Zhang Huiyang, Li Xiang, Jiang Yan
Department of Radiology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China.
Medicine (Baltimore). 2025 Jan 31;104(5):e41294. doi: 10.1097/MD.0000000000041294.
Primary ectopic meningiomas (PEMs) are extremely rare, with limited literature available on the subject. Understanding their clinical and radiological characteristics is crucial for accurate diagnosis and treatment.
This study presents a case of a multicentric PEM involving the lungs and cranial bone barrier, aiming to provide new insights into its clinical and diagnostic features.
A 46-year-old woman with no prior history of intracranial meningiomas or other tumors was found to have multiple lobulated nodules in the lungs during a routine physical examination. Computed tomography scans revealed well-defined lesions with mild to moderate heterogeneous enhancement. Magnetic resonance imaging showed a lesion at the cranial bone barrier, which presented as a high-signal area on T2-weighted FLAIR images and mild to moderate enhancement on T1-weighted images. The magnetic resonance spectroscopy displayed a broad Lip peak but lacked N-acetylaspartate or creatine peaks. Histopathological and immunohistochemical analyses confirmed the diagnosis of multicentric PEMs.
We performed surgical resection of the lesion on the cranial bone plate and conducted follow-up examinations for the multiple lesions in the lungs.
This case highlights the diagnostic challenges of multicentric PEMs involving the lungs and cranial bone barrier. Due to their extremely low incidence and nonspecific clinical manifestations, a comprehensive evaluation combining radiological, pathological, and immunophenotypic data is essential for accurate diagnosis.
This case underscores the importance of a thorough, multidisciplinary approach to diagnosis and treatment and provides valuable insights for managing similar rare cases.
原发性异位脑膜瘤（PEMs）极为罕见，关于该主题的文献有限。了解其临床和放射学特征对于准确诊断和治疗至关重要。
本研究报告了一例累及肺部和颅骨屏障的多中心PEM病例，旨在为其临床和诊断特征提供新的见解。
一名46岁女性，既往无颅内脑膜瘤或其他肿瘤病史，在常规体检中发现肺部有多个分叶状结节。计算机断层扫描显示边界清晰的病变，有轻度至中度不均匀强化。磁共振成像显示颅骨屏障处有一病变，在T2加权液体衰减反转恢复序列图像上表现为高信号区，在T1加权图像上有轻度至中度强化。磁共振波谱显示一个宽的脂质峰，但缺乏N-乙酰天门冬氨酸或肌酸峰。组织病理学和免疫组织化学分析证实为多中心PEMs。
我们对颅骨板上的病变进行了手术切除，并对肺部的多个病变进行了随访检查。
该病例突出了累及肺部和颅骨屏障的多中心PEMs的诊断挑战。由于其发病率极低且临床表现不具特异性，综合放射学、病理学和免疫表型数据进行全面评估对于准确诊断至关重要。
该病例强调了采用全面、多学科方法进行诊断和治疗的重要性，并为处理类似罕见病例提供了有价值的见解。
