Intradiploic Orbital Roof Meningioma with Pneumosinus Dilatans in a Child: A Case Report and Review of the Literature

Abstract

Intradiploic meningioma of the orbital roof is a type of intraosseous meningioma. It is very rare in children, and only 7 cases have been reported in the pediatric age group. We report a case of a 14-year-old female who presented with progressive exophthalmos, diplopia and pain involving the right eye. Computed tomography (CT) scan and magnetic resonance imaging (MRI) revealed an intradiploic orbital roof tumor with diploe expansion and pneumosinus dilatans. The tumor was completely removed surgically. The histopathological diagnosis was transitional meningioma. The clinical and radiological findings of intadiploic meningioma are discussed with a review of the relevant literature.

Comprehensive analysis of Iranian reports of pediatric central nervous system tumors

“…The study objectives were categorized as clinical (n = 18 articles, 173 patients), epidemiologic (n = 9 articles [5, 8, 12–13, 16, 26, 28, 33–34], 1,881 patients), pathologic (n = 4 articles [11, 14, 15, 18], 1,160 patients), genetic (n = 2 articles [7, 30], 75 patients), surgical (n = 1 article [21], 172 patients), or radiologic (n = 1 article [29], 23 patients). Study designs were primarily single case reports (n = 16 articles [2–4, 9, 16–17, 19–22, 24, 29, 31–32, 36–37], 19 patients) and cross-sectional studies (n = 15 articles [7–8, 10–14, 15, 18, 25–26, 28, 30, 33–34], 3,271 patients).…”

Orbital roof intradiploic meningioma in a 16-year-old girl

“…They can originate from subcutaneous tissue of skin, paranasal sinus, orbit, neck, salivary gland, calvaria and along per neural sheath of cranial nerves. [ 1 2 7 ] Winkler in 1904 first described a meningioma originating from extradural location. [ 8 ] Extradural meningioma arising in the skull is usually referred as intraosseous, calvarial or intradiploic.…”

“…Radiographically, X-ray can delineate location and its chronic pressure effect on surrounding bone. [ 2 3 5 6 7 8 10 11 ] It shows generally osteoplastic or hyperostosis reaction in the form of granular or speckled calcification which involves roof or wall of the orbit. Radiologically intradiploic meningiomas are typically either osteoplastic or osteolytic, however, mixed versions also have been reported although the majority are osteoblastic, extremely rarely are osteolytic or very extremely have a mixed pattern.…”

“…[ 1 ] It is postulated to arise from arachnoid cell rests captured at inappropriate sites during embryonic development or implantation of these cells by some mechanical insult like trauma or dural tear. [ 2 ] Their origin can also be attributed to cellular dedifferentiation within the diploic space or cranial nerve sheath cells during their course through dipoles. These arise in paranasal sinuses, neck, and orbit and very rarely in diploe of cranial bones.…”

“…Pediatric orbital roof intradiploic meningioma is reported in the isolated case reports. [ 2 3 4 5 6 ] These tumors are observed mostly within the first two decades of life and histologically are usually of psammomatous variety. Here the authors present a case of a 16-year-old female who had progressive proptosis with intact vision and was managed successfully surgically.…”