A Case of Extra-axial Anaplastic Meningioma with Direct Orbital Extension

PURPOSE: We report the first case of extra-axial anaplastic meningioma with direct orbital extension for differential diagnosis of orbital tumors. CASE SUMMARY: An 83-year-old woman presented with a protruding left eye and a palpable mass on the forehead. A brain computed tomography scan revealed a huge sarcomatous mass that had directly invaded the surrounding tissues. We removed the tumor by craniotomy and found that it involved the extradural and intradural spaces, brain parenchyma, subcutaneous tissue, left temporalis, orbital roof, and the other frontal lobe across the midline. A cranioplasty was performed, and the orbital roof was reconstructed with artificial bone and bone cement. The final histological diagnosis was anaplastic meningioma. The left eyeball was restored to its normal position 1 month after the surgery. Also, visual acuity and eye movement of the left eye were preserved. CONCLUSIONS: Direct orbital extension of originated extra-axial cerebral convexity anaplastic meningioma is rare but should be considered in the differential diagnosis of a rapidly growing orbital mass.

Analysis of 120 surgical cases with convexity meningioma / 中国医师进修杂志

Objective To analyze the patients with convexity meningioma with respect to pathological factors leading to recurrence, surgical technique, and complication. Methods The data of 120 surgical cases of convexity meningioma were retrospectively reviewed. Statistical analysis were performed by SPSS 17.0 with method of Kaplan-Meier survival analysis. Results The 30-day mortality was 0. The pathology of the tumors was benign in 105 cases (87.5%), atypical meningioma in 12 cases (10.0%), and anaplastic/malignant meningioma in 3 cases (2.5%). In 8 cases designated benign, there were borderline atypical features. Two cases of benign tumor recurred whose pathology involved tumors with borderline atypia.Conclusions Patients with convexity meningioma should be actively operated, and Simpson Ⅰ resection must be performed to the best of ability whether the tumors are benign or malignant. Further postoperative adjuvant treatment will be implemented or not according to the histopathological types of the tumors. Although there are many factors of recurrence for convexity meningioma. The range of surgical resection and pathological types are still the important causes for recrudescence.