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Kemps GJ, de Boer D, Tijssen MP, Kunst DH, Waterval JJ. CSF or middle ear effusion? Diagnostical dilemmas in a patient with temporal bone meningioma: A case report. Heliyon 2024; 10:e28059. [PMID: 38524529 PMCID: PMC10957423 DOI: 10.1016/j.heliyon.2024.e28059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 03/10/2024] [Accepted: 03/11/2024] [Indexed: 03/26/2024] Open
Abstract
Introduction Cerebrospinal fluid (CSF) fistulas are a rare phenomenon, that can lead to life-threatening complications if left untreated. Presenting as rhinorrhea or otorrhea, they can be difficult to diagnose due to admixture of other bodily fluids. Typically, CSF fistulas develop after trauma, but in rare instances, they can be diagnosed in patients with a neoplastic lesion. Objective To discuss several steps in diagnosing CSF fistulas. Patient A fifty-year-old female with an intra-osseous temporal bone meningioma. Interventions For diagnosing CSF admixture in fluids, two tests are looked into: beta-2 transferrin (β2T) and beta-trace protein (βTP) testing. Conclusion Testing for βTP is a highly sensitive, quick and non-invasive method to assess CSF admixture in middle ear effusion. Because of its lower cost, faster results and easy sample collection, βTP testing has in our clinic replaced β2T testing. The current case illustrates a rare etiology of a CSF fistula, where β2T testing presumably showed false-negative results and βTP testing showed true-positive results.
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Affiliation(s)
- Glen J.F. Kemps
- Department of Otolaryngology, Isala Hospital, Zwolle, the Netherlands
| | - Douwe de Boer
- Central Diagnostic Laboratory, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Maud P.M. Tijssen
- Department of Radiology, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Dirk H.P.M. Kunst
- Department of Otorhinolaryngology, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Jérôme J. Waterval
- Department of Otorhinolaryngology, Maastricht University Medical Centre, Maastricht, the Netherlands
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Gao L, Chen P, Yang L, Li Y, Han F, Liu H, Zhang J. Imaging Features of Primary Intraosseous Meningiomas. J Comput Assist Tomogr 2023; 47:934-939. [PMID: 37948369 DOI: 10.1097/rct.0000000000001492] [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: 06/15/2023]
Abstract
OBJECTIVE To describe the imaging features of primary intraosseous meningiomas (PIMs) to aid an accurate diagnosis. METHODS Clinical materials and radiological data for 9 patients with pathologically confirmed PIMs were reviewed comprehensively. RESULTS Most lesions involved inner and outer plates of the calvaria and all were relatively well circumscribed. Upon computed tomography, portions of the solid neoplasm were hyperattenuated or isoattenuated. Hyperostosis was found in many lesions, but calcification was seen rarely. On magnetic resonance imaging, most neoplasms were hypointense on T1-weighted images, hyperintense on T2-weighted images, and heterogeneous on fluid-attenuated inversion recovery images. In most cases, the soft tissue of neoplasms showed hyperintense on diffusion-weighted imaging and hypointense on apparent diffusion coefficient. All lesions were obviously enhanced after gadolinium administration. Each patient accepted surgical treatment and recurrence was not observed during follow-up. CONCLUSIONS Primary intraosseous meningiomas are very rare tumors that occur usually in later life. They are well-defined and tend to involve the inner and outer plates of the calvaria, with a classic appearance of hyperostosis on computed tomography. Primary intraosseous meningiomas display hypointense on T1-weighted images, hyperintense on T2-weighted images, and hyperattenuated or isoattenuated on computed tomography. Hyperintense on diffusion-weighted imaging, hypointense on apparent diffusion coefficient can also be found. Obvious enhancement supplied additional information for an accurate diagnosis. A neoplasm with these features should raise the suspicion of a PIM.
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Affiliation(s)
- Lu Gao
- From the Departments of Diagnostic Radiology
| | - Peiyao Chen
- From the Departments of Diagnostic Radiology
| | - Lin Yang
- Vascular Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an
| | - Yang Li
- From the Departments of Diagnostic Radiology
| | - Fang Han
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai
| | - Heng Liu
- Department of Radiology, The Center for Medical Imaging of Guizhou Province, Affiliated Hospital of Zunyi Medical University, Zunyi, People's Republic of China
| | - Jiawen Zhang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai
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Benign Meningioma With Rare Radiological and Behavioral Features. J Craniofac Surg 2022; 33:e837-e840. [PMID: 35882350 DOI: 10.1097/scs.0000000000008766] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 04/04/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Meningiomas are usually dura-based primary nonmalignant neoplasms of the central nervous system. It is extremely rare that a meningioma is located at the convexity of the brain, but shows no dura attachment and causes osteolysis of the skull. CASE PRESENTATION A 57-year-old woman presented with an incidentally discovered scalp lump on the head. Neurological deficits were not found. Radiological examination revealed a localized osteolytic lesion in the right parietal bone, which was initially diagnosed as a bone tumor and was surgically resected. At surgery, a tumor mass was found located at the brain convexity without dura attachment. It was tightly attached to the brain parenchyma and had no distinct boundary from the brain. The mass was rather small, but resulted in significant osteolysis of the skull and destruction of the dura. Simpson grade I resection of the tumor was performed. Histological and immunohistochemical results indicated a meningothelial meningioma. CONCLUSIONS Both preoperative and intraoperative diagnoses are difficult for this case. Knowledge of this case is crucial for clinicians to be aware of this entity because it can be easily confused with bone tumors. Further research on the relationship between meningioma and bone metabolism is required to investigate the mechanism of osteolysis.
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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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Van de Voorde N, Mortier GR, Vanhoenacker FM. Fibrous Dysplasia, Paget's Disease of Bone, and Other Uncommon Sclerotic Bone Lesions of the Craniofacial Bones. Semin Musculoskelet Radiol 2020; 24:570-578. [PMID: 33036044 DOI: 10.1055/s-0039-3400292] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Imaging studies of the brain, head and neck, sinuses, and dental computed tomography are among the most frequently performed procedures in radiologic departments. Systematic evaluation in the bone window may reveal common and uncommon sclerotic osseous abnormalities of the craniofacial skeleton.Most of these findings are incidental and unrelated to the initial clinical indications. Sporadically symptoms may arise due to lesional mass effect with compression on adjacent structures and neuroforaminal encroachment, resulting in proptosis, vision, or hearing loss. Other symptoms include craniofacial deformity, mandibular occlusion deformity, and local pain.This article reviews the most common disorders characterized by an increased bone density involving the craniofacial bones including fibrous dysplasia, Paget's disease of bone, meningioma with associated hyperostosis, and osteoma. Finally, typical examples of rarer sclerosing bone dysplasias are discussed as well.Emphasis is placed on imaging features and the differential diagnosis.
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Affiliation(s)
- Nick Van de Voorde
- Department of Radiology, Antwerp University Hospital and Antwerp University, Edegem, Belgium
| | - Geert R Mortier
- Department of Medical Genetics, Antwerp University Hospital and Antwerp University, Edegem, Belgium
| | - Filip M Vanhoenacker
- Department of Radiology, Antwerp University Hospital and Antwerp University, Edegem, Belgium.,Department of Medical Genetics, Antwerp University Hospital and Antwerp University, Edegem, Belgium.,Department of Radiology, AZ Sint-Maarten, Mechelen, Belgium.,Department of Radiology and Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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Kim NR, Yie GT. Intraoperative frozen cytology of intraosseous cystic meningioma in the sphenoid bone. J Pathol Transl Med 2020; 54:508-512. [PMID: 32601263 PMCID: PMC7674761 DOI: 10.4132/jptm.2020.05.21] [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: 04/21/2020] [Accepted: 05/21/2020] [Indexed: 11/26/2022] Open
Abstract
Meningiomas in bone are rarely subjected to fine-needle aspiration diagnosis, and those arising in the skull bone with a cystic presentation are rare. A 24-year-old woman presented with subdural hemorrhage, and subsequent radiology depicted an osteolytic mass-like lesion in the sphenoid bone. Intraoperatively, a solid and cystic hemorrhagic lesion mimicking an aneurysmal bone cyst was observed in the sphenoid bone with dural tearing. Frozen cytology showed singly scattered or epithelioid clusters of round to elongated cells intermixed with many neutrophils. Tumor cells had bland-looking round nuclei with rare prominent nucleoli and nuclear inclusions and eosinophilic granular to globoid cytoplasm in capillary-rich fragments. Histology revealed intraosseous meningothelial and microcystic meningioma (World Health Organization grade 1) in right lesser wing of the sphenoid bone. Considering its unusual location and cytologic findings, differential diagnoses included chordoma, chondroma, chondrosarcoma, and aneurysmal bone cyst. The present case posed a diagnostic challenge due to possible confusion with these entities.
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Affiliation(s)
- Na Rae Kim
- Department of Pathology, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Gie-Taek Yie
- Department of Neurosurgery, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
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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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8
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Malignant primary intraosseous meningioma in a pediatric patient: A case report and review. INTERDISCIPLINARY NEUROSURGERY 2018. [DOI: 10.1016/j.inat.2018.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Osteolytic clear cell meningioma of the petrous bone occurring 36 years after posterior cranial fossa irradiation: Case report. Neurol Neurochir Pol 2016; 50:297-302. [PMID: 27375148 DOI: 10.1016/j.pjnns.2016.04.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 01/30/2016] [Accepted: 04/13/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE AND IMPORTANCE While bone invasion and hyperostosis are frequent phenomena in meningiomas, primary intraosseous meningiomas are rare and their occurrence in the skull base is an extraordinary exception. Moreover, radiation-induced meningiomas represent a unique clinical dilemma given the fact that patients with these tumors had often received a prior full course of radiotherapy. CLINICAL PRESENTATION A 42-year-old man presented with a 3-month history of progressively worsening facial asymmetry. His medical history was consistent for a posterior cranial fossa irradiation at the age of 6 years for a non-confirmed brain stem tumor. On admission his Karnofsky performance status was graded as 50% and his neurological examination showed a complete right facial nerve paralysis and hearing impairment. Computed tomography and magnetic resonance imaging demonstrated an osteolytic tumor invading the whole right petrous bone without intracranial involvement. INTERVENTION As the tumor reached the external auditory canal, a tissue sample was obtained locally. Pathological examination of the lesion identified a grade II clear cell meningioma and the patient was consequently addressed for an intensity modulated radiation therapy. His condition remained unchanged till the most recent follow-up examination, 8 months later. CONCLUSIONS To the best of our knowledge, a radiation induced osteolytic clear cell meningioma of the petrous bone has not been previously reported. As little literature exists regarding the use of adjuvant therapies for these tumors, intensity modulated radiation therapy remains an attractive treatment option in case of pervious irradiation and general status alteration.
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11
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Hong SC, Woon K, O'Keeffe B. Brain mushroom: A case of osteolytic intraosseous meningioma with transcalvaria herniation. Br J Neurosurg 2015; 29:876-8. [PMID: 25891498 DOI: 10.3109/02688697.2015.1029432] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
A 61-year-old male presented with primary intraosseous osteolytic meningioma and transcalvaria herniation. This is an extremely rare condition with only 16 case reports of osteolytic intraosseous meningioma. This case is unique because it was accompanied by a transcalvaria herniation.
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Affiliation(s)
- Sheng Chiong Hong
- a Department of Neurosurgery, Wellington Hospital , Wellington , New Zealand
| | - Kelvin Woon
- a Department of Neurosurgery, Wellington Hospital , Wellington , New Zealand
| | - Benjamin O'Keeffe
- a Department of Neurosurgery, Wellington Hospital , Wellington , New Zealand
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Bernal-García LM, Cabezudo-Artero JM, Marcelo-Zamorano MB, Fernández-Alarcón L, Gilete-Tejero I. [Primary osteolytic intraosseous meningioma of the occipital bone]. Neurocirugia (Astur) 2015; 26:241-5. [PMID: 25716895 DOI: 10.1016/j.neucir.2015.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Revised: 12/19/2014] [Accepted: 01/08/2015] [Indexed: 10/23/2022]
Abstract
Primary intraosseous meningiomas are considered extradural meningiomas when no dural attachment is present. Most of them arise from the cranial bones and can present either as an osteoblastic or an osteolytic lesion. Osteolytic intraosseous meningiomas are the rarest and very few cases have been reported. Given that many of these may develop signs of malignancy, early histological confirmation is important in order to ensure appropriate treatment. The recommended therapy is surgery, with complete resection whenever possible. We present the case of a large primary intraosseous osteolytic meningioma within the occipital bone, which was completely excised five years ago, currently presenting no signs of recurrence.
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Affiliation(s)
| | | | | | - Luis Fernández-Alarcón
- Sección de Radiología Intervencionista, Servicio de Radiología, Hospital Universitario Infanta Cristina, Badajoz, España
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Cheng HT, Chang CH, Chio CC, Chang ST, Wang YL. Atypical intraosseous osteolytic meningioma mimicking calvarial metastasis. FORMOSAN JOURNAL OF SURGERY 2012. [DOI: 10.1016/j.fjs.2012.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Abstract
Almost 1-2% of meningiomas are lesions described as ectopic or extradural meningiomas. Primary intraosseous meningiomas are a rare form of intra-bone tumours that account for approximately 67% of extradural meningiomas. A 41-year-old male patient presented with a headache and a bulge at the right frontal region. Cranial computed tomography displayed a hyperostotic lesion. Magnetic resonance imaging showed enhancement of the bone lesion after injection of gadolinium. A burr hole was drilled at the thickest section of the lesion, and pathological examination of the bone dust extracted from this site was performed. The pathological study indicated the presence of a meningioma. Right frontal craniectomy was performed and the hyperostotic bone was resected. No invasion was observed at the dura. A calvarial defect was reconstructed during the same session with methyl methacrylate cranioplasty.
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Affiliation(s)
- Adem Yilmaz
- Department of Neurosurgery, Sişli Etfal Education and Research Hospital, Sişli, Istanbul 34077, Turkey.
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Sambasivan M, Sanal KP, Mahesh S. Primary intradiploic meningioma in the pediatric age-group. J Pediatr Neurosci 2010; 5:76-8. [PMID: 21042517 PMCID: PMC2964798 DOI: 10.4103/1817-1745.66680] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The authors report a pediatric patient who presented with a slow-growing swelling on the scalp. Computed tomography (CT) of the head revealed an osteolytic intradiploic lesion of the cranial vault. The lesion was excised in toto, and histopathological examination revealed benign intradiploic meningioma. The possible etiology, clinical findings, CT appearance, differential diagnosis, and treatment strategy are discussed.
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Affiliation(s)
- Mahadevan Sambasivan
- Department of Neurosurgery, Cosmopolitan Hospitals, Murinjapalam, Pattom P.O., Trivandrum, Kerala-695 004, India
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Baek JU, Cho YD, Yoo JC. An osteolytic meningioma en plaque of the sphenoid ridge. J Korean Neurosurg Soc 2008; 43:34-6. [PMID: 19096543 DOI: 10.3340/jkns.2008.43.1.34] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2007] [Accepted: 01/02/2008] [Indexed: 11/27/2022] Open
Abstract
Meningioma en plaque (MEP) is a rare tumor characterized more by its clinical and biological behavior than its histological appearance. Hyperostosis of the skull is one of the characteristic signs of MEP. This bony change can produce clinical symptoms and signs in MEP by pressing against adjacent structures. The authors report a rare case of an osteolytic MEP extending from the sphenoid wing into the orbital wall, middle fossa, and temporalis muscle.
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Affiliation(s)
- Jin-Uk Baek
- Department of Neurosurgery, Daegu Catholic University, School of Medicine, Daegu, Korea
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Al-khawaja D, Murali R, Sindler P. Primary calvarial meningioma. J Clin Neurosci 2007; 14:1235-9. [PMID: 17931869 DOI: 10.1016/j.jocn.2006.08.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2006] [Revised: 07/08/2006] [Accepted: 08/11/2006] [Indexed: 10/22/2022]
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Abstract
✓Primary intraosseous meningiomas are a subtype of primary extradural meningiomas and constitute fewer than 2% of meningiomas overall, but they represent approximately two thirds of all extradural meningiomas. These types of meningiomas originate within the bones of the skull and thus can have a clinical presentation and radiographic differential diagnosis that is different from those for intradural meningiomas.
Primary intraosseous meningiomas are classified based on their location and histopathological characteristics. Treatment primarily involves resection with wide margins if possible. Very little literature exists regarding the use of adjuvant therapies such as radiation and chemotherapy for these tumors. In fact, the literature regarding primary intra-osseous meningiomas consists mostly of clinical case reports and case series. This literature is reviewed and summarized in this article.
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Affiliation(s)
| | | | - Chi-Shing Zee
- 3Radiology, University of Southern California, Los Angeles, California
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