En Plaque Meningiomas: A Narrative Review

Abstract

Background En plaque meningiomas are a rare subtype of meningiomas that are frequently encountered in the spheno-orbital region. Characterized by a hyperostotic and dural invasive architecture, these tumors present unique diagnostic and treatment considerations. Objectives The authors conduct a narrative literature review of clinical reports of en plaque meningiomas to summarize the epidemiology, clinical presentation, diagnostic criteria, and treatment considerations in treating en plaque meningiomas. Additionally, the authors present a case from their own experience to illustrate its complexity and unique features. Methods A literature search was conducted using the MEDLINE database using the following terminology in various combinations: meningioma, meningeal neoplasms, en plaque, skull base, spheno-orbital, and sphenoid wing. Only literature published in English between 1938 and 2018 was reviewed. All case series were specifically reviewed for sufficient data on treatment outcomes, and all literature was analyzed for reports of misdiagnosed cases. Conclusion En plaque meningiomas may present with a variety of symptoms according to their location and degree of bone invasion, requiring a careful diagnostic and treatment approach. While early and aggressive surgical resection is generally accepted as the optimal goal of treatment, these lesions require an individualized approach, with further investigation needed regarding the role of new therapies.

En-plaque sphenoid wing grade II meningioma: Case report and review of literature

“…EPM may also be associated with hyperostosis. These features differentiate it from the more common Meningioma En-masse [ 10 , 18 ]. EPM is three to six times more common in females than in males.…”

“…The mean age of presentation of EPM is in the fifth decade. EPM more commonly arises in the sphenoidal wing and orbital regions and less frequently along the cerebral convexity, temporal bone, and foramen magnum [ 5 , 10 , 19 , 20 ].…”

“…Hyperostosis of the orbital bones can result in proptosis. Some patients also complain of retrobulbar pressure, orbital pain, and headache [ 5 , 6 , 10 , 20 ].…”

“…EPM arises much more commonly in females than males [ 8 , 9 ]. Most of the reported cases of EPM are WHO grade I, with very few cases being grade II or III [ 5 , 10 ].…”

“…Surgical resection of sphenoid wing EPM is especially challenging as the tumour tends to invade the cavernous sinus and/or the orbit and their neurovascular structures. Consequently, tumours in such locations have a higher rate of recurrence [ 10 ].…”