Yun Jung-Ho, Lee Sang-Koo
Department of Neurosurgery, Dankook University College of Medicine, Cheonan, Korea.
J Korean Neurosurg Soc. 2014 Dec;56(6):509-12. doi: 10.3340/jkns.2014.56.6.509. Epub 2014 Dec 31.
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.
原发性骨内脑膜瘤是一种罕见的肿瘤,具有非典型病理成分(溶骨性病变以及硬脑膜和软组织侵犯)的情况极为罕见。一名65岁女性因右侧额部出现一个5个月的软性肿块前来就诊。磁共振成像显示右侧额骨有一个4厘米大小、多叶状、强化明显的病变,计算机断层扫描显示颅骨有破坏性病变。肿块与头皮和硬脑膜紧密粘连,延伸至硬脑膜外层和内层的部分区域,但未侵犯脑组织。同时将硬膜外肿块和软组织肿块完全切除,并用人工骨材料修复颅骨缺损。病理研究显示为世界卫生组织II级非典型脑膜瘤。术后6个月,脑部磁共振成像显示颅脑和脊髓病变均未复发。在此,我们报告一例伴有软组织和硬脑膜侵犯的原发性溶骨性骨内非典型脑膜瘤病例。