Akutsu Hiroyoshi, Sugita Kyoichi, Sonobe Makoto, Matsumura Akira
Department of Neurosurgery, Mito National Hospital, Ibaraki, Japan.
Surg Neurol. 2004 Feb;61(2):165-9; discussion 169. doi: 10.1016/s0090-3019(03)00521-4.
We describe a case of convexity meningioma en plaque (MEP) invading the skull and scalp with diffuse massive hyperostosis, presenting striking radiological findings.
A 48-year-old woman was admitted to our hospital with headache, general fatigue, diplopia, and blurred vision. A skull X-ray film, computed tomography (CT), and 3-dimensional CT demonstrated diffuse significant hyperostosis and sclerosis in the cranial vault. Magnetic resonance (MR) imaging revealed a frontoparietal, well-enhanced extra-axial mass lesion, which is compatible with findings of MEP. The tumor was partially resected. Histological examination revealed massive tumor invasion into the dura mater, hyperostotic skull, and scalp.
Hyperostosis is frequently observed in MEP, although there has been no report of a case of MEP such as ours demonstrating diffuse tumor extension and diffuse hyperostosis. Analyzing the CT finding of hyperostotic bone is useful for differentiation of MEP from other diseases that include a hyperostotic condition.
我们描述了一例凸面脑膜瘤斑块状(MEP)侵犯颅骨和头皮并伴有弥漫性大量骨质增生的病例,其影像学表现显著。
一名48岁女性因头痛、全身乏力、复视和视力模糊入院。颅骨X线片、计算机断层扫描(CT)和三维CT显示颅顶弥漫性明显骨质增生和硬化。磁共振(MR)成像显示额顶部一个强化良好的轴外肿块病变,与MEP的表现相符。肿瘤部分切除。组织学检查显示肿瘤大量侵犯硬脑膜、骨质增生的颅骨和头皮。
MEP中经常观察到骨质增生,尽管尚无像我们这样显示弥漫性肿瘤扩展和弥漫性骨质增生的MEP病例报告。分析骨质增生骨的CT表现有助于将MEP与包括骨质增生情况在内的其他疾病相鉴别。