Intraosseous meningioma, a rare presentation of a common brain tumor: illustrative case
Sherif Elwatidy1, Abdulaziz Alanazi2, Rahaf F Alanazi3
11Division of Neurosurgery, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Background:
The subset of extradural meningiomas arising from bone is called primary intraosseous meningioma. The present article outlines the clinical presentation, investigation, surgical management, and clinical outcomes of a challenging case of intraosseous meningioma.
Observations:
A 27-year-old male presented with new-onset seizure of 3 years' duration and growing painless hard swelling involving the left frontoparietal bone, the medial aspect of the left orbit, the nasal bone, and the temporal bone. Brain computed tomography showed a diffuse intradiploic space osseous lesion with a ground-glass appearance. The patient underwent bifrontal craniotomy and tumor excision. The histopathological sections showed the presence of classic whorls of meningothelial cells around reactive bony tissue suggestive of intraosseous meningioma. Postoperatively, the patient was neurologically intact, and he was discharged in a stable condition. The outcome of this case was satisfactory.
Lessons:
The treatment of primary intraosseous meningioma is wide surgical excision together with the involved dura and any intradural tumor. The location of the tumor determines the approach and the amount of resection, keeping in mind preservation of function. The use of adjuvant therapy is reserved for cases of tumor recurrence or an atypical type.
Insights
Primary intraosseous meningioma, a rare bone-originating tumor, requires wide surgical excision. This case highlights successful surgical management and satisfactory outcomes for this challenging condition.
Area of Science:
- Neurosurgery
- Oncology
- Pathology
Background:
- Primary intraosseous meningioma is a rare extradural meningioma originating from bone.
- This article details the presentation, investigation, surgical management, and outcomes of a challenging intraosseous meningioma case.
Purpose of the Study:
- To outline the clinical presentation, investigation, surgical management, and clinical outcomes of a challenging case of primary intraosseous meningioma.
Main Methods:
- A 27-year-old male with a 3-year history of seizures and a palpable cranial swelling underwent bifrontal craniotomy and tumor excision.
- Histopathological examination revealed classic whorls of meningothelial cells around reactive bony tissue, confirming intraosseous meningioma.
Main Results:
- The patient presented with seizures and a cranial swelling involving multiple bones.
- Postoperative recovery was uneventful, with the patient remaining neurologically intact.
- The outcome of the surgical management was satisfactory.
Conclusions:
- Wide surgical excision, including involved dura and any intradural extension, is the standard treatment for primary intraosseous meningioma.
- Surgical approach and extent of resection are dictated by tumor location and the need for functional preservation.
- Adjuvant therapy is reserved for recurrent or atypical meningioma cases.
