MENINGIOMA - AN UNUSUAL CERVICAL TUMOR - A CASE ORIGINATING IN THE PETROUS BONE - A REVIEW OF THE LITERATURE ON MENINGIOMAS PRESENTING AS NECK MASSES

Primary ectopic meningiomas are uncommon. The authors report a case of a 12-year-old boy with a meningioma presenting as a neck mass. The co nclusion of the initial biopsy was chemodectoma, but on surgical resec tion, the tumour was found to have invaded the petrous bone. Post-oper ative follow-up was uneventful but magnetic resonance imagery revealed extension to the cerebello-pontine angle, the cavernous sinus, the te ntorium and the falx. The authors discuss the main pathogenic hypothes es and the classification of ectopic meningiomas. Based on 62 similar cases reported in the literature, primary ectopic meningiomas are foun d most often in young subjects, with no female predominance, neurofibr omatosis is often observed and angioblastic or malignant features are frequent. These tumours can be divided into 6 localizations (jugulo-ca rotid space, lymph nodes, parotid gland, thyroid gland, soft paraverte bral tissues, skin) and into 3 pathogenic groups (solitary ectopic tum our of the neck, tumour of the neck connected to a cranial or spinal m eningioma, metastasis). Meningioma of the jugulo-carotid space with co nnection to the skull base is the most frequent entity. Solitary ectop ic meningiomas of the neck occur in only 1 out of 5 cases. In 2 out of 3 cases, the neck localization involves a connection to a cranial or spinal meningioma. In a few cases the neck mass is a metastasis. These findings suggest that a complete neuroradiological work-up is require d. Prognosis depends on the completeness of the surgical resection and the histologic agressiveness frequently encountered.