Figure - available from: Case Reports in Radiology
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Axial CT images showed a cerebriform and irregular isodense mass with prominent perilesional vasogenic edema (a-b) in the right parietal-occipital-temporal region.
Source publication
Meningiomas are the most common primary nonneuroglial extra-axial neoplasms, which commonly present as spherical or oval masses with a dural attachment. Meningiomas without dural attachment are rare and, according to their locations, are classified into 5 varieties, including intraventricular, deep Sylvain fissure, pineal region, intraparenchymal,...
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Citations
... Meningiomas are the most common non-glial primary tumors of the central nervous system and extraaxial neoplasms [1]. The prevalence of meningiomas is 53 of 100.000 people worldwide, and 35.5% is found in Asian and African people [2,3]. The annual incidence of meningioma is around 1,28 and 7,8 of 100.000 based on the worldwide data registries [4]. ...
... Meningiomas vary based on the clinical findings, imaging, and histopathology from benign to malignant types. Meningiomas are classified into three types based on their histopathology characteristics and recurrence regarding World Health Organization (WHO) [3]. The types of meningiomas are benign meningioma (WHO grade I), atypical meningioma (WHO grade II), and anaplastic or malignant meningioma (WHO grade III) [6]. ...
Background
Primary intraparenchymal meningiomas exceedingly rare and oftentimes challenging to diagnose, given their misleading radiological features. It is hypothesized that they arise from the cap cells of the pia mater that enter the brain via penetrating blood vessels during brain development. We systematically reviewed and analyzed previously reported features of primary intraparenchymal meningiomas in terms of radiography, presenting symptoms, and histopathology.
Methods
A literature search of the Web of Science and PubMed databases and crossed references was performed on March 2021, per PRISMA guidelines, with no restrictions regarding publication date. Data regarding demographic features, clinical, radiographic, and histopathological characteristics were extracted.
Results
A total of 52 patients (including reported Case) were included in this review. The mean age was 21.1 years (range, 0.3-66 years) with a male-to-female ratio of 1.9:1. The most common localizations of intraparenchymal meningiomas were in the frontal (30.8%) and temporal (21.2%) lobes. Cyst formation was more readily observed and was noted in 51.4% of patients. Histopathology revealed a higher incidence of WHO grade II (14/52, 26.9%) and WHO grade III (7/52, 13.5%) of primary intraparenchymal meningiomas.
Conclusion
We present a comprehensive analysis of every reported primary intraparenchymal meningioma. Due to their rarity and capacity to mimic other more common intra-axial tumors, they represent a diagnostic challenge. This systematic review highlights the importance of paying attention to atypical intra-axial lesions with a particular reflection on the discrepancy between clinical characteristics and imaging features.
