Report of A Case of Intraosseous Meningioma Presenting as a Multilocular Osteolytic Skull Lesion

Abstract

A case of intraosseous meningioma of the parietal bone in a 69-year-old female is described. Intraosseousmeningiomas are very rare,, She was admitted to our hospital with a hard, painless growing mass in the left parietalregion. Neurological examination and laboratory data revealed no abnormalities except for recent memory disturbance. However, a plain craniogram showed a 3 × 4 cm osteolytic lesion in the left parietal bone. CT scan demonstrated a multilocular intraosseous mass. Gd-enhanced MRI showed heterogenous enhancement of the masslesion and thickened dura mater adjacent to the tumor (dural tail sign). Selective external carotid angiogram showed tumor stain in the thinned skull fed by middle meningeal and superficial temporal arteries. After embolization of the middle meningeal artery, the tumor was removed en bloc with the surrounding normal bone. Macro-scopically complete tumor resection (Simpson's grade 1) was carried out. The patient had an uneventful recoveryand remains well without recurrence at 1/2 years follow-up. Histological examination of the specimen revealedmeningothelial (WHO2000) meningioma. Tumor cells infiltrated through the adjacent dura mater. No mitosis was identified.