J Korean Soc Radiol.  2015 Jan;72(1):68-72. 10.3348/jksr.2015.72.1.68.

Primary Intraosseous Meningioma in the Orbital Bony Wall: A Case Report and Review of the Literature Review

• Lee SJ
• Ryu JH
• Kim HD
• Lee KH
• Baek HJ
• Kim OH
• Yoon JH
• Park YM
• Kim DW
• Kim JY

• KMID: 1823937
• DOI: http://doi.org/10.3348/jksr.2015.72.1.68

Abstract

Meningiomas arising outside the intracranial compartment are known as extradural meningiomas. Extradural meningiomas are rare conditions, accounting for less than 2% of all meningiomas. Primary intraosseous meningioma is used to describe a subset of extradural meningiomas arising from bone. A 46-year-old woman presented with left exophthalmos. Computed tomography and magnetic resonance images revealed an expansile bony lesion in the orbital lateral wall of the left sphenoid bone. The patient underwent craniotomy for excision of the bony lesion. Pathologic examination revealed an intraosseous meningioma.

MeSH Terms

Craniotomy
Diplopia
Exophthalmos
Female
Humans
Meningioma*
Middle Aged
Orbit*
Sphenoid Bone

Figure

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  Fig. 1 A 46-year-old woman presented with left exophthalmos. Axial T1-weighted (A) and T2-weighted (B), and gadolinium-enhanced axial T1-weighted (C) MR images show an expansile bony lesion in the left lateral wall of the orbit. The intraosseous component (white arrow) is hypointense on T1- and T2-weighted images. The soft tissue component (black arrow) that represents underlying dura behind the sphenoid ridge is iso- and hyperintense on T1- and T2-weighted images with intense enhancement after administration of gadolinium.

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  Fig. 2 CT images of a 46-year-old woman presented with left exophthalmos. A. Pre-contrast CT scan with bone widow shows an expansile and sclerotic bony lesion (arrow) in the orbital lateral wall of the left sphenoid bone. There are multiple pin-point low-attenuated foci in the bony lesion. B. Post-contrast CT images show a slightly enhancing plaque-like dural thickening (white arrow) adjacent to the bony lesion (black arrow).

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  Fig. 3 Histopathological feature of intraosseous hemangioma. A. Microscopic examination reveals a set of neoplastic cell lobules between bony trabecula (hematoxylin & eosin stain, × 100). B. Within a high-power field, the tumor cells have indistinct cell borders and show a whorled appearance (hematoxylin & eosin stain, × 400). C. Immunohistochemical staining for vimentin shows strong cytoplasmic reactivity (× 400).

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