Intracranial/Extracranial Meningioma Arising in the Hypoglossal Canal: Case Report

Abstract

A case of a patient with a posterior fossa meningioma extending through the hypoglossal canal to the cervical region as described in this article has not been previously described in the literature. Investigations and surgical management are outlined and pathological classifications are discussed. A literature review including recent reports of extracranial meningiomas is presented. Extracranial meningiomas are exceedingly rare and a high index of suspicion is necessary to make the diagnosis.KEYWORDS: Extracranial meningioma, posterior fossa meningioma, carotid artery occlusion, thyroplasty, meningioma classification Meningiomas are common tumors of the nervous system, representing 18% of primary intracranial tumors and 25% of primary intraspinal tumors. 1 Meningiomas appear to be more common in Africans and represent almost 30% of primary intracranial tumors. 2 Extracranial and extraspinal meningiomas are rare with an incidence of 1 to 2%. 3 Extension of intracranial meningiomas to the parapharyngeal and cervical regions is exceedingly rare. 4 The clinical diagnosis of cervical meningiomas can be difficult as more common cervical tumors such as metastatic epithelial tumors, schwannomas, or paragangliomas are likely to be suspected first. 5 We report on a meningioma with intracranial and extracranial components that presents with a cervical mass. CASE REPORTA 28-year-old African man presented with a 7-year history of a slowly enlarging right cervical mass and

Rare Case of Intracranial - Extracranial Meningioma Presenting as Cervical Mass in Young Patient

“…7 Many theories have been postulated to explain the extracranial spread of tumor. 8,9 This may occur by direct extension of meningioma through a natural, traumatic or iatrogenic skull defect. Extension can be through the foramina, suture lines or there can be transdiploic extension.…”

An unusual bump on the head. Intraextracranial meningioma presenting incidentally

“…Meningiomas are common intracranial neoplasms, accounting for 18% of all primary brain tumours 1. Extracranial manifestations however, are exceedingly rare with an incidence of 1% to 2% 2.…”

“…A search of the literature reveals descriptions of primary intracranial meningiomas with extra cranial extension through a natural, traumatic or iatrogenic defect within the skull 1. Metastatic presentations are among the most rare with Teague et al reporting a metastatic meningioma within the lungs 5.…”

Imaging Features of Extra Cranial Parapharyngeal Space Meningioma: Case Report

“…Significant post-operative morbidity and recurrence has been noted in few surgically treated extracranial meningiomas. However, surgical removal of parapharyngeal space meningioma is possible after occlusion of the ipsilateral internal carotid artery if the patient has good circulation from the contralateral carotid artery [14]. External beam radiation therapy may serve as palliative modality in inoperable or elderly patients or as an adjunct for control of residual disease after definitive surgery [15][16].…”