TY - JOUR
T1 - Unusual skull tumors with psammomatoid bodies
T2 - A diagnostic challenge
AU - Richardson, Timothy E.
AU - Georgescu, Maria Magdalena
AU - Kapur, Payal
AU - Hwang, Helena
AU - Barnett, Samuel L.
AU - Raisanen, Jack M.
AU - Cai, Chunyu
AU - Hatanpaa, Kimmo J.
N1 - Publisher Copyright:
© 2017 Dustri-Verlag Dr. K. Feistle.
PY - 2017/5/1
Y1 - 2017/5/1
N2 - Aim: We describe a series of three diagnostically challenging, histologically similar fibro-osseous skull masses. Methods: The cases were identified in our archives among 50,000 neuropathology specimens. A comprehensive review of the histological, immunohistochemical, ultrastructural, and imaging features as well as the clinical outcome was performed. Results: The routine histology was similar in all 3 cases and showed spindle cell proliferations with frequent calcospheres or psammomatoid bodies. There was no evidence of an underlying subdural component. Immunohistochemistry for the meningioma markers EMA and SSTR2A raised the possibility of intraosseous meningioma, as all 3 lesions were convincingly positive for epithelial membrane antigen (EMA) and 1 lesion was convincingly positive for the somatostatin receptor subtype 2A (SSTR2A); weak, questionable positivity for SSTR2 was present in the remaining 2 cases. In addition, electron microscopy was available in 1 case and showed features consistent with meningioma. Conclusions: Overall, the findings were most consistent with intraosseous meningioma. Primary intraosseous meningiomas are rare lesions that may present a diagnostic challenge. It is important to consider meningiomas in the differential diagnosis, as extradural meningiomas are associated with an increased risk of recurrence and may occasionally undergo malignant transformation.
AB - Aim: We describe a series of three diagnostically challenging, histologically similar fibro-osseous skull masses. Methods: The cases were identified in our archives among 50,000 neuropathology specimens. A comprehensive review of the histological, immunohistochemical, ultrastructural, and imaging features as well as the clinical outcome was performed. Results: The routine histology was similar in all 3 cases and showed spindle cell proliferations with frequent calcospheres or psammomatoid bodies. There was no evidence of an underlying subdural component. Immunohistochemistry for the meningioma markers EMA and SSTR2A raised the possibility of intraosseous meningioma, as all 3 lesions were convincingly positive for epithelial membrane antigen (EMA) and 1 lesion was convincingly positive for the somatostatin receptor subtype 2A (SSTR2A); weak, questionable positivity for SSTR2 was present in the remaining 2 cases. In addition, electron microscopy was available in 1 case and showed features consistent with meningioma. Conclusions: Overall, the findings were most consistent with intraosseous meningioma. Primary intraosseous meningiomas are rare lesions that may present a diagnostic challenge. It is important to consider meningiomas in the differential diagnosis, as extradural meningiomas are associated with an increased risk of recurrence and may occasionally undergo malignant transformation.
KW - EMA
KW - Fibrous dysplasia
KW - Primary extradural meningioma
KW - Primary intraosseous meningioma
KW - SSTR2A
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U2 - 10.5414/NP300997
DO - 10.5414/NP300997
M3 - Article
C2 - 28128725
AN - SCOPUS:85019852025
SN - 0722-5091
VL - 36
SP - 114
EP - 120
JO - Clinical Neuropathology
JF - Clinical Neuropathology
IS - 3
ER -