Primary Osteolytic Intraosseous Atypical Meningioma with Soft Tissue and Dural Invasion: Report of a Case and Review of Literatures

Abstract

Primary intraosseous meningioma is a rare tumor, and atypical pathologic components both osteolytic lesion and dura and soft tissue invasion is extremely rare. A 65-year-old woman presented with a 5-month history of a soft mass on the right frontal area. MR imaging revealed a 4 cm sized, multilobulated, strongly-enhancing lesion on the right frontal bone, and CT showed a destructive skull lesion. The mass was adhered tightly to the scalp and dura mater, and it extended to some part of the outer and inner dural layers without brain invasion. The extradural mass and soft tissue mass were totally removed simultaneously and we reconstructed the calvarial defect with artificial bone material. The pathological study revealed an atypical meningioma as World Health Organization grade II. Six months after the operation, brain MR imaging showed that not found recurrence in both cranial and spinal lesion. Here, we report a case of primary osteolytic intraosseous atypical meningioma with soft tissue and dural invasion.

Intraosseous Meningioma Masquerading as Fibrous Dysplasia

“…Meningiomas can also display mixed osteoblastic and osteoclastic activity, or more rarely an osteolytic response [3]. Although sphenoid involvement might be secondary to an extension of a dural meningioma, in our case, the clinical history and tumor configuration on MRI favor a primary intraosseous meningioma with dural extension [4,5].…”

Frontal intradiploic meningioma with progressive intracranial invasion

“…Others thought that proliferation of undifferentiated pluripotent embryonal precursor cells in the bone might be another origin. [ 11 ] Lang et al [ 5 ] classified primary extradural meningiomas according to anatomic location of tumors. They divided the tumors into 3 types: type I, a purely extracalvarial tumor; type 2, a purely calvarial tumor; type 3, a calvarial tumor with extracranial extension, and this classification method has been used so far.…”

Primary Intraosseous Osteolytic Meningioma of the Skull Mimicking Scalp Mass: A Case Report and Review of Literature

“…Therefore, the pathogenesis of the so-called primary "intraosseous" meningiomas remains obscure. JH Yun and SK Lee suggest that primary intraosseous meningioma generally has more tendency to form a broader base in the calvarium than that in the dura, while tumors of meningeal origin including meningioma have broader base in the dura than in the calvarium [ 9 ]. Similarly we had experience of an atypical meningioma that arises from meninges.…”