Journal of Neurosciences in Rural Practice
 


 
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IMAGES IN NEUROSCIENCES
Year : 2017  |  Volume : 8  |  Issue : 4  |  Page : 653  

Intracranial ossified metaplastic meningioma: Unusual cause of headache


Department of Radiodiagnosis, Sree Balaji Medical College and Hospital, Chennai, Tamil Nadu, India

Date of Web Publication17-Nov-2017

Correspondence Address:
Venkatraman Indiran
Department of Radiodiagnosis, Sree Balaji Medical College and Hospital, 7 Works Road, Chromepet, Chennai - 600 044, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jnrp.jnrp_277_17

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How to cite this article:
Indiran V. Intracranial ossified metaplastic meningioma: Unusual cause of headache. J Neurosci Rural Pract 2017;8:653

How to cite this URL:
Indiran V. Intracranial ossified metaplastic meningioma: Unusual cause of headache. J Neurosci Rural Pract [serial online] 2017 [cited 2017 Dec 18];8:653. Available from: http://www.ruralneuropractice.com/text.asp?2017/8/4/653/218474

A 33-year-old female presented with history of headache for 6 months. There was no history of seizures. Plain and contrast-enhanced computed tomography showed a large extraaxial completely ossified lesion with lobulated margins in the left frontal region with extension across the diploic space, into overlying scalp [Figure 1] and [Video 1]. There was no enhancing soft tissue component. There was no perilesional edema. Craniotomy and near total excision of the tumor were done. Histopathological examination revealed metaplastic meningioma of ossific subtype. Meningiomas, the most common benign intracranial tumors, arise from arachnoid cap cells. They are also the most common nonglial primary tumor and most common extraaxial neoplasm. Meningiomas classically appear as hyperdense homogeneously enhancing mass. Calcification seen in 20%–27% of meningiomas is usually punctuate but may be large.[1] Ossified meningioma, classified histologically as a phenotype of metaplastic meningioma, is extremely rare and belongs to WHO Grade I. Other histological phenotypes of metaplastic meningioma include cartilaginous, lipomatous, myxoid, xanthomatous, and cartilaginous tissue. The majority of ossific meningiomas are spinal in location with <20 cases of intracranial ossified meningioma reported so far.[2],[3] Clinical symptoms include headache, dizziness, seizure, blurred vision, and weakness of lower limbs. Surgical removal is the ideal treatment option, with radiotherapy being useful in recurrent cases. Although not extensively studied, overall prognosis of metaplastic meningiomas is good.[3]
Figure 1: Computed tomography (a) scanogram and (b-e) sections in bone window show a large well-defined extraaxial ossified lesion with lobulated margins lesion in the left frontal region with extension across the diploic space, into the overlying scalp tissue. (f) The same lesion in brain window

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   References Top

1.
Rohringer M, Sutherland GR, Louw DF, Sima AA. Incidence and clinicopathological features of meningioma. J Neurosurg 1989;71 (5 Pt 1):665-72.  Back to cited text no. 1
    
2.
Tai HC, Chen CJ, Chen CM, Chen WL, Chen PY. Ossified metaplastic meningioma with intratumoral hemorrhage. J Cytol Histol 2010;1:102.  Back to cited text no. 2
    
3.
Tang H, Sun H, Chen H, Gong Y, Mao Y, Xie Q, et al. Clinicopathological analysis of metaplastic meningioma: Report of 15 cases in Huashan Hospital. Chin J Cancer Res 2013;25:112-8.  Back to cited text no. 3
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