Nawashiro Hiroshi, Nawashiro Tomoki, Nawashiro Ayako
Division of Neurosurgery, Tokorozawa Central Hospital, Tokorozawa, Saitama, Japan.
Department of Neurosurgery, Yokkaichi Municipal Hospital, Mie, Japan.
World Neurosurg. 2019 May;125:104-105. doi: 10.1016/j.wneu.2019.01.185. Epub 2019 Feb 8.
Meningiomas extended to the scalp without any bony changes are rare. A 79-year-old man presented with a large subcutaneous mass in the midline parieto-occipital region and progressive right hemiparesis. The contrast-enhanced millimetric computed tomography scans of the head showed the intracranial parasagittal enhanced mass invading the superior sagittal sinus and the subcutaneous mass without any bony destructive, osteoblastic, or osteolytic changes. Under the operative microscope, no visible communication was found between the intracranial and extracranial mass lesions. Histopathologic examination of both intracranial and extracranial tumors demonstrated the same atypical meningioma (World Health Organization grade II). The possible route of extracranial extension of the tumor may be the sizable parietal foramen.
脑膜瘤延伸至头皮且无任何骨质改变的情况较为罕见。一名79岁男性患者，表现为顶枕部中线处一个巨大的皮下肿物及进行性右侧偏瘫。头颅对比增强毫米级计算机断层扫描显示颅内矢状窦旁强化肿物侵犯上矢状窦，皮下肿物无任何骨质破坏、成骨或溶骨改变。在手术显微镜下，未发现颅内和颅外肿物病变之间有可见的连通。颅内和颅外肿瘤的组织病理学检查均显示为同一例非典型脑膜瘤（世界卫生组织II级）。肿瘤颅外延伸的可能途径可能是较大的顶骨孔。
