Boramae Medical Center, Seoul, South Korea
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12
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D'Oto A, Tolisano AM, Isaacson B. An Indolent Middle Ear Mass. JAMA Otolaryngol Head Neck Surg 2019; 145:181-182. [PMID: 30489613 DOI: 10.1001/jamaoto.2018.2956] [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)
- Alexandra D'Oto
- The University of Tennessee Health Science Center College of Medicine, Memphis
| | - Anthony M Tolisano
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas
| | - Brandon Isaacson
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas
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13
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Ear and Temporal Bone Pathology: Neural, Sclerosing and Myofibroblastic Lesions. Head Neck Pathol 2018; 12:392-406. [PMID: 30069839 PMCID: PMC6081283 DOI: 10.1007/s12105-018-0891-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 02/05/2018] [Indexed: 12/24/2022]
Abstract
Neural, sclerosing, and myofibroblastic lesions of the ear and temporal bone present diagnostic challenges for both clinicians and pathologists due to significant overlap in their clinical presentations, histologic appearances, and immunohistochemical profiles. While some of these lesions, such as schwannomas, are relatively common, others are rendered even more difficult because they are encountered very rarely in routine surgical pathology practice. This review is intended to provide an update on the pathology of some of the most commonly encountered primary diagnostic entities for the ear and temporal bone, and includes the following neural lesions: schwannoma, meningioma, and encephalocele/meningocele. Sclerosing lesions that will be discussed include spindle cell and sclerosing rhabdomyosarcoma, sclerosing epithelioid fibrosarcoma, and sclerosing paraganglioma. Finally, myofibroblastic lesions that will be reviewed are nodular fasciitis, IgG4-related disease, and solitary fibrous tumor. For each of these lesions, the differential diagnosis and useful ancillary tests will be discussed in the context of a broad range of additional primary and secondary lesions.
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14
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Affiliation(s)
- Lester D Thompson
- 0Department of Pathology, Southern California Permanente Medical Group, Woodland Hills Medical Center, Woodland Hills, CA, USA
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16
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External auditory canal meningioma: imaging features in a series of three cases. The Journal of Laryngology & Otology 2017; 131:273-279. [PMID: 28124632 DOI: 10.1017/s0022215117000044] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Direct extension of an intracranial meningioma to involve the temporal bone is rare. Recognised sites of origin and routes of access to the middle ear and labyrinthine apparatus have been described. Direct spread through the temporal bone to primarily involve the external auditory canal has not been widely reported in the literature. CASE REPORTS This paper discusses clinical and radiological findings in three cases of temporal bone meningioma presenting as masses within the external auditory canal. CONCLUSION Diagnosing temporal meningioma can be challenging because of its rarity and the often non-specific clinical and histological findings. It is important for both the surgeon and radiologist to be aware of the diagnosis and its related imaging findings in order to facilitate a timely diagnosis.
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Ma C, Li X, Li Y, Qu X. Primary Ectopic Meningioma of the Tongue: Case Report and Review of the Literature. J Oral Maxillofac Surg 2016; 74:2216-2228. [PMID: 27235182 DOI: 10.1016/j.joms.2016.04.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 04/18/2016] [Accepted: 04/18/2016] [Indexed: 10/21/2022]
Abstract
Primary ectopic (extracranial) meningiomas (PEMs) are very rare and have been reported only sporadically. Histologically speaking, PEMs are similar to their intracranial counterparts in being composed of neoplastic arachnoidal (meningothelial) cells. In addition, several types of microscopic cellular morphologies have been observed in intracranial meningiomas: meningothelial (syncytial), psammomatous, atypical, anaplastic, fibrous, and angioblastic. To the best of the authors' knowledge, PEM presenting as a mass in the tongue has not been reported previously. This report describes a case of lingual PEM in a 17-year-old boy. Special attention is given to the unique clinical presentation and management. The literature was reviewed to provide valuable knowledge to clinicians.
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Affiliation(s)
- Chunyue Ma
- Resident, Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Xiaoguang Li
- Resident, Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Youpeng Li
- Resident, Emergency Intensive Care Unit, The Third Affiliated Hospital of Wenzhou Medical University, Ruian, China
| | - Xingzhou Qu
- Professor, Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China.
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Medial Cranial Fossa Meningioma Diagnosed as Mixed Anxiety Disorder with Dissociative Symptoms and Vertigo. Case Rep Psychiatry 2016; 2016:3827547. [PMID: 27651969 PMCID: PMC5019916 DOI: 10.1155/2016/3827547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 08/14/2016] [Indexed: 11/18/2022] Open
Abstract
Meningiomas are mostly benign tumors of the meninges that may stay clinically silent or present first with psychiatric symptoms only. We present a case of medial cranial fossa meningioma that was first diagnosed as mixed anxiety disorder with dissociative symptoms and vertigo. In light of the intact neurological and vestibular system examination, our patient's vertigo and depersonalization were firstly addressed as psychosomatic symptoms of the psychiatric syndrome. Despite decreased anxiety and improved mood, dissociative symptoms and vertigo were resistant to treatment which prompted further research yielding a left hemisphere localized meningioma. Resection of meningioma resulted in full remission of the patient proving it to be responsible for the etiology of the psychiatric syndrome and vertigo. We suggest that brain imaging should be performed for patients with late-onset (>50 years) psychiatric symptoms and those with treatment resistance. It is important to keep in mind always that medically unexplained symptoms may become explicable with detailed assessment and regular follow-up of the patient.
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Ectopic meningioma (hamartoma) of the middle ear: a challenging case in frozen section. Otol Neurotol 2015; 35:e231-2. [PMID: 24914790 DOI: 10.1097/mao.0000000000000404] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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20
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Ricciardiello F, Fattore L, Liguori ME, Oliva F, Luce A, Abate T, Caraglia M, Pianese A, Raucci AF. Temporal bone meningioma involving the middle ear: A case report. Oncol Lett 2015; 10:2249-2252. [PMID: 26622828 DOI: 10.3892/ol.2015.3516] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 03/19/2015] [Indexed: 01/25/2023] Open
Abstract
Meningioma is a common intracranial tumor involving the meninges. The localization of this type of tumor is rarely extracranial due to its typically low invasive properties. Furthermore, invasion of the middle ear is exceptional. The present study reported a case of meningioma extending into the middle ear from the middle cranial fossa through the tegmen tympani. The clinical and pathological characteristics, as well as the outcome of the patient, were described.
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Affiliation(s)
| | - Lucia Fattore
- Ear Nose and Throat Unit, University of Naples Federico II, Naples 80131, Italy
| | - Maria Ester Liguori
- Ear Nose and Throat Unit, University of Naples Federico II, Naples 80131, Italy
| | - Flavia Oliva
- Ear Nose and Throat Unit, University of Naples Federico II, Naples 80131, Italy
| | - Amalia Luce
- Department of Biochemistry, Biophysics and General Pathology, Second University of Naples, Naples 80138, Italy
| | - Teresa Abate
- Ear Nose and Throat Unit, University of Naples Federico II, Naples 80131, Italy
| | - Michele Caraglia
- Department of Biochemistry, Biophysics and General Pathology, Second University of Naples, Naples 80138, Italy
| | - Annalisa Pianese
- Ear Nose and Throat Unit, University of Naples Federico II, Naples 80131, Italy
| | - Aldo Falco Raucci
- Ear Nose and Throat Unit, Santa Maria delle Grazie Hospital, Pozzuoli, Naples 80078, Italy
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21
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Ribeiro A, Lopes G, Leonardo A, Rodrigues e Rodrigues M. Meningioma of the external auditory canal. Eur Ann Otorhinolaryngol Head Neck Dis 2015; 132:243. [PMID: 25840785 DOI: 10.1016/j.anorl.2015.03.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- A Ribeiro
- ENT, Hospital Pedro Hispano, Matosinhos, Rua Dr. Eduardo Torres, 4464-513 Senhora da Hora, Portugal.
| | - G Lopes
- ENT, Hospital Pedro Hispano, Matosinhos, Rua Dr. Eduardo Torres, 4464-513 Senhora da Hora, Portugal
| | - A Leonardo
- ENT, Hospital Pedro Hispano, Matosinhos, Rua Dr. Eduardo Torres, 4464-513 Senhora da Hora, Portugal
| | - M Rodrigues e Rodrigues
- ENT, Hospital Pedro Hispano, Matosinhos, Rua Dr. Eduardo Torres, 4464-513 Senhora da Hora, Portugal
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22
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Mermod M, Simon C, Daniel RT, Pasche P, Levivier M, George M. Something more sinister: middle fossa meningioma. Am J Med 2015; 128:27-9. [PMID: 25218937 DOI: 10.1016/j.amjmed.2014.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 09/03/2014] [Accepted: 09/03/2014] [Indexed: 10/24/2022]
Affiliation(s)
- Maxime Mermod
- Service d'Oto-Rhino-Laryngologie et Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
| | - Christian Simon
- Service d'Oto-Rhino-Laryngologie et Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Roy Thomas Daniel
- Service de Neurochirurgie, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Philippe Pasche
- Service d'Oto-Rhino-Laryngologie et Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Marc Levivier
- Service de Neurochirurgie, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Mercy George
- Service d'Oto-Rhino-Laryngologie et Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
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23
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Nicolay S, De Foer B, Bernaerts A, Van Dinther J, Parizel PM. A case of a temporal bone meningioma presenting as a serous otitis media. Acta Radiol Short Rep 2014; 3:2047981614555048. [PMID: 25535569 PMCID: PMC4271712 DOI: 10.1177/2047981614555048] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 09/20/2014] [Indexed: 11/21/2022] Open
Abstract
We report the imaging features of a case of a temporal bone meningioma extending into the middle ear cavity and clinically presenting as a serous otitis media. Temporal bone meningioma extending in the mastoid or the middle ear cavity, however, is very rare. In case of unexplained or therapy-resistant serous otitis media and a nasopharyngeal tumor being ruled out, a temporal bone computed tomography (CT) should be performed. If CT findings are suggestive of a temporal bone meningioma, a magnetic resonance imaging (MRI) examination with gadolinium will confirm diagnosis and show the exact extension of the lesion.
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Affiliation(s)
- Simon Nicolay
- Department of Radiology, GZA Hospital Sint-Augustinus, Wilrijk, Belgium ; Department of Radiology, Antwerp University Hospital (UZA) and University of Antwerp (UA), Belgium
| | - Bert De Foer
- Department of Radiology, GZA Hospital Sint-Augustinus, Wilrijk, Belgium
| | - Anja Bernaerts
- Department of Radiology, GZA Hospital Sint-Augustinus, Wilrijk, Belgium
| | - Joost Van Dinther
- European Institute for ORL, GZA Hospital Sint-Augustinus, Wilrijk, Belgium
| | - Paul M Parizel
- Department of Radiology, Antwerp University Hospital (UZA) and University of Antwerp (UA), Belgium
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Said-Al-Naief N, Pourian A, Cure J, Lopez R. Clinicopathologic conference case 3: a 75- year-old man with progressive right-sided hearing loss and dizziness. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 118:e89-94. [PMID: 25295344 DOI: 10.1016/j.oooo.2014.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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25
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Mezouri I, Bellefqih S, Chenna H, El Kacemi H, Kebdani T, Benjaafar N. [Meningioma of the maxillary sinus: report of a case with review of the literature]. Pan Afr Med J 2014; 18:137. [PMID: 25419275 PMCID: PMC4236793 DOI: 10.11604/pamj.2014.18.137.4746] [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: 06/03/2014] [Accepted: 06/10/2014] [Indexed: 12/02/2022] Open
Abstract
Les méningiomes extracrâniens sont rares, leur localisation au niveau du sinus maxillaire est exceptionnelle. Nous rapportons le cas d'une patiente âgée de 41 ans, ayant présenté une exophtalmie avec des céphalées intermittentes évoluant depuis 8 ans. Le diagnostic a été retenu à partir de la biopsie et du scanner cérébral et du massif facial. Le traitement a consisté en une irradiation exclusive à la dose de 54 Gray (Gy). La patiente est restée en bon contrôle locorégional, après un recul de 18 mois. A travers ce cas clinique on a démontré que le sinus maxillaire peut être touché par le méningiome, et qu'il doit être inclus dans le diagnostic différentiel des tumeurs des tissus mous.
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Affiliation(s)
- Imane Mezouri
- Service de Radiothérapie, Institut National d'Oncologie, avenue Allal Elfassi, Rabat, Maroc
| | - Sara Bellefqih
- Service de Radiothérapie, Institut National d'Oncologie, avenue Allal Elfassi, Rabat, Maroc
| | - Hanane Chenna
- Service de Radiothérapie, Institut National d'Oncologie, avenue Allal Elfassi, Rabat, Maroc
| | - Hanan El Kacemi
- Service de Radiothérapie, Institut National d'Oncologie, avenue Allal Elfassi, Rabat, Maroc
| | - Tayeb Kebdani
- Service de Radiothérapie, Institut National d'Oncologie, avenue Allal Elfassi, Rabat, Maroc
| | - Noureddine Benjaafar
- Service de Radiothérapie, Institut National d'Oncologie, avenue Allal Elfassi, Rabat, Maroc
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Stevens KL, Carlson ML, Pelosi S, Haynes DS. Middle ear meningiomas: a case series reviewing the clinical presentation, radiologic features, and contemporary management of a rare temporal bone pathology. Am J Otolaryngol 2014; 35:384-9. [PMID: 24650749 DOI: 10.1016/j.amjoto.2014.02.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Accepted: 02/08/2014] [Indexed: 11/27/2022]
Abstract
Meningiomas are the most common extra-axial intracranial neoplasm and frequently develop in the parasagittal region. Rarely, meningiomas may involve the middle ear and mastoid, resulting from contiguous spread of adjacent intracranial tumor, or less commonly as an isolated primary tumor of the middle ear. Patients with primary middle ear meningiomas (MEMs) often present with non-specific otologic complaints including hearing loss, otorrhea and otalgia thereby mimicking common chronic otitis media, while secondary lesions more frequently manifest sensorineural hearing loss, cranial neuropathy and other neurologic symptoms from the associated intracranial component. The radiological appearance of MEMs often overlaps with other tumors of the temporal bone. Therefore, a correct diagnosis cannot always be made prior to surgical biopsy. While gross total resection with preservation of existing neurological function is possible with smaller lesions, complete tumor removal may be extremely morbid with more extensive or adherent MEMs. In such cases, aggressive subtotal resection with close radiologic follow-up should be considered. Given the rarity of the studied condition, the literature addressing MEMs is sparse. The current study reviews ten additional cases of MEMs, highlighting the clinicopathologic and radiological features that distinguish meningiomas from other middle ear and mastoid pathology.
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27
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Ocque R, Khalbuss WE, Monaco SE, Michelow PM, Pantanowitz L. Cytopathology of extracranial ectopic and metastatic meningiomas. Acta Cytol 2014; 58:1-8. [PMID: 24192779 DOI: 10.1159/000355284] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2013] [Accepted: 08/22/2013] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Extracranial meningiomas may infrequently be encountered as ectopic or metastatic tumors. Their rarity and unique cytomorphology often pose significant diagnostic dilemmas. The aim of this study was to report our experience with a series of ectopic and metastatic meningiomas, characterizing their cytomorphology with histological correlation. MATERIALS AND METHODS A retrospective analysis involving 13 patients with cytological preparations from extracranial meningiomas was performed. Cytology cases were correlated with available surgical resection specimens. Data regarding clinical findings, tumor information, cytomorphology, follow-up histological features and immunohistochemistry were recorded and analyzed. RESULTS There were 5 cases with metastases and 8 ectopic meningiomas. Metastases occurred in the scalp/skull, lung, paraspinal soft tissue and liver. Primary ectopic meningiomas were located in the paranasal sinuses and ear, orbit and neck. Cytomorphological features characteristic of meningiomas were identified in the majority of samples including tightly cohesive clusters of spindled cells, whorls, intranuclear inclusions, nuclear grooves and psammomatous calcification. Unusual cytomorphological features identified in only a few cases included epithelioid cell predominance, abundant inflammatory cells, small-cell change, papillary structures and pseudoacinar growth. Metastatic tumors exhibited more nuclear atypia and occasionally mitoses or necrosis. Meningiomas were shown to be immunoreactive for epithelial membrane antigen, pancytokeratin and vimentin. CONCLUSION Although rare, extracranial meningiomas can be encountered in cytologic specimens and should be included in the differential diagnosis when characteristic morphological features of meningiomas are seen. Cytopathologists should be aware that these lesions could be mistaken for other tumors, especially when confounded by atypia and unusual cytomorphological features.
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Affiliation(s)
- Rebecca Ocque
- Department of Pathology, University of Pittsburgh Medical Center, Shadyside Hospital, Pittsburgh, Pa., USA
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Qureshi A, Quinones-Hinojosa A, Ziai W. A rare infectious presentation of a temporal bone meningioma. J Neurooncol 2013; 116:633-4. [PMID: 24338211 DOI: 10.1007/s11060-013-1319-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Accepted: 11/28/2013] [Indexed: 11/26/2022]
Affiliation(s)
- Abid Qureshi
- The Johns Hopkins University School of Medicine, Baltimore, MD, USA
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29
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Intracranial-extracranial meningioma mimicking an aggressive skull bone tumor. ROMANIAN NEUROSURGERY 2013. [DOI: 10.2478/romneu-2013-0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Intracranial meningiomas with extracranial extension are rare lesions with only few reported cases in literature. In present article we report a case of 62 year male patient presented with progressive swelling over right side frontal region of 2 year duration. In our case the tumor was in close proximity to right fronto-parietal suture and there was a possibility that suture line could have paved the way for its extracranial spread and also there was evidence of transdiploic extension on histopatholgical examination.
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Panjvani SI, Gandhi MB, Sarvaiya AN, Chaudhari BR, Gupta GS. An extracranial invasive meningioma mimicking malignant bone tumor - "carpet meningioma". J Clin Diagn Res 2013; 7:1159-62. [PMID: 23905128 DOI: 10.7860/jcdr/2013/5394.3100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2012] [Accepted: 04/27/2013] [Indexed: 11/24/2022]
Abstract
Meningioma is a common benign intracranial neoplasm. The incidence of an extracranial extension to other sites is rare. Due to the neglected intracranial component, the chances of an under diagnosis or a misdiagnosis of the extracranial component is there, which may adversely affect the management and therefore, the prognosis. Here, we are reporting a case of a 39 years old male patient with a preoperative probable diagnosis of a malignant bone tumour which involved the skull bone, which was made, based on the imaging studies , which was histopathologically found to be an invasive meningioma with an extensive extracranial skull vault involvement and was confirmed by immunohistochemistry. We have proposed a term, "carpet meningioma" for this extracranial invasive meningioma, because it had covered the skull vault like a carpet. The follow up studies after 1 year have revealed no evidence of a recurrence.
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Affiliation(s)
- Sahil I Panjvani
- 3 Year Resident, Department of Pathology, Smt. NHL Municipal Medical College , Ahmedabad, Gujarat, India
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Abstract
We have described a primary esophageal meningioma (MG) clinical case diagnosed in a 62-year-old woman; also, we review the literature about extracranial MGs. To our knowledge, this is the first case report of an extracranial MG occurring primarily in the esophagus. These are benign neoplasms reported classically in the central nervous system (CNS). The extrancranial MGs have histopathologic and inmunohistochemical features identical to those observed in CNS MGs; thus, the main diagnostic hurdle is to keep it in the differential for lesions occurring outside the CNS.
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Kusunoki T, Ikeda K, Miyashita M. A Case Report of Meningioma Extending to the Middle Ear. Clin Pract 2012; 2:e67. [PMID: 24765466 PMCID: PMC3981307 DOI: 10.4081/cp.2012.e67] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Revised: 06/06/2012] [Accepted: 06/07/2012] [Indexed: 11/23/2022] Open
Abstract
Extracranial meningioma with extension into a middle ear is very uncommon. A 74-year-old female was admitted to our hospital with right ear bleeding when removing earwax. In this case, magnetic resonance imaging, computed tomography, her past history and operative findings would consider as infiltrative growth from the right sphenoid ridge meningioma to the right middle ear via the right petrous pyramid and bilateral optic nerve. She underwent only partial extirpation with decompression for optic nerve, rather than total extirpation including middle ear and temporal bone, due to wide invasion of the middle cranial fossa and caversinus sinus.
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Mogi A, Hirato J, Kosaka T, Yamaki E, Kuwano H. Primary mediastinal atypical meningioma: report of a case and literature review. World J Surg Oncol 2012; 10:17. [PMID: 22264362 PMCID: PMC3278378 DOI: 10.1186/1477-7819-10-17] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2011] [Accepted: 01/21/2012] [Indexed: 12/12/2022] Open
Abstract
Meningiomas are common neoplasms arising from the central nervous system meninges. On the other hand, primary ectopic meningiomas are extremely rare and usually limited to the head and neck region or to the paravertebral soft tissues. Their occurrence in the mediastinum is even rarer. Until now, only 4 cases of primary mediastinal meningioma have been reported in the literature searched on Medline. Because of its rarity and intriguing pathogenesis, we report here a case of primary mediastinal meningioma that was treated by surgical resection. The clinical features, treatment, pathological findings, and prognosis are analyzed, and the literature on ectopic meningioma is reviewed.
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Affiliation(s)
- Akira Mogi
- Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan.
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Pankhania M, Rourke T, Draper MR. The middle ear mass: a rare but important diagnosis. BMJ Case Rep 2011; 2011:bcr.10.2011.4981. [PMID: 22669530 DOI: 10.1136/bcr.10.2011.4981] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
The authors report a rare case of primary intracranial meningioma presenting as a middle ear mass with conductive hearing loss. The authors aim to highlight the importance of diagnosing a middle ear mass, which although rare, may have a substantial impact on ongoing patient management. A discussion of other middle ear pathologies is made in order to demonstrate the subtle differences in presentation.
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Affiliation(s)
- Miran Pankhania
- Plastic Surgery Department, Wexham Park Hospital, Slough, UK.
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36
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Affiliation(s)
- Joseph G Manjaly
- Department of ENT, Salisbury District Hospital , Salisbury SP2 8BJ , UK
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37
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Dong Y, Zhou X, Wu B, Wang J, Ma H, Zhou H, Jiang S, Lu G, Hu Q. Four cases of distinctive meningiomas with Zellballen growth pattern. APMIS 2010; 117:936-40. [PMID: 20078559 DOI: 10.1111/j.1600-0463.2009.02551.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Meningiomas are attributed to those tumours with slow-growing pattern occurring predominantly in middle-aged or elderly patients. Fifteen histological variants have been described based on the variable histomorphological features. Herein we report four cases with specific Zellballen growth pattern, giving the tumours a 'paraganglioma-like' general aspect. The diagnosis of meningiomas was confirmed by immunohistochemical and ultrastructural findings. Histopathologists should be aware of this specific morphology which can lead to misdiagnosis.
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Affiliation(s)
- Yingchun Dong
- Department of Pathology, Clinical School of Medical College of Nanjing University/Nanjing Jinling Hospital, Nanjing, China
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Rushing EJ, Bouffard JP, McCall S, Olsen C, Mena H, Sandberg GD, Thompson LDR. Primary extracranial meningiomas: an analysis of 146 cases. Head Neck Pathol 2009; 3:116-30. [PMID: 19644540 PMCID: PMC2715454 DOI: 10.1007/s12105-009-0118-1] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2009] [Accepted: 04/11/2009] [Indexed: 12/17/2022]
Abstract
Primary extracranial meningiomas are rare neoplasms, frequently misdiagnosed, resulting in inappropriate clinical management. To date, a large clinicopathologic study has not been reported. One hundred and forty-six cases diagnosed between 1970 and 1999 were retrieved from the files of the Armed Forces Institute of Pathology. Histologic features were reviewed, immunohistochemistry analysis was performed (n = 85), and patient follow-up was obtained (n = 110). The patients included 74 (50.7%) females and 72 (49.3%) males. Tumors of the skin were much more common in males than females (1.7:1). There was an overall mean age at presentation of 42.4 years, with a range of 0.3-88 years. The overall mean age at presentation was significantly younger for skin primaries (36.2 years) than for ear (50.1 years) and nasal cavity (47.1 years) primaries. Symptoms were in general non-specific and reflected the anatomic site of involvement, affecting the following areas in order of frequency: scalp skin (40.4%), ear and temporal bone (26%), and sinonasal tract (24%). The tumors ranged in size from 0.5 up to 8 cm, with a mean size of 2.3 cm. Histologically, the majority of tumors were meningothelial (77.4%), followed by atypical (7.5%), psammomatous (4.1%) and anaplastic (2.7%). Psammoma bodies were present in 45 tumors (30.8%), and bone invasion in 31 (21.2%) of tumors. The vast majority were WHO Grade I tumors (87.7%), followed by Grade II (9.6%) and Grade III (2.7%) tumors. Immunohistochemically, the tumor cells labeled for EMA (76%; 61/80), S-100 protein (19%; 15/78), CK 7 (22%; 12/55), and while there was ki-67 labeling in 27% (21/78), <3% of cells were positive. The differential diagnosis included a number of mesenchymal and epithelial tumors (paraganglioma, schwannoma, carcinoma, melanoma, neuroendocrine adenoma of the middle ear), depending on the anatomic site of involvement. Treatment and follow-up was available in 110 patients: Biopsy, local excision, or wide excision was employed. Follow-up time ranged from 1 month to 32 years, with an average of 14.5 years. Recurrences were noted in 26 (23.6%) patients, who were further managed by additional surgery. At last follow-up, recurrent disease was persistent in 15 patients (mean, 7.7 years): 13 patients were dead (died with disease) and two were alive; the remaining patients were disease free (alive 60, mean 19.0 years, dead 35, mean 9.6 years). There is no statistically significant difference in 5-year survival rates by site: ear and temporal bone: 83.3%; nasal cavity: 81.8%; scalp skin: 78.5%; other sites: 65.5% (P = 0.155). Meningiomas can present in a wide variety of sites, especially within the head and neck region. They behave as slow-growing neoplasms with a good prognosis, with longest survival associated with younger age, and complete resection. Awareness of this diagnosis in an unexpected location will help to avoid potential difficulties associated with the diagnosis and management of these tumors.
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Affiliation(s)
- Elisabeth J. Rushing
- Department of Neuropathology and Ophthalmic Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000 USA
| | - John-Paul Bouffard
- Department of Neuropathology and Ophthalmic Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000 USA
| | - Sherman McCall
- Department of Molecular Pathology, Armed Forces Institute of Pathology, Washington, DC USA
| | - Cara Olsen
- Department of Preventive Medicine and Biometrics, Uniformed University of the Health Sciences, Bethesda, MD USA
| | - Hernando Mena
- Department of Neuropathology and Ophthalmic Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000 USA
| | - Glenn D. Sandberg
- Department of Neuropathology and Ophthalmic Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000 USA
| | - Lester D. R. Thompson
- Department of Pathology, Southern California Permanente Medical Group, Los Angeles, CA USA
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40
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Cenacchi G, Ferri GG, Salfi N, Tarantino L, Modugno GC, Ceroni AR, Martinelli GN. Secretory meningioma of the middle ear: a light microscopic, immunohistochemical and ultrastructural study of one case. Neuropathology 2008; 28:69-73. [PMID: 18181836 DOI: 10.1111/j.1440-1789.2007.00821.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A 66-year-old woman was referred with left hearing loss. A probable diagnosis of left secretory otitis media with effusion was formulated. A left myringotomy was performed to remove hyperplastic hard tissue from the tympanic cavity. A high resolution CT scan of the temporal bone disclosed a soft-tissue mass completely involving the mastoid and tympanic cavity, surrounding the ossicular chain which appeared spared with no signs of infiltration. The histopathologic, immunohistochemical and ultrastructural response was secretory meningioma, a rare variant of conventional meningothelial meningioma in atypical sites.
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Affiliation(s)
- Giovanna Cenacchi
- Dipartimento Clinico di Scienze Radiologiche e Istocitopatologiche, Sezione di Anatomia e Istologia Patologica, Università di Bologna, Italy.
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41
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Marcelissen TAT, de Bondt RBJ, Lammens M, Manni JJ. Primary temporal bone secretory meningioma presenting as chronic otitis media. Eur Arch Otorhinolaryngol 2008; 265:843-6. [PMID: 18172659 PMCID: PMC2440930 DOI: 10.1007/s00405-007-0531-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2007] [Accepted: 10/31/2007] [Indexed: 11/30/2022]
Abstract
We report an extremely rare case of a secretory meningioma primarily involving the temporal bone. A 56-year old female patient presented to us with a history of a chronic otitis media and unilateral hearing loss. Diagnostic investigations revealed a tumor arising from the temporal bone without signs of intracranial involvement. Histopathological examination showed a meningioma of the secretory type. The tumor was partially resected and serial imaging at follow-up revealed no extension of the tumor. No new symptoms developed 1 year after surgery. Secretory meningioma is a rare meningioma subtype and extracranial presentation in the temporal bone is very unusual. We present the first case of a primary temporal bone secretory meningioma in the otorhinolaryngological literature. As radical as possible surgical excision with serial imaging at follow-up is recommended.
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Affiliation(s)
- T A T Marcelissen
- Department of Otolaryngology and Head and Neck Surgery, University Hospital Maastricht, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands.
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42
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McGuire TP, Palme CE, Perez-Ordonez B, Gilbert RW, Sándor GKB. Primary intraosseous meningioma of the calvaria: analysis of the literature and case report. ACTA ACUST UNITED AC 2007; 104:e34-41. [PMID: 17656124 DOI: 10.1016/j.tripleo.2007.03.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2007] [Revised: 03/12/2007] [Accepted: 03/18/2007] [Indexed: 01/19/2023]
Abstract
Meningiomas are the most common of the benign intracranial neoplasms. They are uncommon as primary or secondary extracranial entities. Of these, the primary intraosseous variant may represent the rarest form. We report the case of a rare primary intraosseous meningioma presenting as a localized, symptom-free supraorbital bony expansion in an 81-year-old female patient and tabulate the previously reported cases of primary intraosseous meningiomas of the craniomaxillofacial region for analysis.
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Affiliation(s)
- Taylor P McGuire
- Facial Cosmetic and Reconstructive Surgery, Department of Surgery, Baptist Memorial Golden Triangle Hospital and Center for Oral and Facial Surgery, Columbus, MS, USA
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43
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Ereño C, Izquierdo AP, Basurko JM, Bilbao FJ, López JI. Temporal bone secretory meningioma presenting as a middle ear mass. Pathol Res Pract 2006; 202:481-4. [PMID: 16517091 DOI: 10.1016/j.prp.2005.12.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2005] [Accepted: 12/23/2005] [Indexed: 11/25/2022]
Abstract
A 44-year-old woman presented with a history of increasing left hypoacusis and sporadic vertigo. CT scan revealed a tumor occupying the mastoid, middle ear, and external auditory canal. After surgical removal, a typical secretory meningioma was diagnosed. The histological hallmark and the immunohistochemical profile of secretory meningiomas are reviewed. The differential diagnosis of this tumor in this location is also commented on. As far as we know, primary temporal bone meningiomas with secretory histology have not been previously reported in the medical literature.
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Affiliation(s)
- Cosme Ereño
- Department of Anatomic Pathology, Hospital de Basurto, Avda. de Montevideo 18, Basque Country University, 48013 Bilbao, Spain.
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44
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Kumar G, Basu S, Sen P, Kamal SA, Jiskoot PMS. Ectopic meningioma: a case report with a literature review. Eur Arch Otorhinolaryngol 2006; 263:426-9. [PMID: 16408238 DOI: 10.1007/s00405-005-1030-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2005] [Accepted: 08/02/2005] [Indexed: 11/24/2022]
Abstract
Ectopic (extradural) meningiomas that do not originate from either the optic fascicle or the intracranial meninges are exceedingly rare. A patient with an ectopic meningioma in the external auditory canal and mastoid was treated in our unit. The world literature of the last 20 years was reviewed.
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Affiliation(s)
- G Kumar
- Department of Otolaryngology, Whipps Cross Hospital, London, UK.
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45
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Rojas R, Palacios E, D'Antonio M. An Unusual Primary Intratympanic Meningioma. EAR, NOSE & THROAT JOURNAL 2004. [DOI: 10.1177/014556130408300905] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Rafael Rojas
- Department of Radiology, Louisiana State University Health Sciences Center, New Orleans
| | - Enrique Palacios
- Department of Radiology, Louisiana State University Health Sciences Center, New Orleans
| | - Michael D'Antonio
- Department of Radiology, Louisiana State University Health Sciences Center, New Orleans
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46
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Münscher A, Grzyska U, Leuwer R. [Deafness with tinnitus]. HNO 2004; 52:616-9. [PMID: 15309259 DOI: 10.1007/s00106-003-1015-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- A Münscher
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Hamburg-Eppendorf.
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Abstract
Meningiomas are by far the most common tumours arising from the meninges. Progressive enlargement of the tumour leads to focal or generalised seizure disorders or neurological deficits caused by compression of adjacent neural tissue. Surgery remains the primary treatment of choice, although the use of fractionated radiotherapy or stereotactic single-dose radiosurgery is increasing for meningiomas that are incompletely excised, surgically inaccessible, or recurrent and either atypical or anaplastic. Although most meningiomas have good long-term prognosis after treatment, there are still controversies over management in a proportion of cases. We review various features of meningioma biology, diagnosis, and treatment and provide an overview of the current rationale and evidence base for the various therapeutic approaches.
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Affiliation(s)
- Ian R Whittle
- Department of Clinical Neurosciences, Western General Hospital, Edinburgh EH4 2XU, UK.
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