Diagnostic and therapeutic problems in extracranial meningiomas

Whicker, James H.; Devine, Kenneth D.; MacCarty, Collin S.

doi:10.1016/s0002-9610(73)80029-7

Cited by 68 publications

(30 citation statements)

References 8 publications

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“…However, when the scalp, orbit, sinonasal tract, oral cavity, and soft tissues are excluded, the incidence decreases to Ͻ1% (9,35,36,46,51,55,(57)(58)(59). Primary ear and temporal bone meningiomas made up only 2.0% of the benign or malignant primary ear and temporal bone tumors seen in consultation at the AFIP during the period of study.…”

Section: Discussionmentioning

confidence: 99%

“…Up to 20% of intracranial meningiomas may have extraneuraxial extension (3,36,38,(45)(46)(47)55), including the skull, scalp (all cutaneous sites), orbit, upper airway involvement (nasal cavity, paranasal sinuses, nasopharynx), soft tissues, and ear and temporal bone. However, when the scalp, orbit, sinonasal tract, oral cavity, and soft tissues are excluded, the incidence decreases to Ͻ1% (9,35,36,46,51,55,(57)(58)(59).…”

Section: Discussionmentioning

confidence: 99%

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Primary Ear and Temporal Bone Meningiomas: A Clinicopathologic Study of 36 Cases with a Review of the Literature

et al. 2003

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"Primary" ear and temporal bone meningiomas are tumors that are frequently misdiagnosed and unrecognized, resulting in inappropriate clinical management. To date, a large clinicopathologic study of meningiomas in this anatomic site has not been reported. Thirty-six cases of ear and temporal bone meningiomas diagnosed between 1970 and 1996 were retrieved from our files. Histologic features were reviewed, immunohistochemical analysis was performed (n ‫؍‬ 19), and patient follow-up was obtained (n ‫؍‬ 35). The patients included 24 females and 12 males, aged 10 -80 years (mean, 49.6 years), with female patients presenting at an older age (mean, 52.0 years) than male patients (mean, 44.8 years). Patients presented clinically with hearing changes (n ‫؍‬ 20), otitis (n ‫؍‬ 7), pain (n ‫؍‬ 5), and/or dizziness/vertigo (n ‫؍‬ 3). Symptoms were present for an average of 24.6 months. The tumors affected the middle ear (n ‫؍‬ 25), external auditory canal (n ‫؍‬ 4), or a combination of temporal bone and middle ear (n ‫؍‬ 7). The tumors ranged in size from 0.5 to 4.5 cm in greatest dimension (mean, 1.2 cm). Radiographic studies demonstrated a central nervous system connection in 2 patients. Histologically, the tumors demonstrated features similar to those of intracranial meningiomas, including meningothelial (n ‫؍‬ 33), psammomatous (n ‫؍‬ 2), and atypical (n ‫؍‬ 1). An associated cholesteatoma was identified in 9 cases. Immunohistochemical studies confirmed the diagnosis of meningioma with positive reactions for epithelial membrane antigen (79%) and vimentin (100%). The differential diagnosis includes paraganglioma, schwannoma, carcinoma, melanoma, and middle ear adenoma. Surgical excision was used in all patients. Ten patients developed a recurrence from 5 months to 2 years later. Five patients died with recurrent disease (mean, 3.5 years), and the remaining 30 patients were alive (n ‫؍‬ 25, mean: 19.0 years) or had died (n ‫؍‬ 5, mean: 9.5 years) of unrelated causes without evidence of disease. We conclude that extracranial ear and temporal bone meningiomas are rare tumors histologically similar to their intracranial counterparts. They behave as slow-growing neoplasms with a good overall prognosis (raw 5-y survival, 83%). Extent of surgical excision is probably the most important factor in determining outlook because recurrences develop in 28% of cases.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Primary Ear and Temporal Bone Meningiomas: A Clinicopathologic Study of 36 Cases with a Review of the Literature

et al. 2003

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“…However, meningiomas may rarely also present as extracranial tumors. Of all meningiomas, those that are extracranial, either ectopic or metastatic tumors, have an incidence of 1-2% [3]. Primary ectopic meningiomas have been reported to occur throughout the body, with a predilection for the head and neck region [4].…”

Section: Introductionmentioning

confidence: 99%

Cytopathology of Extracranial Ectopic and Metastatic Meningiomas

et al. 2013

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Introduction: Extracranial meningiomas may infrequently be encountered as ectopic or metastatic tumors. Their rarity and unique cytomorphology often pose significant diagnostic dilemmas. The aim of this study was to report our experience with a series of ectopic and metastatic meningiomas, characterizing their cytomorphology with histological correlation. Materials and Methods: A retrospective analysis involving 13 patients with cytological preparations from extracranial meningiomas was performed. Cytology cases were correlated with available surgical resection specimens. Data regarding clinical findings, tumor information, cytomorphology, follow-up histological features and immunohistochemistry were recorded and analyzed. Results: There were 5 cases with metastases and 8 ectopic meningiomas. Metastases occurred in the scalp/skull, lung, paraspinal soft tissue and liver. Primary ectopic meningiomas were located in the paranasal sinuses and ear, orbit and neck. Cytomorphological features characteristic of meningiomas were identified in the majority of samples including tightly cohesive clusters of spindled cells, whorls, intranuclear inclusions, nuclear grooves and psammomatous calcification. Unusual cytomorphological features identified in only a few cases included epithelioid cell predominance, abundant inflammatory cells, small-cell change, papillary structures and pseudoacinar growth. Metastatic tumors exhibited more nuclear atypia and occasionally mitoses or necrosis. Meningiomas were shown to be immunoreactive for epithelial membrane antigen, pancytokeratin and vimentin. Conclusion: Although rare, extracranial meningiomas can be encountered in cytologic specimens and should be included in the differential diagnosis when characteristic morphological features of meningiomas are seen. Cytopathologists should be aware that these lesions could be mistaken for other tumors, especially when confounded by atypia and unusual cytomorphological features.

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“…Os meningiomas são tumores formados por tecido conjuntivo pleiomór-fico, derivado, provavelmente, dos meningocitos, que são células das vilosidades aracnóides 7 . A origem dos meningiomas intracranianos já está bem estabelecida.…”

Section: Comentáriosunclassified

“…Nos nossos doentes, o tumor situava-se ao nível do pterion (caso 1) ou da sutura coronaria (caso 2). Outra teoria, baseada na histología dos componentes celulares do meningioma, admite origem mesenquimal para o tumor, classificando os meningoctios como fibroblastos especializados, podendo surgir em qualquer lugar em que haja tecido mesenquimal 7 . Também é discutido o papel desempenhado pelos traumatismos na formação de meningiomas 1 .…”

Section: Comentáriosunclassified

Meningiomas intraosseos: relato de 2 casos

Almeida¹,

Azevedo²,

Filho³

et al. 1975

Arq. Neuro-Psiquiatr.

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Os meningiomas extracranianos e extraespinais primários são raros, tendo sido descritos, até 1973, cerca de 50 casos :i . Algumas das localizações mais comuns são a órbita, o nervo óptico, a pele, a cavidade nasal, o ouvido médio e o pescoço s . 5 . O meningioma intraósseo primário da calota craniana distingue-se do meningioma intraósseo secundário por não ser extensão de tumor intracraniano e pela ausência de comprometimento da dura-mater. Azar-Kia & col. Ao exame clínico, nada foi observado de anormal, além da saliência fronto-temporal de forma ovalada, com 7 cm em seu maior diâmetro, de consistência dura e indolor à palpação. Cranograma -Grande neo-formacão de natureza óssea, fazendo proeminência na região fronto-temporal direita (pterion). A neoplasia tem aspecto irregular, notando-se menor densidade na parte central. Angiografia carotíclea bilateral -Grupo silviano do lado direito deslocado para cientro, pela tumoração óssea. Não existem sinais de processo expansivo intracraniano. Alguns ramos da artéria carótida externa dirigem-se para a área de hiperostose (Fig. 1). Intervenção cirúrgica -Aparentemente foi retirado todo o tecido anormal, que era muito sangrante, apresentando em seu interior vários pequenos cistos.Não havia comprometimento da dura-mater. Exame histopatológico -Meningioma psamomatoso infiltrando tecido ósseo. Evolução -O caso evoluiu hem. Um ano após a cirurgia foi feita plástica da falha óssea com acrílico.

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Diagnostic and therapeutic problems in extracranial meningiomas

Cited by 68 publications

References 8 publications

Primary Ear and Temporal Bone Meningiomas: A Clinicopathologic Study of 36 Cases with a Review of the Literature

Primary Ear and Temporal Bone Meningiomas: A Clinicopathologic Study of 36 Cases with a Review of the Literature

Cytopathology of Extracranial Ectopic and Metastatic Meningiomas

Meningiomas intraosseos: relato de 2 casos

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