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Intracranial osteolytic malignant meningiomas appearing as extracranial soft-tissue masses
1Department of Neurosurgery, University of Texas, M. D. Anderson Cancer Center, Houston.
Abstract:
Malignancy is rare in intracranial meningiomas. Although the topic is widely discussed, there is little agreement in the literature as to the histological and radiological features that warrant the diagnosis of malignant meningioma. Three patients are described who had soft-tissue masses and underlying osteolytic lesions on computed tomography. All three patients also had a large intracranial component that proved to be a malignant meningioma. Rarely do meningiomas have all three of these features. We propose that a meningioma causing osteolysis and soft-tissue extension should be considered malignant until proven otherwise.
Insights
Malignant intracranial meningiomas are rare. The presence of soft-tissue masses and osteolytic lesions on CT scans suggests malignancy, even with a large intracranial component.
Area of Science:
- Neurology
- Oncology
- Radiology
Background:
- Intracranial meningiomas are tumors arising from the meninges.
- Malignant transformation of meningiomas is uncommon.
- Diagnostic criteria for malignant meningioma remain debated in the literature.
Observation:
- Computed tomography (CT) revealed soft-tissue masses and osteolytic lesions in three patients.
- All three patients presented with a significant intracranial tumor component.
- The combination of these three features (intracranial tumor, soft-tissue mass, osteolysis) is rare in meningiomas.
Findings:
- The intracranial tumors in these three patients were histologically confirmed as malignant meningiomas.
- The co-occurrence of osteolytic lesions and soft-tissue extension alongside an intracranial meningioma is a significant indicator.
Implications:
- The study proposes that meningiomas exhibiting osteolysis and soft-tissue extension should be presumed malignant.
- This finding aids in the early diagnosis and management of rare aggressive meningiomas.
- Radiological features on CT can be crucial in suspecting malignancy in meningioma cases.