PRIMARY EXTRACRANIAL MENINGIOMA OF THE MANDIBLE: A CASE REPORT AND LITERATURE REVIEW OF THIS RARE PRESENTATION

Abstract

Meningiomas are common benign neoplasms developing within the central nervous system and arise from the meningothelial cells. Extracranial (ectopic) meningiomas are rare and may represent an extracranial extension of an intracranial meningioma or distant metastasis from a primary intracranial meningioma, or they may originate from arachnoid cells in the sheaths of the cranial nerves that are exiting the skull through the foramina or sutures. Ectopic meningiomas can also arise as true primary extracranial meningiomas originating from ectopic arachnoid lining cells or multipotential mesenchymal cells. Primary extracranial meningiomas occurring in the jaws are extremely rare, with only 11 reported cases (2 cases in the maxilla and 9 cases in the mandible) in the literature. The infrequent occurrence of this entity presenting in this unusual location of the jaws often poses a diagnostic challenge to the oral pathologist, resulting in misdiagnosis. We present the 10th mandibular case of extracranial meningioma involving the right side of the mandible in a 56-year-old female patient. The clinical and radiographic presentation, histopathologic features, and histopathologic differential and immunohistochemical findings of this case are presented. The proposed pathogenesis, treatment options, and prognosis are also discussed along with a review of the literature.