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Primary meningeal osteosarcoma of the brain during childhood. Case report
Adnan Dagcinar1, Fatih Bayrakli, Ozlem Yapicier
1Department of Neurosurgery, Marmara University School of Medicine, Istanbul, Turkey.
Insights
Primary meningeal osteosarcomas are rare pediatric tumors. Aggressive treatment including surgery, chemotherapy, and radiotherapy is crucial due to rapid progression.
Area of Science:
- Neuro-oncology
- Pediatric Oncology
- Surgical Pathology
Background:
- Primary meningeal osteosarcomas are exceedingly rare, with limited pediatric cases reported.
- Accurate diagnosis can be challenging due to their rarity and potential mimicry of other dural-based tumors.
Observation:
- A case study of an 8-year-old boy presenting with seizures due to a meningeal osteosarcoma in the sylvian fissure.
- Initial differential diagnoses included meningioma and glioma, highlighting diagnostic challenges.
Findings:
- The pediatric meningeal osteosarcoma exhibited rapid progression and recurrence post-surgical resection.
- Histopathological evaluation is essential for definitive diagnosis of this rare entity.
Implications:
- Emphasizes the need for high clinical suspicion and prompt histopathological confirmation for meningeal osteosarcomas.
- Highlights the necessity of aggressive multimodal treatment (surgery, chemotherapy, radiotherapy) for optimal outcomes in pediatric cases.
Abstract:
Primary meningeal osteosarcomas are rare tumors, with only 19 reported cases in the literature; only 4 of these, including the present case, are in pediatric patients. In this report, the authors present the case of an 8-year-old boy with a history of generalized tonic-clonic seizures who was found to harbor a meningeal osteosarcoma within the sylvian fissure. Initial working diagnoses included meningioma and glioma. After tumor enlargement and progressive symptoms, the patient underwent a large frontotemporal craniotomy and complete resection of the lesion, which recurred 6 and 12 months after the initial surgery and was surgically treated after each recurrence. The rarity of primary meningeal osteosarcomas can make their diagnosis difficult, and histopathological evaluation is mandatory for diagnosis. Because of their fast progression, they must be treated aggressively by means of surgery, chemotherapy, and radiotherapy.
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