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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] [What about the content of this article? (0)] [Affiliation(s)] [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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