Differential diagnosis of a primary skull bone tumor – Characteristics of an purely intraosseous extradural meningioma. Case report and literature review

Objective

This case report aims to describe a rare occurrence of a purely intraosseous meningioma, presenting as a lytic bone lesion in the skull.

Case Report

We present the case of a 67-year-old female patient who presented with a persistent headache and underwent diagnostic imaging, including CT scan and MRI. Surgical resection with wide margins and cranial reconstruction was performed, followed by histopathological examination of the tumor.

Discussion

The radiological investigation revealed an infiltrative and lytic heterogeneous lesion in the left parietal bone. Whole-body PET-CT scan showed no signs of primary involvement. The patient underwent successful surgery, and the histopathological examination confirmed the diagnosis of a grade I meningothelial meningioma with adjacent hyperostosis. Primary intraosseous meningiomas are exceedingly rare and challenging to diagnose due to their mimicry of other benign and malignant skull lesions. Surgical resection with wide margins is recommended, and histopathological examination with immunohistochemistry aids in confirming the diagnosis. Long-term surveillance is necessary due to the potential for recurrence and malignant transformation.