Primary extracranial meningioma of the mandible: a case report and literature review

Abstract

Objective To investigate the clinical pathology and imaging features of extracranial meningiomas, diagnosis and treatment. Methods The literatures about the extracranial of the mandible before October 2017 were searched in PubMed and Weipu and Wanfang database by using mandibular and primary meningioma as key words.The clinical and imaging findings, histological morphology, immunohistochemical features and treatment of 8 cases reported in literature and 1 case in this paper of extracranial meningiomas were observed. Results A middle-aged woman showed a painless swelling mass in the mandible. CT was clear osteolytic lesion. Uniform spindle-shaped cells partly arranged in whorls were histological manifestation. Epithelial membrane antigen(EmA) and vimentin were positive for tumor cells supporting the diagnosis of meningioma. The tumor was completely resected. No recurrence was observed for 9 months after surgery. Nine cases of meningioma, including 1 case in this paper and 8 cases reported, 2 males and 7 females, aged 20-74 years old, mostly the local swelling of the lower jaw as the main clinical manifestations. The imaging of meningiomas was clear osteolytic lesions, mostly transmissive, but also transmission and non-transmission mixed images. Histology was the same as the intracranial meningioma. The tumor composed of uniform spindle-shaped cells partly arranged in whorls and interconnecting fascicles. Tumor cells demonstrated oval-shaped nuclei with pale wavy eosinophilic cytoplasm and were set in a background of fibrilla ground substance. Tumor cells were positive for EMA and vimentin, negative for progestrone receptor, pan cytokeratin, calponin, smooth muscle actin, desmin, S-100, β-tubulin-3, CD34, B-cell lymphoma-2 and CD99, Ki-67 proliferation index 1%. Surgical treatment consisted of a block resection of the tumor with reconstruction of the using a bone graft. Histologically benign patients had a good prognosis and surgical resection was curable. Conclusions The extracranial is very rare, and it needs to be diagnosed by clinical manifestations and imaging and histopathology. Surgical complete resection of the mass and reconstruction can be cured. Key words: Meningioma; Mandible; Extracranial meningioma; Pathology, clinical