Meningiomas invading the temporal bone with extension to the neck

Area of Science:

• Neurosurgery
• Oncology
• Pathology

Background:

• Meningiomas are the second most common primary intracranial neoplasms, accounting for 13-18% of all such tumors.
• They originate from dural fibroblasts and arachnoid cells, typically found along venous sinuses and cranial nerve foramina.

Observation:

• 20% of intracranial meningiomas develop extracranial extensions, most frequently to the orbit, calvaria, nasal sinuses, and parapharyngeal space.
• Meningiomas involving the temporal bone show increased extracranial extension (43%), often via the jugular and lacerate foramina into the parapharyngeal space.

Findings:

• Parapharyngeal meningiomas can represent primary intracranial tumors with extracranial extension, jugular foramen neoplasms, cranial nerve-associated tumors, or metastases.
• Neck-extending meningiomas exhibit unique characteristics including extracranial expansion, higher recurrence rates, multicentric growth, and association with central neurofibromatosis.

Implications:

• Understanding the pathways and origins of extracranial meningiomas is crucial for accurate diagnosis and treatment planning.
• The association with neurofibromatosis highlights the importance of considering systemic conditions in meningioma presentation.