Large Intra-Osseous Cystic Meningioma in a Child: A Rare Entity

Abstract

Introduction. Meningiomas are rare tumors in children, in whom the intracranial pathology is dominated by craniopharyngiomas and medulloblastomas. Cystic meningiomas are also rare, as is their intraosseous location. Intraosseous meningiomas are ectopic meningiomas. Their diagnosis is rarely done preoperatively. We report a case of cystic intraosseous meningioma managed in our department. Observation. Mr. ON, 16 years old, presented progressively a right temporal tumefaction causing an aesthetic prejudice. This tumefaction raised the flag of the right ear. It was covered by normal skin and there was moderate right hypo acoustics. CT scan showed a right sphenotemporal lesion with hyperdense contours and hypodense contents. It repressed the brain without invading it but affected the anatomic structures of the ear. Surgical procedure allowed for almost complete excision of the lesion. Histology of the operative specimen concluded to an intraosseous meningothelial meningioma. After a 4-year follow-up, the tumor residue remained stable. Conclusion. In addition to the diagnostic difficulty, we faced two other therapeutic difficulties. The first is that complete excision was not possible to avoid compromising a hearing always good. The second difficulty was related to the age of the patient who did not allow us to consider the cranial plasty before the end of the growth.