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Wang C, Liao H, Luo W, Wei S, Wei W, Zhao Y, Ma J, Su D. Association of imaging classification and histopathological grading in primary intraosseous meningioma of the skull. Clin Neurol Neurosurg 2024; 243:108239. [PMID: 38936174 DOI: 10.1016/j.clineuro.2024.108239] [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: 01/25/2024] [Revised: 02/27/2024] [Accepted: 03/08/2024] [Indexed: 06/29/2024]
Abstract
BACKGROUND Primary intraosseous meningioma of the skull (PIMS) is a rare type of primary extradural meningioma (PEM) involving cranial bone. The existing literature strongly suggest the importance of radiological feacures in pathological diagnosis of PIMS. Thereby, the aim of this study is to investigate the association between imaging classification and histopathological grading in PIMS. METHODS In this retrospective study, we retrospectively analyzed the computed tomography scan/magnetic resonance imaging and pathological data pertaining to patients with pathologically proven PIMS. The association between radiological features, imaging classification, and histopathological grading was analyzed using logistic regression analysis. RESULTS In this study, data of 25 patients with PIMS were assessed. The univariate logistic regression analysis results showed significant correlation between histopathological grading and imaging classification (OR: 22.5; 95% CI: 2.552-198.378; p = 0.005), intra- and extracalvarial extension (OR: 7.2; 95% CI: 1.066-48.639; p = 0.043), and tumor margin (OR: 7.19; 95% CI: 1.06-47.61; p = 0.043). According to the results of multivariate logistic regression analysis, imaging classification was the strongest independent risk factor for high-grade PIMS, and the risk of aggressiveness of osteoblastic type of PIMS was 16.664 times higher than that of osteolytic type of PIMS (OR: 16.664; 95% CI: 1.15-241.508; p = 0.039). CONCLUSIONS Imaging classification is an independent risk factor for high-grade PIMS.
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Affiliation(s)
- Chen Wang
- Department of Medical Imaging Center, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, China
| | - Hai Liao
- Department of Medical Imaging Center, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, China
| | - Wenqi Luo
- Department of Pathology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, China
| | - Shiju Wei
- Department of Radiology, Pingguo People's Hospital, Baise, Guangxi, China
| | - Wei Wei
- Department of Medical Imaging Center, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, China
| | - Yang Zhao
- Department of Medical Imaging Center, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, China
| | - Jie Ma
- Department of Medical Imaging Center, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, China
| | - Danke Su
- Department of Medical Imaging Center, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, China.
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2
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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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3
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Wilson DS, Mohammad S, Hussain A. A Novel Report of Suspected Prostate Adenocarcinoma to Orbital Roof Meningioma Metastasis. Ophthalmic Plast Reconstr Surg 2023; 39:e166-e168. [PMID: 37326486 DOI: 10.1097/iop.0000000000002423] [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: 06/17/2023]
Abstract
: Tumor-to-meningioma metastasis (TTMM) is an uncommon phenomenon, in which a primary malignant tumor metastasizes to a recipient preexisting meningioma. Herein, the authors report a case of a 74-year-old man with a known history of metastatic prostate adenocarcinoma who with frontal headache and right orbital apex syndrome. Initial CT studies demonstrated a right orbital roof osseous lesion. Subsequent MRI was reported as characteristic of an intraosseous meningioma with intracranial and intraorbital extensions. A biopsy of the right orbital mass was obtained and returned a diagnosis of metastatic prostate cancer. The combination of imaging and pathologic findings suggested that the clinical scenario was overall most in keeping with a skull bone-based prostate adenocarcinoma metastasis infiltrating a preexisting meningioma. This is a rare case of TTMM in an orbit-based meningioma, presenting with an orbital apex syndrome.
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Affiliation(s)
- Darcie S Wilson
- Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Syed Mohammad
- Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Ahsen Hussain
- Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
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4
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Dires Fenta B, Israel Korga T, Dinka Bikila T, Kassahun Tadele A, Lijalem Yigezu B, Gosa Negash M. Primary Intraosseous Meningioma: Bifrontal Skull Mass. PATHOLOGY AND LABORATORY MEDICINE INTERNATIONAL 2022. [DOI: 10.2147/plmi.s388172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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5
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Zou M, Yang R, Tang Z, Luo D, Jiang Q. Primary intraosseous meningioma with subcutaneous and dural invasion: A case report and literature review. Front Surg 2022; 9:995986. [PMID: 36329982 PMCID: PMC9622770 DOI: 10.3389/fsurg.2022.995986] [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: 07/16/2022] [Accepted: 09/28/2022] [Indexed: 11/07/2022] Open
Abstract
Primary intraosseous meningiomas (PIOMs) are a rare subset of meningiomas, comprising fewer than 1% of all such tumors. Furthermore, PIOMs presenting as osteogenic lesions that invade both the dura and subcutaneous tissue are extremely rare. Unlike intracranial meningiomas, diagnosing and treating PIOMs are challenges due to their insidious clinical behavior and a lack of clear radiological diagnostic criteria. We report the case of a 60-year-old female with headache and a slightly outward protrusion of the parietal region of the skull. CT showed an osteogenic lesion in the right parietal bone. MR imaging indicated mild to moderate homogeneous enhancement with an intense dural reaction. The suggested clinical diagnosis was lymphoma, so we performed a skull biopsy, which revealed an intraosseous benign meningioma. A precise resection strategy was planned with a neuronavigation system accompanied by a one-step customized titanium mesh cranioplasty. The lesion was completely removed, and pathological analysis confirmed a meningothelial meningioma (WHO Grade I) of intraosseous layer origin invading the dura mater and subcutaneous tissue. This case highlights the need for an initial biopsy when the lesion is difficult to diagnose on imaging. Complete resection should be attempted to minimize the risk of recurrence.
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6
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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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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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8
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Crea A, Grimod G, Scalia G, Verlotta M, Mazzeo L, Rossi G, Mattavelli D, Rampinelli V, Luzzi S, Spena G. Fronto-orbito-ethmoidal intradiploic meningiomas: A case study with systematic review. Surg Neurol Int 2021; 12:485. [PMID: 34754535 PMCID: PMC8571263 DOI: 10.25259/sni_386_2021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 09/08/2021] [Indexed: 10/26/2022] Open
Abstract
Background Primary intradiploic meningiomas, extra-axial tumors arising primarily in the skull, are rare. The authors reported a complex case of intradiploic intraosseous metaplastic meningioma of the left medial wall and orbital roof with the left frontal sinus invasion and left ethmoidal body bone substitution. The authors also conducted a systematic review concerning diagnosis and management of patients affected by purely calvarial intradiploic meningiomas along with a focus on fronto-orbito-ethmoidal ones. Methods A literature search was conducted using PubMed and Scopus databases according to preferred reporting items for systematic reviews and meta-analysis statement and with the following Mesh terms: Intradiploic, intraosseous, calvarial, and meningioma. Eligibility criteria were limited by the nature of existing literature on intradiploic meningiomas, consisting of only case series, and case reports. Results A total of 128 published studies were identified through our search. 41 studies were included in this systematic review, 59 patients with a female/male ratio of 1.2/1. The mean age of the patients is of 47.69 years (range 3-84 years). Only seven out of 59 patients (11.9%) presented a complex intradiploic meningioma located in fronto-orbito-ethmoidal region like our case. In almost all patients, a gross-total resection was performed (96.6%) and only in two patients (3.4%) a subtotal resection was achieved. Conclusion The authors shared this successfully treated case to add to the overall clinical experience in the management of this rare subtype tumor, with the hope that more studies are conducted to further address the mechanism of intradiploic meningiomas development.
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Affiliation(s)
- Antonio Crea
- Department of Neuroscience, Neurosurgery Unit, Alessandro Manzoni Hospital, Lecco, Italy
| | - Gianluca Grimod
- Department of Neuroscience, Neurosurgery Unit, Alessandro Manzoni Hospital, Lecco, Italy
| | - Gianluca Scalia
- Department of Neurosurgery, Highly Specialized Hospital of National Importance "Garibaldi", Catania, Italy
| | - Mariarosaria Verlotta
- Department of Neuroscience, Neurosurgery Unit, Alessandro Manzoni Hospital, Lecco, Italy
| | - Lucio Mazzeo
- Department of Neuroscience, Neurosurgery Unit, Alessandro Manzoni Hospital, Lecco, Italy
| | - Giorgio Rossi
- Department of Oncology, Pathological Anatomy and Histology Unit, Alessandro Manzoni Hospital, Lecco, Italy
| | - Davide Mattavelli
- Department of Surgical Specialties, Radiological Sciences and Public Health, Unit of Otorhinolaryngology - Head and neck Surgery, Piazza del Mercato, Brescia, Italy
| | - Vittorio Rampinelli
- Department of Surgical Specialties, Radiological Sciences and Public Health, Unit of Otorhinolaryngology - Head and neck Surgery, Piazza del Mercato, Brescia, Italy
| | - Sabino Luzzi
- Department of Neurosurgery, IRCCS Fondazione Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Giannantonio Spena
- Department of Neuroscience, Neurosurgery Unit, Alessandro Manzoni Hospital, Lecco, Italy
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9
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Sasaki K, Saito A, Nishijima Y, Inoue T, Suzuki S, Ezura M, Uenohara H, Tominaga T. Giant Intraosseous Meningioma Associated with Calvarial Hyperostosis and Subcutaneous Invasion: Case Reports and Literature Review. Asian J Neurosurg 2021; 16:589-594. [PMID: 34660375 PMCID: PMC8477816 DOI: 10.4103/ajns.ajns_534_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/22/2021] [Accepted: 03/21/2021] [Indexed: 11/22/2022] Open
Abstract
Most meningiomas grow intracranially, and primary intraosseous meningioma is rarely reported. We present two rare surgical cases of giant intraosseous meningothelial meningioma. The first patient was a 35-year-old male with parietal skull deformity without neurological symptoms. Total resection was successful. The origin was the parasagittal intraosseous layer, and the superior sagittal sinus was partially opened. The second patient was a 20-year-old female with a slightly upward protrusion of the frontal skull without pain or neurological deficits. The lesion was totally resected, and the origin was the parasagittal intraosseous layer invading into the dura matter and subcutaneous layer. The clinical management of these cases presented a surgical challenge because of detachment and repair from venous sinuses. The current report provides surgical tips for such rare diseases and is a good reference for the future treatment of similar diseases.
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Affiliation(s)
- Keisuke Sasaki
- Department of Neurosurgery, Tohoku University, Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Atsushi Saito
- Department of Neurosurgery, Kohnan Hospital, Sendai, Miyagi, Japan
| | - Yasuo Nishijima
- Department of Neurosurgery, National Hospital Organization Sendai Medical Center, Sendai, Miyagi, Japan
| | - Takashi Inoue
- Department of Neurosurgery, National Hospital Organization Sendai Medical Center, Sendai, Miyagi, Japan
| | - Shinsuke Suzuki
- Department of Neurosurgery, National Hospital Organization Sendai Medical Center, Sendai, Miyagi, Japan
| | - Masayuki Ezura
- Department of Neurosurgery, National Hospital Organization Sendai Medical Center, Sendai, Miyagi, Japan
| | - Hiroshi Uenohara
- Department of Neurosurgery, National Hospital Organization Sendai Medical Center, Sendai, Miyagi, Japan
| | - Teiji Tominaga
- Department of Neurosurgery, Tohoku University, Graduate School of Medicine, Sendai, Miyagi, Japan
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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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11
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Sundblom J, Nowinski D, Casar-Borota O, Ryttlefors M. Removal of giant intraosseous meningioma followed by cranioplasty using a custom-made bioceramic implant: case report. J Neurosurg 2019; 131:735-739. [PMID: 30215553 DOI: 10.3171/2018.4.jns1850] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 04/23/2018] [Indexed: 11/06/2022]
Abstract
Intraosseous meningioma of the chordoid type is a rare clinical entity. Radical surgical removal and subsequent cranioplasty is the treatment of choice. Here, the authors report a severe case involving more than 70% of the calvarial surface area, which was removed and repaired using a prefabricated custom-made, titanium-reinforced, bioceramic implant and bone-cutting guides. Tumor removal and good esthetic outcome were achieved, along with a 17.1% increase of intracranial volume. Bioceramic implants have shown promising initial results and may represent an important new tool in the surgeon's armamentarium.
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Affiliation(s)
- Jimmy Sundblom
- 1Department of Neuroscience, Neurosurgery, Uppsala University Hospital
| | - Daniel Nowinski
- 2Department of Surgical Sciences, Plastic Surgery, Uppsala University Hospital
| | - Olivera Casar-Borota
- 3Department of Immunology, Genetics and Pathology, Uppsala University; and
- 4Department of Clinical Pathology, Uppsala University Hospital, Uppsala, Sweden
| | - Mats Ryttlefors
- 1Department of Neuroscience, Neurosurgery, Uppsala University Hospital
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12
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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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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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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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Kwon SY, Shin HS, Kim TH, Kim HJ. Primary Intraosseous Osteolytic Meningioma of the Skull Mimicking Scalp Mass: A Case Report and Review of Literature. Brain Tumor Res Treat 2015; 3:151-5. [PMID: 26605275 PMCID: PMC4656895 DOI: 10.14791/btrt.2015.3.2.151] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 10/05/2015] [Accepted: 10/05/2015] [Indexed: 11/30/2022] Open
Abstract
Primary extradural meningioma is about 1-2% of all meningiomas. Primary intraosseous meningioma is a rare form of intra-bone tumors that account for approximately 67% of extradural meningiomas. We report a primary intraosseous meningioma of a 69-year-old man who had headaches and a mass on right parietal scalp for the past few months. Remarkably, the brain tissue within the osteolytic cavity of the skull was normal in computed tomography and magnetic resonance images. Resection, duraplasty, and cranioplasty were performed. The patient's symptoms disappeared after surgery, and the histological diagnosis was an osseous meningothelial meningioma (World Health Organization grade I).
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Affiliation(s)
- Soon Young Kwon
- Department of Neurosurgery, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Hyung Shik Shin
- Department of Neurosurgery, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Tae Hong Kim
- Department of Neurosurgery, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Hyun Jung Kim
- Department of Pathology, Inje University Sanggye Paik Hospital, Seoul, Korea
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