Indian Journal of Pathology and Microbiology
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Year : 2008  |  Volume : 51  |  Issue : 1  |  Page : 51-52
Primary intraosseous meningioma

Department of Pathology and Surgery, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India

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Primary intraosseous meningioma of the skull is an uncommon lesion often confused preoperatively with a primary bone tumor of the skull. We report this rare tumor in a 19-year-old male who was radiographically diagnosed as osteoid osteoma.

Keywords: Intraosseous, meningioma, primary

How to cite this article:
Marwah N, Gupta S, Marwah S, Singh S, Kalra R, Arora B. Primary intraosseous meningioma. Indian J Pathol Microbiol 2008;51:51-2

How to cite this URL:
Marwah N, Gupta S, Marwah S, Singh S, Kalra R, Arora B. Primary intraosseous meningioma. Indian J Pathol Microbiol [serial online] 2008 [cited 2022 Jan 20];51:51-2. Available from: https://www.ijpmonline.org/text.asp?2008/51/1/51/40396

   Introduction Top

Meningiomas without dural connection or association with a cranial suture are unusual and are termed as ectopic. Ectopic meningiomas have been reported to occur in the subcutaneous tissues of skin, paranasal sinuses, orbit, neck, salivary glands, and calvaria. [1],[2] They are usually mistaken for primary bone tumor. We report this case occurring in a 19-year-old male.

   Case History Top

A 19-year-old male presented with persistent left-sided headaches, for approximately 1 year. It was dull and aching, centered over the left parietal region. There was no history of any trauma. Skull X-ray revealed a 4 x 3.5 cm 2 area of high density in the left parietal bone. CT scanning of skull indicated hyperostosis involving all the layers. The underlying dura and brain was normal. This skull tumor was diagnosed as osteoma. The patient was referred for the biopsy of the skull lesion which revealed a benign psammomatous meningioma [Figure - 1].

   Discussion Top

Ectopic meningiomas represent a well-described entity. The location of these lesions is varied. [1],[2] True primary intraosseous meningiomas are those lesions that do not involve the underlying dura. [3] The exact origin of these tumors is now attributed to presence of arachnoid cap cells in the arachnoid granulations and in normal dura. [4] Azar-Kia et al. suggested that rests of arachnoid cap cells are trapped in the cranial sutures during birth and molding of head. It is thought that small meningoceles containing arachnoid cells may form during that period and that these cap cells become entrapped within the cranial sutures, giving rise to intraosseous meningioma later in life. [5] The clinical presentation and imaging studies of these lesions are variable. On plain X-ray films, the skull lesion can be hyperostotic, osteolytic, or mixed. The differential diagnosis for a hyperostotic or sclerotic lesion includes osteoma, intracranial meningioma, metastatic cancer, and endocrine disorders like hyperparathyroidism. Differential diagnosis for an osteolytic lesion includes chondroma, epidermoid cyst, osteogenic sarcoma, myeloma, metastatic cancer, or fibrous dysplasia. Computerized tomography with bone windows is often useful but not diagnostic. Hence biopsy plays a significant role. [6]

Primary intraosseous meningiomas are generally benign lesions. Surgical resection and adjuvant radiation therapy are recommended when lesion is symptomatic and/or progressive.

   References Top

1.Altinors M, Cetin A, Pak I. Scalp mengingioma: case report. Neurosurgery 1985;16:379-80.  Back to cited text no. 1    
2.Lopez DA, Silvers DN, Helwig EB. Cutaneous meningiomas - a clinico-pathologic study. Cancer 1974;34:728-44.  Back to cited text no. 2  [PUBMED]  
3.Todd S, Bette K, Kleinschmidt DM. Primary intraosseous meningioma: a case report. J Neurosurg 1995;83:912-5.  Back to cited text no. 3    
4.Azar-Kia B, Sarwar M, Mare JA. Intraosseous meningioma. Neuroradiology 1974;6:246-53.  Back to cited text no. 4    
5.Henchoz L, Borruat FX. Intraosseous meningioma: a rare cause of chronic optic neuropathy and exophthalmos. Klin Monatsbl Augenheilkd 2004;221: 414-7.  Back to cited text no. 5  [PUBMED]  [FULLTEXT]
6.Nauto M, Tsuji N, Mitri J, Tanoka S, Vemasty Y, Itakura T. A case of intraosseous meningioma with extracranial progression having difficulty in making a preoperative diagnosis. No Shinkei Gelza 2005;33:51-6.  Back to cited text no. 6    

Correspondence Address:
N Marwah
Department of Pathology and Surgery, Pt. B.D. Sharma PGIMS, Rohtak 124 001, Haryana
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0377-4929.40396

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  [Figure - 1]

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