• Journal of Korean Neurosurgical Society
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• 제55권4호
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• pp.205-207
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• 2014

Meningioma is a common primary tumor of central nervous system. However, extracranial extension of the intracranial meningioma is unusual, and mostly accompanied the osteolytic change of the skull. We herein describe an atypical meningioma having extracranial extension with hyperostotic change of the skull. The patient was a 72-year-old woman who presented a large mass in the right frontal scalp and left hemiparesis. Brain magnetic resonance imaging and computed tomography scans revealed an intracranial mass, diffuse meningeal thickening, hyperostotic change of the skull with focal extension into the right frontal scalp. She underwent total removal of extracranial tumor, bifrontal craniectomy, and partial removal of intracranial tumor followed by cranioplasty. Tumor pathology was confirmed as atypical meningioma, and she received adjuvant radiotherapy. In this report, we present and discuss a meningioma en plaque of atypical histopathology having an extracranial extension with diffuse intracranial growth and hyperostotic change of the skull.

• Journal of Korean Neurosurgical Society
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• 제63권6호
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• pp.821-826
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• 2020

Objective : Hyperostosis in meningiomas can be present in 4.5% to 44% of cases. Radical resection should include aggressive removal of invaded bone. It is not clear however to what extent bone removal should be carried to achieve pathologically free margins, especially that in many cases, there is a T2 hyperintense signal that extends beyond the hyperostotic bone. In this study we try to investigate the perimeter of tumour cells outside the visible nidus of hyperostotic bone and to what extent they are present outside this nidus. This would serve as an initial step for setting guidelines on dealing with hyperostosis in meningioma surgery. Methods : This is a prospective case series that included 14 patients with convexity meningiomas and hyperostosis during the period from March 2017 to August 2018 in two university hospitals. Patients demographics, clinical, imaging characteristics, intraoperative and postoperative data were collected and analysed. In all cases, all visible abnormal bone was excised bearing in mind to also include the hyperintense diploe in magnetic resonance imaging (MRI) T2 weighted images after careful preoperative assessment. To examine bony tumour invasion, five marked bone biopsies were taken from the craniotomy flap for histopathological examinations. These include one from the centre of hyperostotic nidus and the other four from the corners at a 2-cm distance from the margin of the nidus. Results : Our study included five males (35.7%) and nine females (64.3%) with a mean age of 43.75 years (33-55). Tumor site was parietal in seven cases (50%), fronto-parietal in three cases (21.4%), parieto-occipital in two cases (14.2%), frontal region in one case and bicoronal (midline) in one case. Tumour pathology revealed a World Health Organization (WHO) grade I in seven cases (50%), atypical meningioma (WHO II) in five cases (35.7%) and anaplastic meningioma (WHO III) in two cases (14.2%). In all grade I and II meningiomas, bone biopsies harvested from the nidus revealed infiltration with tumour cells while all other bone biopsies from the four corners (2 cm from nidus) were free. In cases of anaplastic meningiomas, all five biopsies were positive for tumour cells. Conclusion : Removal of the gross epicentre of hyperostotic bone with the surrounding 2 cm is adequate to ensure radical excision and free bone margins in grade I and II meningiomas. Hyperintense signal change in MRI T2 weighted images, even beyond visible hypersototic areas, doesn't necessarily represent tumour invasion.

• Imaging Science in Dentistry
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• 제31권3호
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• pp.181-184
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• 2001

Thirteen-year-old girl complaining of the swelling and pain on the left midface visited our dental hospital. On the radiographic examination, well-defined radiolucent lesion with hyperostotic border was found in the left maxilla accompanying with the external root resorption of the involved teeth and the displaced second molar. CT showed calcified bodies, thinning of hard palate, inferior orbital wall and lateral wall of nasal fossa, and thinning and perforation of the buccal plate of the maxilla. Enucleation and curettage of the lesion and nasoantrostomy was carried out and histopathologic examination mainly showed a solid tumor tissue composed of odontogenic epithelium and pulp tissues admixed with dentin and enamel formation. And some part of reduced follicular epithelium of tooth germ showed a change mimicking calcifying odontogenic cyst. Taken together, we concluded the lesion is an ameloblastic fibro-odontoma with a change of calcifying odontogenic cyst.

• 치과방사선
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• 제24권1호
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• pp.95-105
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• 1994

The aim of this study was to evaluate the clinical, radiographic and histopathologic features of 23 cases of solitary bone cyst by means of the analysis of radiographs and biopsy specimens in 23 persons visited the Department of Oral and Maxillofacial Radiology, School of Dentistry, Kyung Hee University and Chunbuk National University. The obtained results were as follows; 1. The incidence of solitary bone cyst was almost equal in males(52.2%) and in females(47.8%) and the prevalent age of the solitary bone cyst were the second decade(47.8%) and the third decade (21.7%). 2. In the signs and symptoms of solitary bone cyst, pain or tenderness revealed in 17.4%, swelling revealed in 13.0%, pain and swelling revealed in 21.7%, paresthesia revealed in 4.4% and 43.5% were asymptom and the tooth vitality involved in the solitary bone cyst, 76.5% were positive and 23.5% were either positive or negative. 3. In the location of the solitary bone cyst, 47.8% present posterior region, 21.7% present anterior region, 21.6% present anterior and posterior region, 4.4% present condylar process area. 4. In the hyperostotic border of the solitary bone cyst, 47.8% were seen entirely, 21.8% were seen partialy, and 30.4% were not seen. 5. In the change of tooth, 59.1% were intact, 18.2% were loss of the alveolar lamina dura, 13.6% were root resorption 4.55% were tooth displacement, 4.55% were root resorption and tooth displacement. 6. In the change of cortical bone of the solitary bone cyst, 39.1% were intact and 60.9% were thinning and expansion of cortical bone. 7. In the histopathologic findings of 9 cases, 33.3% were thin connective tissue wall, 11.1% were thickened myxofibromatous wall, 55.6% were thickened myxofibromatous wall with dysplastic bone formation.

• 구강회복응용과학지
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• 제28권3호
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• pp.301-307
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• 2012

50세 여자 환자와 남자 환자가 파노라마 방사선사진에서 우연히 발견된 무증상의 하악 구치부의 방사선투과성 병소로 인해 의뢰되었다. 임상검사에서 특이할 만한 소견은 발견되지 않았다. 파노라마 방사선사진에서 각각 우측과 좌측 하악 구치부에서 경계가 비교적 명확하며, 과골성 변연을 수반하지 않는 원형의 방사선투과성 병소가 관찰되었다. 병소 내부는 다방성의 양상이었으며, 또한 병소 부위를 주행하는 하악관의 불연속성 소견이 관찰되었다. 이에 양성 종양을 배제하기 위해서 조영증강 전산화단층사진을 촬영하였다. 전산화단층사진의 축상면에서 불규칙한 경계를 가지는 명확한 설측 함요부가 관찰되었으며, 내부는 지방 및 일부 악하선 조직으로 채워져 있었으나 다른 질환을 의심할 만한 연조직 종괴는 관찰되지 않았다. 최종적으로 비전형적 형태의 발육성 타액선 골결손으로 진단하였으며, 이 중 한 증례에서, 4개월 후의 재검사시 촬영한 파노라마 방사선사진에서 뚜렷한 변화가 관찰되지 않았다. 본 증례들과 같은 비전형적 발육성 타액선 골결손을 다른 질환과 감별하기 위해서는 단면 및 내부 구조물에 대한 보다 정확한 평가가 이루어져야 하므로 일반방사선사진뿐만 아니라 전산화단층영상 또는 자기공명영상이 추가적으로 필요하리라 생각된다.