PRIMARY INTRAOSSEOUS MENINGIOMA - CASE-REPORT

Primary intraosseous meningioma of the skull is an uncommon lesion oft en confused preoperatively with a primary bone tumor of the skull. The case of an intraosseous meningioma without dural connection or associ ation with a cranial suture is reported that was radiographically diag nosed as Paget's disease and initially treated conservatively. Persist ent headache prompted a biopsy, yielding a benign, heavily ossified, a nd psammomatous meningioma. The lesion was treated with wide surgical excision and acrylic cranioplasty. Subsequent review of the literature has revealed 35 additional cases of purely intraosseous meningioma. A n analysis of these 36 cases demonstrates a mean patient age at diagno sis of 45 years and a 2:1 female preponderance, with the majority of l esions associated with cranial sutures. Sixty-four percent of the lesi ons were hyperostotic on plain skull x-ray films; the rest were osteol ytic or a mixture of both. There was no relationship to prior trauma. The treatment of choice is wide surgical resection followed by cranial reconstruction.