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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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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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Zeleník K, Hanzlíková P, Blatová B, Formánek M, Komínek P. Temporal bone meningiomas: emphasizing radiologic signs to improve preoperative diagnosis. Eur Arch Otorhinolaryngol 2020; 278:271-273. [PMID: 32533237 DOI: 10.1007/s00405-020-06110-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 06/03/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Temporal bone meningioma is an extremely rare disease. Lack of clinical attention due to its rarity might lead to delayed diagnosis. This short communication aims to emphasize radiologic signs of temporal bone meningiomas to improve preoperative diagnosis. METHODS Radiological characteristics of temporal bone meningiomas are discussed. RESULTS Temporal bone meningioma is characterized by diffuse "hairy" trabecular hyperostosis without the destruction of trabecular structures, bone thickening, and irregular surface margins of the temporal bone on computed tomography. The dural tail sign is a unique feature of temporal bone meningioma on magnetic resonance imaging. CONCLUSION Otolaryngologists certainly should be aware of characteristic radiologic signs of temporal bone meningiomas. Using modern computed tomography and magnetic resonance imaging protocols enables with a high degree of accuracy to distinguish temporal bone meningiomas from other more common entities in this location.
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Affiliation(s)
- Karol Zeleník
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Ostrava, 17. listopadu 1790, 708 00, Ostrava, Czech Republic. .,Department of Craniofacial Surgery, Faculty of Medicine, University of Ostrava, Syllabova 19, 703 00, Ostrava, Czech Republic.
| | - Pavla Hanzlíková
- Department of Imaging Methods, Faculty of Medicine, University of Ostrava, Syllabova 19, 703 00, Ostrava, Czech Republic
| | - Barbora Blatová
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Ostrava, 17. listopadu 1790, 708 00, Ostrava, Czech Republic.,Department of Craniofacial Surgery, Faculty of Medicine, University of Ostrava, Syllabova 19, 703 00, Ostrava, Czech Republic
| | - Martin Formánek
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Ostrava, 17. listopadu 1790, 708 00, Ostrava, Czech Republic.,Department of Craniofacial Surgery, Faculty of Medicine, University of Ostrava, Syllabova 19, 703 00, Ostrava, Czech Republic
| | - Pavel Komínek
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Ostrava, 17. listopadu 1790, 708 00, Ostrava, Czech Republic.,Department of Craniofacial Surgery, Faculty of Medicine, University of Ostrava, Syllabova 19, 703 00, Ostrava, Czech Republic
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Verhoeven V, Vrints I, De Keyser J, Menovsky T, Thiessen F, Tondu T. A contemporary and a historical patient with an ectopic meningioma. Acta Chir Belg 2019; 119:254-258. [PMID: 29490576 DOI: 10.1080/00015458.2018.1438561] [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: 01/25/2018] [Accepted: 02/04/2018] [Indexed: 10/17/2022]
Abstract
Introduction: Ectopic meningiomas are rare tumors which can be encountered by all surgical specialties. Patients and methods: We report on two different cases, a contemporary one and a historical one, highlighting the diversity of clinical presentations and prognoses of these lesions. Furthermore epidemiological aspects, clinical features, and diagnostic and therapeutic work-up in patients with an ectopic meningioma are reviewed. Results: Typically, ectopic meningiomas present as gradually expanding lesions, causing a variety of symptoms by their mass effect. Diagnosis is based on histological characteristics, which are similar to those of intracranial meningiomas. Treatment is primarily surgical. Conclusions: The cases we report are at different ends of the clinical and prognostic spectrum. Therapeutic options for different clinical scenarios are discussed.
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Affiliation(s)
- Veronique Verhoeven
- a Department of Primary and Interdisciplinary Care (ELIZA) - Faculty of Medicine and Health Sciences , University of Antwerp , Belgium
| | - Ina Vrints
- b Department of Plastic and Reconstructive Surgery , Antwerp University Hospital , Antwerp , Belgium
| | | | - Tomas Menovsky
- d Department of Neurosurgery , Antwerp University Hospital , Antwerp , Belgium - Faculty of Medicine and Health Sciences , University of Antwerp , Belgium
| | - Filip Thiessen
- b Department of Plastic and Reconstructive Surgery , Antwerp University Hospital , Antwerp , Belgium
| | - Thierry Tondu
- b Department of Plastic and Reconstructive Surgery , Antwerp University Hospital , Antwerp , Belgium
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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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Affiliation(s)
- Joseph G Manjaly
- Department of ENT, Salisbury District Hospital , Salisbury SP2 8BJ , UK
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Deshmukh SD, Rokade VV, Pathak GS, Nemade SV, Ashturkar AV. Primary extra-cranial meningioma in the right submandibular region of an 18-year-old woman: a case report. J Med Case Rep 2011; 5:271. [PMID: 21722387 PMCID: PMC3224503 DOI: 10.1186/1752-1947-5-271] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2010] [Accepted: 07/02/2011] [Indexed: 11/10/2022] Open
Abstract
Introduction Extra-cranial meningioma or ectopic meningioma is a rare tumor. This tumor has been reported in various anatomic sites in the head and neck, mediastinum, skin and soft tissues. We report a rare case of ectopic meningioma in the submandibular region detected by using fine-needle aspiration cytology, histopathology and immunohistochemistry. This case represents another unusual site for extra-cranial meningioma, which prompted us to report it. Case presentation An 18-year-old Dravidian woman presented with swelling in the right submandibular region. The computed tomographic scan findings were suggestive of a neoplastic mass lesion in the right submandibular region. Fine-needle aspiration cytology led to the differential diagnosis of a monomorphic adenoma of a salivary gland or an ectopic meningioma. The patient underwent excision of the submandibular gland and tumor. The histological examination and immunohistochemistry studies confirmed that the lesion was an extra-cranial meningioma. At her two-year follow-up examination, there was no recurrence of the tumor. Conclusion Our experience with this case indicates that, although rare, meningioma should be entertained in the differential diagnosis of a mass lesion in the head and neck region.
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Affiliation(s)
- Sanjay D Deshmukh
- Department of Pathology, Shrimati Kashibai Navale Medical College and General Hospital, Narhe, Pune-411041, India.
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Qutub MF, Haider A, Jawad HA, Khalbuss WE. Fine needle aspiration cytology of ectopic meningioma presenting as a neck mass: a case report and a review of the literature. Cytopathology 2011; 23:61-4. [PMID: 21251096 DOI: 10.1111/j.1365-2303.2010.00833.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- M F Qutub
- King Saud bin Abdulaziz University for Health Sciences, College of Medicine, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi Arabia.
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Mattox A, Hughes B, Oleson J, Reardon D, McLendon R, Adamson C. Treatment recommendations for primary extradural meningiomas. Cancer 2010; 117:24-38. [DOI: 10.1002/cncr.25384] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2010] [Revised: 03/21/2010] [Accepted: 03/23/2010] [Indexed: 12/17/2022]
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Liu Y, Wang C, Zhu S, Li F, Wang H, Liu M, Zhang L, Wu C. Clinical characteristics and treatment of ectopic meningiomas. J Neurooncol 2010; 102:81-7. [PMID: 20607355 DOI: 10.1007/s11060-010-0288-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2010] [Accepted: 06/21/2010] [Indexed: 10/19/2022]
Abstract
We have examined the clinical characteristics and treatment of ectopic meningiomas (EMs). Samples from 17 patients with EMs were analyzed, and their clinical characteristics, mechanism, and treatment were studied in combination with the literature. The main clinical manifestations of EMs included increased intracranial pressure, epilepsy, local mass, and local occupying effects, but diagnosis of EMs depended on the pathology. Surgical removal can achieve the double objectives of confirmed diagnosis and treatment of tumors. The clinical characteristics of EMs vary with the sites of tumors. Operation is the treatment of first choice. Prognosis is better than that of typical meningiomas.
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Affiliation(s)
- Yuguang Liu
- Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan 250012, People's Republic of China.
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Primary meningioma of the middle ear: case report. The Journal of Laryngology & Otology 2009; 124:572-4. [DOI: 10.1017/s0022215109991745] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjective:To report a rare case of primary meningioma of the middle ear.Method:We describe the case of a 55-year-old woman who presented with decreased hearing and fullness in the left ear, with a middle-ear mass. We also review the world literature regarding primary extracranial meningioma of the middle ear and its management.Results:Primary middle-ear meningioma, a rare clinical entity, was diagnosed in this patient based on an initial transmastoid biopsy. Magnetic resonance imaging with gadolinium enhancement excluded the presence of an intracranial component. Complete excision of the tumour was achieved using a combined approach tympanoplasty. The patient had an uneventful post-operative course.Conclusion:Meningiomas, although rare in the middle ear, need to be included in the differential diagnosis of middle-ear lesions presenting to the otolaryngologist. This case emphasises the management strategy required when dealing with a middle-ear mass.
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