Intraosseous meningioma
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An intraosseousIntraosseous meningioma is a sub type of meningioma. It is a rare tumour and account for less than 1% of all osseous tumours. They fall under the sub group of primary extradural meningiomas.
Epidemiology
As with meningiomas in general there is recognised female predilection.
Clinical presentation
Clinical presentation is usually due to mass effect, the manifestations of which will depend on the location. The calvarium and verebral column are the most frequent sites 2.
Presentations include:
- palpable or visible bony mass
- proptosis
- cranial nerve
/ spinal/spinal cord compression - intracranial mass effect
/ hydrocephalus/hydrocephalus
Pathology
Thought to occur from trapped arachnoid meningothelial cap cells within cranial sutures during development. However despite this theory only a small proportion of intraosseous meningiomas actually occur in association with a skull suture 3.
Radiographic features
The majority ~ 65~65% are osteosclerotic while ~ 35~35% are osteolytic 3. Due to this imaging appearances are non specific.
CT
The commoner osteosclerotic type tends to show diffuse sclerosis with bony expansion
MRI
-
T1:
-may show aniso intenseisointense extra axial mass component with the expanded bony component being low signal similar to the rest of the skull -
T2:
-meningioma component is typicallyiso intenseisointense to grey matter while a small proportion can be hyper intense -
T1 C+ (Gd):
-as with conventional meningiomas typically tends to have unform avid contrast enhancement
Treatment and prognosis
They are generally benign and slow growing but there may be higher proportion of malignant change compared with standard meningiomas 3. Surgical resection with bone grafting may be performed in symptomatic cases.
Differential diagnosis
For osteosclerotic type consider:
- Paget's disease
- craniofacial fibrous dysplasia: tends to be more extensive with more bony remodelling
- osteosclerotic metastasis
For osteolytic type consider:
-<p>An <strong>intraosseous meningioma</strong> is a sub type of <a href="/articles/meningioma">meningioma</a>. It is a rare tumour and account for less than 1% of all osseous tumours. They fall under the sub group of <a href="/articles/primary-extradural-meningiomas">primary extradural meningiomas</a>.</p><h4>Epidemiology</h4><p>As with meningiomas in general there is recognised female predilection. </p><h4>Clinical presentation</h4><p>Clinical presentation is usually due to mass effect, the manifestations of which will depend on the location. The calvarium and verebral column are the most frequent sites <sup>2</sup>. </p><p>Presentations include:</p><ul>- +<p><strong>Intraosseous meningioma</strong> is a sub type of <a href="/articles/meningioma">meningioma</a>. It is a rare tumour and account for less than 1% of all osseous tumours. They fall under the sub group of <a href="/articles/primary-extradural-meningiomas">primary extradural meningiomas</a>.</p><h4>Epidemiology</h4><p>As with meningiomas in general there is recognised female predilection. </p><h4>Clinical presentation</h4><p>Clinical presentation is usually due to mass effect, the manifestations of which will depend on the location. The calvarium and verebral column are the most frequent sites <sup>2</sup>. </p><p>Presentations include:</p><ul>
-<li>cranial nerve / spinal cord compression</li>-<li>intracranial mass effect / hydrocephalus</li>-</ul><h4>Pathology</h4><p>Thought to occur from trapped arachnoid meningothelial cap cells within cranial sutures during development. However despite this theory only a small proportion of intraosseous meningiomas actually occur in association with a skull suture <sup>3</sup>.</p><h4>Radiographic features</h4><p>The majority ~ 65% are osteosclerotic while ~ 35% are osteolytic <sup>3</sup>. Due to this imaging appearances are non specific. </p><h5>CT</h5><p>The commoner osteosclerotic type tends to show diffuse sclerosis with bony expansion</p><h5>MRI</h5><ul>- +<li>cranial nerve/spinal cord compression</li>
- +<li>intracranial mass effect/hydrocephalus</li>
- +</ul><h4>Pathology</h4><p>Thought to occur from trapped arachnoid meningothelial cap cells within cranial sutures during development. However despite this theory only a small proportion of intraosseous meningiomas actually occur in association with a skull suture <sup>3</sup>.</p><h4>Radiographic features</h4><p>The majority ~65% are osteosclerotic while ~35% are osteolytic <sup>3</sup>. Due to this imaging appearances are non specific. </p><h5>CT</h5><p>The commoner osteosclerotic type tends to show diffuse sclerosis with bony expansion</p><h5>MRI</h5><ul>
-<strong>T1</strong> - may show an iso intense extra axial mass component with the expanded bony component being low signal similar to the rest of the skull</li>- +<strong>T1:</strong> may show an isointense extra axial mass component with the expanded bony component being low signal similar to the rest of the skull</li>
-<strong>T2</strong> - meningioma component is typically iso intense to grey matter while a small proportion can be hyper intense</li>- +<strong>T2:</strong> meningioma component is typically isointense to grey matter while a small proportion can be hyper intense</li>
-<strong>T1 C+ (Gd)</strong> - as with conventional meningiomas typically tends to have unform avid contrast enhancement </li>- +<strong>T1 C+ (Gd):</strong> as with conventional meningiomas typically tends to have unform avid contrast enhancement </li>
-<li><a href="/articles/pagets-disease-of-bone-1">Paget's disease</a></li>- +<li><a href="/articles/paget-disease-of-bone-2">Paget's disease</a></li>
-<a href="/articles/craniofacial-fibrous-dysplasia">craniofacial fibrous dysplasia</a> : tends to be more extensive with more bony remodelling</li>- +<a href="/articles/craniofacial-fibrous-dysplasia">craniofacial fibrous dysplasia</a>: tends to be more extensive with more bony remodelling</li>
-</ul><p>For osteolytic type consider :</p><ul>- +</ul><p>For osteolytic type consider:</p><ul>