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Brain computerized tomography scan with various windows showed a tiny hyperdense lesion adjacent to the frontal bone. There was no other remarkable finding in the intracranial structures.
Source publication
Meningioma originates from arachnoid cap cells and is the second most common intracranial tumor; however, it can also be found in an extracranial location. A very rare primary extracranial meningioma without the presence of an intracranial component has also been reported. Primary extracranial meningiomas have been found in the skin, scalp, middle...
Context in source publication
Context 1
... was an approximately 1.5-cm-diameter firm pro- truding mass with an overlying 0.5-cm-long incision scar on the middle forehead (Fig. 1). An ultrasonogram showed a 2.05×1.36× 0.49-cm benign-looking hyperechoic nodular lesion (Fig. 2). A subsequent computerized tomography (CT) scan showed that the lesion was confined to the extracranial location (Fig. 3). An exci- sional biopsy was performed under local anesthesia. During the excisional biopsy, the mass was difficult to grossly delineate from the overlying skin and was found to be adhered to the underlying frontalis muscle. Therefore, the mass was excised en-bloc in an el- liptical shape including the skin and frontalis muscle. The ...
Citations
... Primary extracranial meningiomas encompass two distinct types: those originating from arachnoid cells persisting within nerve sheaths, and those occurring ectopically without any connection to the cranial cavity. In contrast, secondary extracranial meningiomas are divided into two classifications: tumors that directly escape from the cranium where they originated, and extracranial meningiomas that have metastasized from intracranial sources [6,7]. ...
... The cause of extracranial meningiomas is still not known, there are some possible hypothesis as sited by Rushing To conclude, the presence of arachnoid cells beyond the confines of the nervous system may instigate extracranial meningiomas [1][2][3][4][5][6][7][8][9][10][11][12][13]. Our case seems to align more fortuitously with the second hypothesis, as our patient, a 10-year-old child with an extracranial meningioma in the infratemporal fossa, lacks any history of cranial trauma, lending a particularly intriguing and atypical dimension to this case. ...
... Diagnosing extracranial meningiomas poses challenges due to their paucisymptomatic and multifarious clinical presentation, often leading to misdiagnosis and delays in identification [2][3][4][5][6][7][8][9]. Notably, the cornerstone of diagnosis lies in histological confirmation, since interpretations of CT scans and MRIs may suggest alternative pathologies given the uncommon nature of extracranial meningiomas [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. ...
Case Report Meningiomas, common tumors of the central nervous system, rarely manifest in extracranial locations, and their occurrence in children is exceptionally rare. This paper presents a comprehensive case study of a 10-year-old female patient diagnosed with an infratemporal fossa meningioma. Immunohistochemistry played a pivotal role in confirming the diagnosis, while CT scans and MRI aided in assessing tumor extension and planning the surgical approach. The tumor was successfully excised using a trans-mandibular osteotomy approach. A thorough literature review highlighted the scarcity of extracranial meningioma cases, particularly in children, and revealed four hypotheses explaining their unusual extracranial localization. Surgical excision remains the primary treatment, with radiation therapy considered for partial removal cases. The diagnostic challenges posed by the paucity of symptoms and the pivotal role of histological confirmation were discussed. This case underscores the importance of immunohistochemistry for diagnosis and initiates the management process for extracranial meningiomas, shedding light on their atypical clinical presentations and etiopathology.
... These are usually referred to as extracranial meningeal tumors or ectopic arachnoid cells, and they only account for 1-2% of general meningioma. Until now, the prior work has only reported individual cases or a series of cases [3,[8][9][10][11][12]. Rushing et al. reported 146 cases of primary extracranial tumors during 1970 and 1999, which is considered the most extensive research [7]. ...
Introduction and importance
Extracranial meningiomas are rare, accounting for 1-2% of all meningiomas with just published in the form of a case report or series. They are categorized as primary or secondary tumors. In this paper, we present a case of extracranial meningioma in the scalp skin, which is believed in Vietnam's first case.
Case presentation
A 38 years old male with a history of brain epidural hematoma surgery in 1995 presented a subcutaneous protruding mass, which revealed approximately 3- centimeters from an incision scar in the left frontoparietal scalp. The tumor was firm, mobilized with contrast enhancement on magnetic resonance image. The complete surgical excision of the whole mass was performed, and histological examination revealed a WHO grade I meningioma.
Clinical discussion
Epidemiology, classification, diagnosis, treatment as well as prognosis of extracranial meningioma were discussed. We also hypothesized the emergence of extracranial meningioma after an epidural hematoma surgery.
Conclusion
Extracranial meningioma is quite rare, but it could be presented after a traumatic brain injury. Neurosurgery was the first choice, safe and effective treatment.
Background:
Meningiomas are benign tumors that originate from the meningothelial arachnoid cells, but they rarely develop extracranially. There is no specific surgical guideline for resecting them in the maxillary sinus, and little is known about their biological behavior and operative management.
Case summary:
We present a 54-year-old female patient referred to our department with a primary extracranial meningioma that presented as buccal swelling associated with headache. On clinical examination the mass was non-tender, fixed, sessile and non-pulsatile situating in the right maxillary sinus. Computed tomography scan showed a well-defined mass of 7 cm × 6 cm × 6 cm compressing the surrounding structures. Magnetic resonance imaging revealed a well circumscribed heterogenous lesion with necrotic center and relatively hypointense on T2-weighted imaging. Imaging studies revealed no evidence of intracranial extension and metastatic nests. Biopsy showed grade I primary extracranial with low mitotic activity. Total maxillectomy with excision of tumor and adjacent paranasal structures following reconstruction of the orbit and maxilla with tissue patch was done by the maxillofacial surgeon. The biopsy reported fibrous meningioma based on the hematoxylin and eosin section. On immunohistochemistry the tumor cells were positive for vimentin, focally positive for epithelial membrane antigen and CD99 and negative for signal transducer and activator of transcription 6. The mass was removed surgically with reconstruction, and the pathological studies confirmed the diagnosis to be an extracranial meningioma. The present study briefly reviews the current knowledge concerning the diagnosis and treatment of extracranial meningiomas in the head and neck area and offers suggestions for managing extracranial meningiomas in the paranasal sinuses.
Conclusion:
To conclude, extracranial meningiomas in the paranasal sinuses may be successfully managed by surgical treatment without evident post-surgery complications.
