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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
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.
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.

