An unusual bump on the head. Intraextracranial meningioma presenting incidentally

Nadarajan,; Goddin, Jamie; D, Luder; Doshi, Anisha

doi:10.1136/bcr.03.2012.6134

Cited by 4 publications

(5 citation statements)

References 6 publications

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“…Owing to the similar results from immunohistochemical staining of type II and III meningiomas, imaging involving a combination of x-ray and MRI or CT and MRI was performed to appropriately classify the tumors. 27,37,38,[40][41][42][43] Based on our findings, both x-rays and CTs were unable to show the presence of intracranial exchange, resulting in MRIs being the recommended imaging technique to determine whether a lesion is dural based. 37,38,41…”

Section: Discussionmentioning

confidence: 99%

Atypical Presentation of Transcranial Extension of Intracranial Meningiomas

Nahm

Gordhandas

Hinds

2021

The American Journal of Dermatopathology

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:Meningiomas are the most common primary central nervous system tumors. These tumors predominantly arise from the neural crest–derived meningothelial cells of the arachnoid dural layer. Intracranial meningiomas are stratified with the World Health Organization classification of tumors. Cutaneous meningiomas present rarely and have their own criteria classification (Lopez classification) of 3 types. The first type is congenital. The second consists of ectopic soft-tissue meningiomas. The third involves tumors that extended into the dermis or subcutis that include the neuroaxis. We present a case of a 56-year-old woman with 4 facial tumors that clinically seemed to be cutaneous cysts or lipomas. She reported a history of surgical resection of an intracranial meningioma on the left forehead scalp line 15 years ago. A recent surgical resection of a glabellar tumor revealed a glistening white mass. Pathologic examination revealed a poorly circumscribed mass in the deep dermis and subcutaneous area with sheets of epithelioid and plasmacytoid tumor cells with nuclear pleomorphism. Mitotic figures and necrosis were also evident. Immunohistochemistry revealed positivity for epithelial membrane antigen, p63, and ERG. The tissue had negative staining for p40, CK7, SOX10, CD68, SMA, desmin, and CD34. The patient's medical history was remarkable in that these tumors had only been growing for several months. Brain magnetic resonance imaging demonstrated widespread tumors in bilateral frontal lobes, skull, orbits, and sinuses. Considering the transcranial extensions and 15-year recurrence time, she was diagnosed with a recurrent atypical brain meningioma type II and cutaneous meningioma Lopez type III.

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Section: Discussionmentioning

confidence: 99%

Atypical Presentation of Transcranial Extension of Intracranial Meningiomas

Nahm

Gordhandas

Hinds

2021

The American Journal of Dermatopathology

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“…Meningiomas have been described as extending into the subcutaneous tissue due to trauma, 15 bony defects in the skull, 16 through transdiploic extension via the venous valves, or through a calvarial foramen. 2 A list of other WHO grade II or higher cutaneous meningioma with scalp involvement is illustrated in Table 2. We theorize that this patient's type III lesion was directly influenced by the stage and osteolytic nature of the primary tumor.…”

Section: Case Studymentioning

confidence: 99%

“…Extracranial manifestations of meningiomas are rare. Patients may lack clinical findings such as headache or focal neurologic findings, but pathologic examination usually plays a major role in making this unusual diagnosis, which can be further supported by imaging 2 . Three distinct clinicopathological groups have been recognized for cutaneous meningiomas: congenital (type I), ectopic from the arachnoid tissue in the skin (type II), or from a direct extension from an intracranial meningioma (type III).…”

Section: Introductionmentioning

confidence: 99%

Type III cutaneous atypical meningioma of the scalp

Anderson

Alhatem

et al. 2022

J Cutan Pathol

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Meningiomas occur rarely in extracranial sites, including the skin, where they may pose a diagnostic challenge because of their histopathologic overlap with several other spindle-cell tumors. Cutaneous meningiomas are divided into type I (congenital), type II (ectopic), and type III (via direct extension) lesions. We present a rare case of atypical meningioma of the skin in a 71-year-old woman who presented with a painful and enlarging lesion on the left central frontal scalp. Biopsy showed bone and soft tissue with involvement of a spindle cell neoplasm, consisting of whorled nests with atypical features, including variably increased mitotic index, areas of hypercellularity, and sheeted architecture. The overall findings were consistent with an atypical meningioma (World Health Organization grade 2). Atypical meningiomas constitute only 5% to 15% of all meningiomas. Magnetic resonance imaging of the skull later demonstrated a left frontal tumor consistent with an atypical meningioma that had eroded through the skull. Dermatopathologists should consider cutaneous meningioma as a differential diagnosis of spindle-cell neoplasms of the skin and subcutaneous tissue in head and neck.

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“…CT was suggestive of an exostosis and an enostosis associated with frontal skull thickening. The mass was excised, and its histological features were consistent with intraosseous meningioma [ 4 ]. Nadarajan et al [ 4 ] reported a similar case of unusual meningioma.…”

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confidence: 99%

“…The mass was excised, and its histological features were consistent with intraosseous meningioma [ 4 ]. Nadarajan et al [ 4 ] reported a similar case of unusual meningioma. An 82-year-old man was had a large deformity over the frontal area of his scalp.…”

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confidence: 99%