Intraosseous Lipomatous Meningioma

Abstract

A 49-year-old man with intermittent headaches and right sided parietal lump was found to have an intraosseous right parietal lesion on computed tomography (CT) and magnetic resonance imaging (MRI). A stereotactic craniectomy and excision of the lesion were performed with histopathology confirming features consistent with primary lipomatous meningioma with intraosseous extension. Lipomatous meningiomas are very uncommon subtype of meningiomas, with ongoing discussions as to their true pathogenesis. To our knowledge this case represents the first reported case of a lipomatous meningioma with predominant intraosseous extension.

Lipomatous meningioma: A rare subtype of benign metaplastic meningiomas

“…This is a consequent of mesenchymal and neuroectodermal differentiation of pluripotent arachnoid cap cells. [89]…”

Lipomatous meningioma: Case report and review of the literature

“…[11] Seizures are the most common manifestation for frontal and frontotemporal tumors, while headaches are more common for parietal tumors. [12, 13] Our patient had a history of migraine headaches, which may have been the result of her slowly growing lipomatous meningioma. Another rare finding is that lipomatous meningiomas can sometimes manifest as behavioral disturbance in patients.…”

Calvarial ectopic meningothelial meningioma

“…Consequently, any lesions occurring outside the central nervous system are very rare [7] . Ectopic intraosseous meningiomas can also be described as intradiploic or calvarial [8] and may appear as osteoblastic [5,9] , osteolytic lesions [4,10–14] or mixed lesions [8] on plain X-rays and computed tomography scans. The present case was a rare intradiploic meningioma.…”

“…Involvement of other ectopic sites such as the paranasal sinuses and orbit usually manifests as pain and proptosis [16] , whereas pain and a palpable mass are common when the tumor affects more distant sites. Histologic examination usually presents meningothelial meningiomas, but the microcystic [8] or lipomatous [14] variations are also reported. Immunohistochemical staining is usually positive for progesterone receptor, epithelial membrane antigen as in our described case, and S100 [8,14] .…”

“…Histologic examination usually presents meningothelial meningiomas, but the microcystic [8] or lipomatous [14] variations are also reported. Immunohistochemical staining is usually positive for progesterone receptor, epithelial membrane antigen as in our described case, and S100 [8,14] .…”