ectopic meningioma

7/29/2019 Ectopic Meningioma

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Week 46: Case 4 presented byPedram Argani, M.D.

Clinical History: 42-year-old male with a scalp mass.

Images:

Image 1

Image 2
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Image 3

Image 4

Choose the correct diagnosis:

a. Ectopic meningioma

b. Lipoma

c. Nevus with Lipomatous Metaplasia

d. Perineurioma

Submit Diagnosis


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Case prepared by:Bahram R. Oliai, [email protected]

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All rights reserved. No part of this website may be reproduced in any form or by any means orincorporated into any information retrievel system, electronic or mechanical, without the written permission of JHU.

Your Answer is CORRECT presented byPedram Argani, M.D.

You answered:Ectopic meningioma

The correct diagnosis is:Ectopic meningioma

Review the Slides

Histology: The lesion infiltrates the subcutaneous tissue and underlying fascia.The lesion has the characteristic histology of meningioma in that itfeatures plump ovoid cells with intranuclear inclusions forming whorls.The tumor is immunoreactive EMA, but not for S100 protein.

Discussion: A lipoma would lack the cellular component described above. Ancientnevus can show fatty replacement, but would be immunoreactive forS100 and not for EMA. Perineuriomas would label for EMA; however,they typically have a spindled morphology and form either onion bulbswhen intraneural or storiform or fascicular patterns when in soft tissue.

Extra-cranial meningiomas can occur in three settings. First, inchildren, they represent developmental abnormalities related to neural

tube closure defects. These seem to have a similar pathogenesis asmeningoceles and are associated with a good prognosis when excised.Second, they may occur as primary soft tissue meningiomas derivedfrom arachnoid nests associated with cranial or spinal nerves. Third,they may represent extracranial extension of primary CNSmeningiomas. Clinical correlation is required to exclude the thirdpossibility. In the current case, the lesion most likely represents thesecond type of cutaneous meningioma, one which is neither congenitalnor of cranial origin.
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Next Case

Case prepared by:Bahram R. Oliai, M.D.

[email protected]

Contact Us| Johns Hopkins Medical Laboratories| Pathology Consultation| Pathology Homepage | Conference HomeCopyright 2000-2006 The Johns Hopkins University

All rights reserved. No part of this website may be reproduced in any form or by any means orincorporated into any information retrievel system, electronic or mechanical, without the written permission of JHU.
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ectopic meningioma

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