Primary extracranial meningioma of the sinonasal tract

Petrulionis, Mindaugas; Valevičienė, Nomeda; Paulauskienė, Iveta; Bruzaite, J.

doi:10.1080/02841850510021210

Cited by 29 publications

(20 citation statements)

References 6 publications

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“…While surgery is the treatment of choice, there are a number of challenges due to the invasiveness of the tumors and the complexity of the anatomy within the sinonasal tract and ear and temporal bone, although scalp and soft tissues lesions are no less difficult to remove if they are adjacent to vital structures. It may be necessary to utilize a multidisciplinary approach with a combination of intracranial, temporal bone, maxillofacial, and skull base techniques to achieve total resection, possibly including widely exenterative procedures to achieve this end [10, 16, 29, 31, 37, 54–61]. …”

Section: Discussionmentioning

confidence: 99%

“…The histopathologic diagnosis is usually straightforward; however, the diagnosis may pose challenges in these unexpected locations where the differential diagnosis includes paraganglioma, carcinoma, melanoma, schwannoma, and olfactory neuroblastoma, among others. Previous reports on meningioma in uncommon locations are largely limited to individual cases or small series [2, 4–10, 12–16]. The objective of this retrospective study is to present our experience, the largest series to date, with extracranial meningiomas, highlighting clinicopathologic features and outcome associated with the surgical treatment of these tumors.…”

Section: Introductionmentioning

confidence: 99%

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Primary Extracranial Meningiomas: An Analysis of 146 Cases

Rushing

Bouffard

McCall

et al. 2009

Head and Neck Pathol

148

193

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Primary extracranial meningiomas are rare neoplasms, frequently misdiagnosed, resulting in inappropriate clinical management. To date, a large clinicopathologic study has not been reported. One hundred and forty-six cases diagnosed between 1970 and 1999 were retrieved from the files of the Armed Forces Institute of Pathology. Histologic features were reviewed, immunohistochemistry analysis was performed (n = 85), and patient follow-up was obtained (n = 110). The patients included 74 (50.7%) females and 72 (49.3%) males. Tumors of the skin were much more common in males than females (1.7:1). There was an overall mean age at presentation of 42.4 years, with a range of 0.3–88 years. The overall mean age at presentation was significantly younger for skin primaries (36.2 years) than for ear (50.1 years) and nasal cavity (47.1 years) primaries. Symptoms were in general non-specific and reflected the anatomic site of involvement, affecting the following areas in order of frequency: scalp skin (40.4%), ear and temporal bone (26%), and sinonasal tract (24%). The tumors ranged in size from 0.5 up to 8 cm, with a mean size of 2.3 cm. Histologically, the majority of tumors were meningothelial (77.4%), followed by atypical (7.5%), psammomatous (4.1%) and anaplastic (2.7%). Psammoma bodies were present in 45 tumors (30.8%), and bone invasion in 31 (21.2%) of tumors. The vast majority were WHO Grade I tumors (87.7%), followed by Grade II (9.6%) and Grade III (2.7%) tumors. Immunohistochemically, the tumor cells labeled for EMA (76%; 61/80), S-100 protein (19%; 15/78), CK 7 (22%; 12/55), and while there was ki-67 labeling in 27% (21/78), <3% of cells were positive. The differential diagnosis included a number of mesenchymal and epithelial tumors (paraganglioma, schwannoma, carcinoma, melanoma, neuroendocrine adenoma of the middle ear), depending on the anatomic site of involvement. Treatment and follow-up was available in 110 patients: Biopsy, local excision, or wide excision was employed. Follow-up time ranged from 1 month to 32 years, with an average of 14.5 years. Recurrences were noted in 26 (23.6%) patients, who were further managed by additional surgery. At last follow-up, recurrent disease was persistent in 15 patients (mean, 7.7 years): 13 patients were dead (died with disease) and two were alive; the remaining patients were disease free (alive 60, mean 19.0 years, dead 35, mean 9.6 years). There is no statistically significant difference in 5-year survival rates by site: ear and temporal bone: 83.3%; nasal cavity: 81.8%; scalp skin: 78.5%; other sites: 65.5% (P = 0.155). Meningiomas can present in a wide variety of sites, especially within the head and neck region. They behave as slow-growing neoplasms with a good prognosis, with longest survival associated with younger age, and complete resection. Awareness of this diagnosis in an unexpected location will help to avoid potential difficulties associated with the diagnosis and management of these tumors.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Primary Extracranial Meningiomas: An Analysis of 146 Cases

Rushing

Bouffard

McCall

et al. 2009

Head and Neck Pathol

148

193

View full text Add to dashboard Cite

show abstract

“…Metastatic presentations are among the most rare with Teague et al reporting a metastatic meningioma within the lungs 5. There are only a handful of reported primary ectopic extracranial meningiomas in the literature with such examples including primary ectopic meningioma of the nose6 and ethmoid sinus 7…”

Section: Discussionmentioning

confidence: 99%

An unusual bump on the head. Intraextracranial meningioma presenting incidentally

Nadarajan

Goddin²,

D³

et al. 2012

Case Reports

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Meningiomas are common intracranial tumours which rarely extend to extra cranial sites. Here, the authors report a rare case of an intracranial meningioma with extracranial spread into the subcutaneous tissues of the scalp, with a brief overview of the literature. An 82-year-old man presented following a fall. At the time of assessment, it was noted that he had a large deformity over the frontal area of his scalp. It was unclear as to the duration of this deformity. Following an inconclusive CT head he underwent a MRI head which revealed an intracranial mass which extended across the frontal lobes. The mass permeated through the skull and extended through to the scalp. He underwent a biopsy of the extracranial component. The histology of which suggested a benign meningioma with low mitotic activity.

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“…Among cases involving the sinonasal tract, Thompson et al described that most of the tumors were found to affect more than one sinus or a combination of nasal cavity and paranasal sinuses and the most commonly affected sinus was the frontal sinus (16). A sinonasal meningioma originating from the sphenoid sinus is relatively rare, whereas there are some isolated case reports of sinonasal meningioma mainly involving the ethmoid sinus (1,8,11,13).…”

Section: Discussionmentioning

confidence: 99%

Extracranial spheno-ethmoidal sinus meningioma: case report

Mori

Cavallo²,

Guadagno³

et al. 2014

Turkish Neurosurgery

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Extracranial meningiomas of the paranasal sinus are the rare tumors of unclear etiology. We report a case of primary extracranial meningioma arising from the roof of the sphenoid sinus.A 60-year-old female presented with 5-month history of right visual disturbance. Imaging studies showed a mass in the sphenoid sinus extending into posterior ethmoid sinus. The tumor was resected completely including the affected bone of anterior cranial base via the endonasal endoscopic approach. Pathological diagnosis was meningothelial meningioma.On the basis of imaging features and intraoperative findings, the tumor was diagnosed as primary extracranial meningioma of the sphenoethmoid sinus. Recent advancement of skull base surgery technique allows removing this rare tumor completely and safely without complications such as cerebrospinal fluid leakage. This is the first report of the management of spheno-ethmoid sinus meningioma with the skull base surgery technique. KEywoRds: Extracranial meningioma, Sphenoid sinus, Ethmoid sinus, Skull base surgery, Endoscopic surgery ÖZParanazal sinüslerin ekstrakraniyal menenjiyomları, etiyolojisi belirsiz nadir tümörlerdir. Sfenoid sinüs çatısından kaynaklanan bir primer ekstrakraniyal menenjiyom olgusunu sunuyoruz. 60 yaşındaki kadın hasta 5 aydır sağ tarafta görme rahatsızlığı ile başvurdu. Görüntüleme çalışmaları sfenoid sinüste posterior etmoid sinüse uzanan bir kitle saptadı. Tümör endonazal endoskopik yaklaşımla anterior kraniyal tabanın etkilenen kemiği dahil tamamen çıkartıldı. Patolojik tanı meningotelyal menenjiyomdu.Görüntüleme özellikleri ve ameliyat bulgularına dayanarak, tümöre sfeno-etmoid sinüs primer ekstrakraniyal menenjiyomu tanısı konuldu. Kafa tabanı cerrahisi tekniklerindeki güncel gelişmeler bu nadir tümörün beyin omurilik sıvısı kaçağı gibi komplikasyonlar olmadan, tamamen ve güvenle çıkarılmasını sağlamaktadır. Bu makale kafa tabanı cerrahisi tekniği ile sfeno-etmoid sinüs menenjiyomu tedavisinin ilk bildirimidir.

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Primary extracranial meningioma of the sinonasal tract

Cited by 29 publications

References 6 publications

Primary Extracranial Meningiomas: An Analysis of 146 Cases

Primary Extracranial Meningiomas: An Analysis of 146 Cases

An unusual bump on the head. Intraextracranial meningioma presenting incidentally

Extracranial spheno-ethmoidal sinus meningioma: case report

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