Large solitary lytic skull vault lesions in adults: radiological review with pathological correlation

Kee, Tze Phei; Liauw, Lishya; Selvarajan, Sathiyamoorthy; Lee, Hwei Yee; Tan, Grace Siew Lim; Yu, Wai‐Yung

doi:10.1016/j.clinimag.2019.10.011

Cited by 4 publications

(1 citation statement)

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“…On CT images, intraosseous meningiomas appear as osteoblastic, osteolytic, or mixed patterns [ 3 , 9 ]. Skull lesions showing osteolytic lesions, as in our case, include epidermoid tumor, multiple myeloma, Langerhans cell histiocytosis, fibrous dysplasia, giant-cell tumor, Paget’s disease, solitary fibrous tumor/hemangiopericytoma (SFT/HPC), hemangioma, osteosarcoma, and ABC [ 10 ]. In the present case, the lesion was located in the sphenoid bone and its preoperative radiologic and gross differential diagnoses included ABC, chordoma, chondrosarcoma, and vascular neoplasm [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Intraoperative frozen cytology of intraosseous cystic meningioma in the sphenoid bone

Kim

Yie

2020

J Pathol Transl Med

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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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Section: Discussionmentioning

confidence: 99%