Multicystic oligodendroglioma with calvarial destruction

Abstract

Context:Calvarial erosion is known to occur with some superficially located tumors. Very few case reports of calvarial erosion associated with oligodendroglioma are reported in the literature, but calvarial destruction with oligodendroglioma is very rare.Aim:To report an unusual case of multicystic frontoparietal oligodendroglioma with destruction of the calvaria and scalp involvement in the absence of prior surgery or radiation.Materials and Methods:A 30-year-old male presented with the history of left focal seizure with secondary generalization for last three to four years along with left sided weakness for the past one month. There was history of slowly progressive decreased vision in both eyes leading to complete blindness in both eyes for the past one month. On neurological examination, patient had left hemiparesis of grade-2/5 with perception of light absent in both eyes. Fundus examination revealed bilateral optic atrophy. Magnetic resonance imaging (MRI) of the brain showed a large supratentorial heterogenous multicystic ring enhancing mass lesion involving right frontal lobe, right frontotemporal opercular region, and posteriorly abutting the central sulcus and anteriorly destroying the calvaria. Patient underwent right frontoparietal craniotomy and near total excision of tumor. Histopathological examination revealed oligodendroglioma WHO grade-2. Patient received postoperative chemoradiotherapy.Results:At nine month follow-up patient neurological status was same and his seizure was controlled on single AED. There was no recurrence of seizure at nine month of follow-up.Conclusions:Calvarial destruction in association with extra and intra axial neoplasm should include oligodendroglioma especially in patients with long history of symptoms, although calvarial destruction is very rare. However, the final diagnosis is established by means of histopathological examination.

Atypical meningeal hemangiopericytoma presenting with punched-out calvarial erosion

“…Bone erosion by HPCs are documented to be 44%-59%, while hyperostosis or intratumoral calcification are commonly not present [3 , 4] . Primary calvarial erosion is an infrequent manifestation in association with brain tumor, and if present, can be caused by oligodendroglioma [5] , [6] , [7] , astrocytoma [8] , [9] , [10] , astroblastoma [11 , 12] , xanthoastrocytoma [13] , and glioblastoma [14] . However, to our knowledge, no study has documented brain HPC-associated calvarial erosions in detail.…”

Magnetic resonance imaging and computed tomographic characteristics of a glioma causing calvarial erosion in a dog

“…On the other hand, osteolytic skull changes associated with meningiomas are uncommon and have only been reported in two dogs and rarely in cats . In human medicine, reactive osteolytic bone changes are more commonly described associated with meningiomas, sarcomas, and metastases, but there are a few reports of calvarial erosion associated with gliomas …”

“…[3][4][5][6] In human medicine, reactive osteolytic bone changes are more commonly described associated with meningiomas, sarcomas, and metastases, but there are a few reports of calvarial erosion associated with gliomas. [7][8][9][10][11] The pathophysiology of glioma-associated skull osteolysis is unknown. In humans, the main proposed mechanisms that could lead to skull osteolysis include: (1) direct invasion of tumor cells into the skull bone; (2) tumor's pressure to the inner table of the skull; and The external surface appears to be irregular and contains high number of osteoblasts (arrows) delimitating the external surface in contact with hypereosinophilic striated muscle fibers (arrowheads).…”