Nonmeningothelial Dural-Based Lesions: A Histopathological Analysis
Pooja K Gajaria1, Asha S Shenoy1, Naina A Goel1
1Department of Pathology, Seth G. S. Medical College and K. E. M. Hospital, Mumbai, Maharashtra, India.
Abstract:
Introduction We report 30 cases of nonmeningothelial dural-based lesions encountered during a 3-year study period. Materials and Methods We retrospectively reviewed pathology records of patients operated for extra-axial, dural-based lesions during the years 2016 to 2018 and included nonmeningothelial lesions as a part of this study. Results Among the 3,243 neurosurgical specimens for histopathologic examination, only 30 (0.93%) were "nonmeningothelial dural-based lesions." Six (20%) patients were in the pediatric age group. Pathologic assessment identified 13 cases of solitary fibrous tumor/hemangiopericytoma (43.3%) and 7 cases of Ewing's sarcoma/primitive neuroectodermal tumor (23.3%). Two cases (6.7%) were of metastasis. Other lesions included a single case each of non-Hodgkin's lymphoma, undifferentiated sarcoma, solitary plasmacytoma, and granulocytic sarcoma. Nonneoplastic lesions included two cases each of Rosai-Dorfman disease and nonspecific inflammatory lesions. Conclusion Nonmeningothelial dural-based lesions being rare, thorough examination of morphological features is a must by the pathologist, to arrive at the accurate diagnosis. Ancillary tests, if required, should be employed in the context of the morphologic picture.
Insights
Nonmeningothelial dural-based lesions are rare, accounting for only 0.93% of cases. Solitary fibrous tumors and Ewing
Area of Science:
- Neurosurgery
- Neuropathology
- Oncology
Background:
- Dural-based lesions are typically meningiomas.
- Nonmeningothelial dural lesions are infrequent and diverse.
- Accurate diagnosis is crucial for patient management.
Purpose of the Study:
- To characterize the spectrum of nonmeningothelial dural-based lesions.
- To determine the incidence of these rare tumors.
- To identify common types and diagnostic challenges.
Main Methods:
- Retrospective review of pathology records from 2016-2018.
- Inclusion of extra-axial, dural-based lesions excluding meningiomas.
- Histopathologic examination of 3,243 neurosurgical specimens.
Main Results:
- 30 (0.93%) nonmeningothelial dural lesions identified.
- Pediatric cases represented 20% of the cohort.
- Common diagnoses included solitary fibrous tumor/hemangiopericytoma (43.3%) and Ewing's sarcoma/PNET (23.3%).
- Other neoplastic and non-neoplastic entities were also observed.
Conclusions:
- Nonmeningothelial dural lesions are rare but diagnostically important.
- Thorough morphologic examination by pathologists is essential.
- Ancillary tests should be used judiciously based on morphology.
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