Wang Yue, Hu Jibo
Department of Radiology, The Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, China.
Front Oncol. 2025 Feb 4;15:1502818. doi: 10.3389/fonc.2025.1502818. eCollection 2025.
Primary intraosseous meningioma (PIM) is a rare lesion often misidentified preoperatively due to its ambiguous benign or malignant characteristics. In this report, we introduce two novel cases of PIM and explore the potential correlation between pathological classification and imaging features. Our aim is to enhance our understanding of PIM and improve its preoperative diagnosis.
The first case is a 68-year-old female patient presenting with a brain mass located in the temporal region. Computed tomography (CT) imaging demonstrated the destruction of adjacent bone structures. A right frontal temporal craniectomy was subsequently performed and histological examination pathologically confirmed the lesion was the chordoid variant of PIM. The second case is a 56-year-old male patient who exhibited an irregular soft-tissue mass in the right sphenoid as visualized on brain CT. The patient underwent a surgical intervention for a skull base neoplasm. Postoperative pathological analysis confirmed the presence of the meningothelial variant of PIM. Upon pathological examination, the two cases were respectively classified as atypical meningioma (Grade II) and benign meningioma (Grade I).
While pathological examination remains indispensable for the definitive confirmation of PIM, the early identification of PIM is critically dependent on radiological imaging methods. The imaging characteristics of PIM exhibit variability across different pathological grades, a factor that can significantly aid in both the diagnostic process and the formulation of appropriate treatment strategies.
原发性骨内脑膜瘤(PIM)是一种罕见病变,因其良性或恶性特征不明确,术前常被误诊。在本报告中,我们介绍两例新型PIM病例,并探讨病理分类与影像学特征之间的潜在相关性。我们的目的是加深对PIM的理解并改善其术前诊断。
第一例是一名68岁女性患者,其颞区有一个脑肿块。计算机断层扫描(CT)成像显示相邻骨结构破坏。随后进行了右额颞开颅手术,组织学检查病理证实该病变为PIM的脊索样变体。第二例是一名56岁男性患者,脑CT显示其右侧蝶骨有一个不规则软组织肿块。该患者因颅底肿瘤接受了手术干预。术后病理分析证实存在PIM的脑膜内皮变体。经病理检查,这两例分别被分类为非典型脑膜瘤(II级)和良性脑膜瘤(I级)。
虽然病理检查对于PIM的最终确诊仍然不可或缺,但PIM的早期识别严重依赖于放射影像学方法。PIM的影像学特征在不同病理分级中表现出变异性,这一因素在诊断过程和制定适当治疗策略方面都能提供显著帮助。