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Intraosseous meningioma mimicking osteosarcoma.

Ruben Delgado1, Hisham F Bahmad1, Vinay Bhatia2

  • 1Mount Sinai Medical Center, The Arkadi M. Rywlin M.D. Department of Pathology and Laboratory Medicine, Miami Beach, FL, USA.

Autopsy & Case Reports
|November 22, 2021
PubMed
Summary

Primary intraosseous meningiomas (PIM) are rare. This case highlights the importance of histopathology for diagnosing calvarial masses, even those mimicking aggressive tumors like osteosarcoma.

Keywords:
Case ReportsMeningiomaOsteosarcomaSkull

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Area of Science:

  • Neuro-oncology
  • Skeletal oncology
  • Neurosurgery

Background:

  • Predominantly intraosseous meningiomas (PIM) are rare, with debated origins, including ectopic arachnoid cell entrapment.
  • Surgical resection is the primary treatment for these lesions.

Observation:

  • A 65-year-old man presented with a 13-year history of a slowly enlarging parieto-occipital mass after head trauma.
  • Symptoms included headaches and blurry vision, with imaging revealing a large calvarial lesion with aggressive features.
  • Pre-operative diagnosis favored osteosarcoma.

Findings:

  • Histopathological examination confirmed a predominantly intraosseous calvarial meningioma, WHO grade I.
  • The lesion measured 14 cm, showing extensive periosteal reaction and intracranial extension.

Implications:

  • This case underscores the critical role of histopathology in diagnosing calvarial masses.
  • It emphasizes considering PIM or intraosseous meningiomas in the differential diagnosis, even with imaging suggestive of aggressive neoplasms.