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Ni H, Yang Q, Shi C, Zhao P, Zhan S, Guo L. Primary ectopic meningiomas: Report of 6 cases with emphasis on atypical morphology and exploratory immunohistochemistry. Histol Histopathol 2022; 37:1253-1259. [PMID: 36367373 DOI: 10.14670/hh-18-550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
AIMS To investigate the histological and immunohistochemical features of primary ectopic meningiomas (PEMs), especially those of primary ectopic atypical meningiomas (PEAMs). METHODS AND RESULTS We examined 6 cases of PEM, including 2 PEAM cases, which occurred separately in left nasal cavity, left lower lung, right neck, left orbit, right upper lung, and left upper lung by histological and immunohistochemical analysis. In general, of the 6 PEM cases analyzed, 4 cases exhibited morphology of Grade Ⅰ, including 1 fibrous, 1 meningothelial, and 2 transitional variant. The remaining 2 cases shared similar atypical morphology of Grade Ⅱ. The tumors were distributed in sheet-like patterns with loss of architecture of classic meningiomas. Significant hypercellularity, multi-focal necrosis, and thin-walled blood vessels were identified. The mitotic figures were estimated at 6 per 10 high-power fields in one case, and 8 mitotic figures in another. Immunohistochemically, the 6 PEM cases were all positive for Vimentin and EMA, while none showed immunostaining for CKpan, S-100, CD34, STAT6, SMA, Syn or Bcl-2. 4 PEM cases of Grade Ⅰ were immunoreactive for PR but negative for P53, while the 2 PEAM cases displayed negative staining for PR but positivity for P53. As for Ki-67, the positive staining of 4 Grade Ⅰ cases was no greater than 2%, while the positive rates of the 2 PEAM cases were 10% and 20%. CONCLUSIONS Our study has expanded cases of PEMs, especially the 2 PEAM cases in rare sites. Our study has also further summarized the pathological features of PEMs, focusing on the histological features of PEAMs, and the immunohistochemical features worthy of further investigations.
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Affiliation(s)
- Hao Ni
- Department of Pathology, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Qianqian Yang
- Department of Pathology, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Chenxi Shi
- Department of Pathology, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Peiyu Zhao
- Suzhou Municipal Hospital, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou, Jiangsu, China.
| | - Shenghua Zhan
- Department of Pathology, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
| | - Lingchuan Guo
- Department of Pathology, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
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Guedes BWM, de Souza Júnior JF, D’Avila Melo NA, de Menezes Neto JMB, Beer-Furlan A, Oliveira AMP. The use of an endoscopic endonasal approach for a secondary intraorbital meningioma: illustrative case. JOURNAL OF NEUROSURGERY: CASE LESSONS 2022; 4:CASE22267. [PMID: 36083773 PMCID: PMC9451051 DOI: 10.3171/case22267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 07/08/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND
Meningiomas are the most frequent primary tumors in the central nervous system (CNS), but intraorbital location is uncommon and accounts for only 0.2% to 4% of all CNS meningiomas. Lesions in this compartment could be classified as primary, secondary, or ectopic. The close relationship with the optic nerve sheath is a landmark to identify the tumor as primary, whereas secondary tumors commonly come from an extension of an intracranial meningioma, and ectopic meningioma is a concept not yet completely established.
OBSERVATIONS
The authors present a rare case of a secondary intraorbital meningioma operated through an endoscopic endonasal approach. Secondary meningiomas at the medial orbit are very uncommon, given their more common superior and lateral location as an extension of sphenoid meningiomas. The endoscopic endonasal route provides direct access to the medial orbit. The authors present an illustrative case of a meningioma located at the medial orbit and resected through an endoscopic endonasal approach that provided excellent visualization and anatomical exposure. Additionally, the authors review the concept and possible similarities between secondary and ectopic intraorbital meningiomas.
LESSONS
An endoscopic endonasal approach should be considered as a feasible treatment option for intraorbital meningiomas, especially if they are in the medial orbital wall.
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Affiliation(s)
| | | | | | | | | | - Arthur M. P. Oliveira
- Departments of Neurosurgery and
- Department of Medicine, Federal University of Sergipe, Aracaju, Sergipe, Brazil; and
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3
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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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Rajabi MT, Cheraqpour K, Mohammadi SS, Veshagh M, Lazarjani SZP, Hosseinzadeh F, Amoli FA, Hosseini S. Isolated Intraconal Meningioma. J Ophthalmic Vis Res 2021; 16:682-687. [PMID: 34840690 PMCID: PMC8593532 DOI: 10.18502/jovr.v16i4.9759] [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: 03/04/2020] [Accepted: 12/23/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose To report a rare case of isolated intraconal meningioma. Case Report A 24-year-old woman presented with painless proptosis in her left eye which
started and progressed during her pregnancy about 10 months ago. Hertel
exophthalomometry revealed anterior displacement of the globe with 4 mm of
proptosis which was remarkable. Magnetic resonance imaging (MRI)
demonstrated an intraconal circumscribed oval-shaped mass with hypointense
signals on T1-weighted images and hyperintense signals on T2-weighted
images, mimicking cavernous hemangioma. This mass, however, was free of any
connections to optic nerve or bones. Due to the imaging characteristics,
more prevalent diagnoses like cavernous hemangioma were placed on the top of
the differential diagnoses list. However, during the surgical excision, the
tumor’s consistency and gross features were not compatible with cavernous
hemangioma. The pathologic findings instead determined meningotheliomatous
meningioma, a very rare condition, which was far from our expectations prior
to the surgery. Conclusion Ectopic orbital meningiomas are rare tumors that are not easily diagnosed
without postoperative histopathology. Despite its low prevalence, they
should be considered in the differential diagnosis list of intraconal masses
with hypointense signals on T1-weighted images and hyperintense signals on
T2-weighted images.
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Affiliation(s)
- Mohammad Taher Rajabi
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Kasra Cheraqpour
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - S Saeed Mohammadi
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Department of Ophthalmology, Abadan University of Medical Sciences, Abadan, Iran
| | - Mohammad Veshagh
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyedeh Zahra Poursayed Lazarjani
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Department of Ophthalmology, Guilan University of Medical Sciences, Rasht, Iran
| | - Farideh Hosseinzadeh
- ENT and Head & Neck Research Center, The Five Senses Health Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Fahimeh Asadi Amoli
- Pathology Department, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Simindokht Hosseini
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Sharma AK, Gandhoke CS, Misra S, Ravi A, Gupta RK, Gupta SK. Ectopic intraconal orbital meningioma - A rare case report. Surg Neurol Int 2021; 12:305. [PMID: 34345446 PMCID: PMC8326082 DOI: 10.25259/sni_84_2021] [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: 01/28/2021] [Accepted: 06/04/2021] [Indexed: 11/04/2022] Open
Abstract
Background Ectopic orbital meningiomas (OM) are a rare subset of OMs which are neither attached to the optic nerve sheath nor to the surrounding bone. Case Description We report the case of a 65-year-old female who presented with a 1 year history of proptosis followed by visual loss and restricted right eye movements since 3 months. Radiology of the orbits was suggestive of intraorbital, intraconal, and heterogeneous contrast enhancing right eye lesion which was completely excised through supraorbital orbitotomy approach. Intraoperatively, the right optic nerve, though compressed, and displaced inferiorly, was free from the lesion. The final histopathological diagnosis was "Meningioma WHO Grade I." At 3 months follow-up, patient's vision in the right eye improved from perception of light positive to 6/12 and there was no evidence of recurrence. Conclusion Rarity of ectopic OM, total surgical excision with an excellent postoperative visual outcome prompted us to report this case.
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Affiliation(s)
- Anil Kumar Sharma
- Department of Neurosurgery, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | | | - Somen Misra
- Department of Ophthalmology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Ashik Ravi
- Department of Ophthalmology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Rakesh Kumar Gupta
- Department of Pathology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Surendra Kumar Gupta
- Department of Neurosurgery, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
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Ruiu A, Stuppner S, Tripodi M, Maffei M, Erdini F, Ferro F. [Diagnosis at first sight]. Radiologe 2021; 61:667-670. [PMID: 33779766 DOI: 10.1007/s00117-021-00836-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2021] [Indexed: 11/27/2022]
Affiliation(s)
- A Ruiu
- Abteilung für Diagnostische und Interventionelle Radiologie, Regionalkrankenhaus Bozen, 39100, Bozen, Provinz Bozen - Südtirol, Italien.
| | - S Stuppner
- Abteilung für Diagnostische und Interventionelle Radiologie, Regionalkrankenhaus Bozen, 39100, Bozen, Provinz Bozen - Südtirol, Italien
| | - M Tripodi
- Abteilung für Neurochirurgie, Regionalkrankenhaus Bozen, Bozen, Südtirol, Italien
| | - M Maffei
- Abteilung für Strahlentherapie, Regionalkrankenhaus Bozen, Bozen, Südtirol, Italien
| | - F Erdini
- Abteilung für pathologische Anatomie, Regionalkrankenhaus Bozen, Bozen, Südtirol, Italien
| | - F Ferro
- Abteilung für Diagnostische und Interventionelle Radiologie, Regionalkrankenhaus Bozen, 39100, Bozen, Provinz Bozen - Südtirol, Italien
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Peripheral Nerve Sheath Tumors of Head and Neck: Imaging-Based Review of World Health Organization Classification. J Comput Assist Tomogr 2020; 44:928-940. [DOI: 10.1097/rct.0000000000001109] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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