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Primary Benign Intraosseous Meningioma on (18)F-FDG PET/CT Mimicking Malignancy
Ho Seong Kim1, Seok Hwi Kim2, Hyung Jin Kim3
1Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu Seoul, 135-710 Republic of Korea.
Abstract:
We present a case of primary benign intraosseous meningioma in the sphenoid bone mimicking malignancy. A 44-year-old female patient who had a protruding right eye and headache came to our hospital. MRI showed a large, destructive, heterogeneously well-enhancing soft tissue mass in the right sphenoid bone suggesting malignancy. (18)F-FDG PET/CT showed a hypermetabolic mass in the same site with an SUVmax of 9.1 The pathological diagnosis by surgery revealed that this tumor was a WHO grade I transitional meningioma. This case suggests that primary benign intraosseous meningioma may show high (18)F-FDG uptake mimicking a malignancy.
Insights
Primary benign intraosseous meningioma can mimic cancer. This sphenoid bone tumor showed high (18)F-FDG uptake on PET/CT, a common sign of malignancy, but was confirmed as benign.
Area of Science:
- Neuro-oncology
- Radiology
- Pathology
Background:
- Intraosseous meningiomas are rare primary bone tumors.
- Meningiomas typically occur in the skull or spine, not within bone.
- Distinguishing benign from malignant bone lesions can be challenging.
Purpose of the Study:
- To report a rare case of primary benign intraosseous meningioma.
- To highlight its potential to mimic malignancy on imaging.
- To discuss the role of (18)F-FDG PET/CT in evaluating such lesions.
Main Methods:
- Case presentation of a 44-year-old female with proptosis and headache.
- Magnetic Resonance Imaging (MRI) to characterize the sphenoid bone mass.
- (18)F-FDG Positron Emission Tomography/Computed Tomography ((18)F-FDG PET/CT) for metabolic assessment.
- Surgical resection and histopathological examination.
Main Results:
- MRI revealed a destructive, enhancing soft tissue mass in the sphenoid bone, suspicious for malignancy.
- (18)F-FDG PET/CT demonstrated a hypermetabolic mass with an SUVmax of 9.1, indicating high metabolic activity.
- Pathology confirmed a WHO grade I transitional meningioma, a benign tumor.
Conclusions:
- Primary benign intraosseous meningioma can present with imaging features suggestive of malignancy.
- High (18)F-FDG uptake in intraosseous meningioma may mimic malignant tumors.
- Histopathological diagnosis remains crucial for definitive characterization.
