Extracranial Extension of Intracranial Atypical Meningioma En Plaque with Osteoblastic Change of the Skull

Meningioma is a common primary tumor of central nervous system. However, extracranial extension of the intracranial meningioma is unusual, and mostly accompanied the osteolytic change of the skull. We herein describe an atypical meningioma having extracranial extension with hyperostotic change of the skull. The patient was a 72-year-old woman who presented a large mass in the right frontal scalp and left hemiparesis. Brain magnetic resonance imaging and computed tomography scans revealed an intracranial mass, diffuse meningeal thickening, hyperostotic change of the skull with focal extension into the right frontal scalp. She underwent total removal of extracranial tumor, bifrontal craniectomy, and partial removal of intracranial tumor followed by cranioplasty. Tumor pathology was confirmed as atypical meningioma, and she received adjuvant radiotherapy. In this report, we present and discuss a meningioma en plaque of atypical histopathology having an extracranial extension with diffuse intracranial growth and hyperostotic change of the skull.

An Osteolytic Meningioma en Plaque of the Sphenoid Ridge

Meningioma en plaque (MEP) is a rare tumor characterized more by its clinical and biological behavior than its histological appearance. Hyperostosis of the skull is one of the characteristic signs of MEP. This bony change can produce clinical symptoms and signs in MEP by pressing against adjacent structures. The authors report a rare case of an osteolytic MEP extending from the sphenoid wing into the orbital wall, middle fossa, and temporalis muscle.

Meningioma en Plaque of Parasagittal Region Presented with Recurrent Venous Infarction

A case of parasagittal meningioma en plaque with a peculiar clinical presentation is reported with a review of the literature. A 72-year-old woman presented with dysphasia and right hemiparesis. Computed tomography and magnetic resonance imaging demonstrated focal edema of left frontal lobe and a thick sheet-like parasagittal enhancing lesion with extension along the falx cerebri and adjacent sulcal enhancement. Differential diagnosis included idiopathic hypertrophic pachymeningitis, meningeal neurosarcoidosis, metastasis and meningioma en plaque. Cerebral angiography revealed occlusion of the anterior one-third of the superior sagittal sinus as well as a faint tumor blush supplied from the anterior branch of the middle meningeal artery. At surgery, the tumor invading the dura and skull was removed totally but the tumor invaded into the superior sagittal sinus was removed subtotally. The tumor was confirmed to be a transitional meningioma on pathological examination.

Convexity Meningioma En Plaque Presenting with Diffuse Hyperostosis of the Skull

Although meningioma is a common and benign intracranial tumor, meningioma en plaque is a rare tumor, especially in the cranial vault. Meningioma en plaque(MEP) usually occurs in the area of the sphenoid wing, and it causes cosmetic and visual problems, as well as the problems that are due to its mass effect. The authors present here a case of convexity meningioma en plaque that involved the skull and scalp with diffuse hyperostosis as the presenting salient radiological findings, which caused marked intraoperative bleeding.