이소성 뇌수막종: 증례보고 (2예)

초록

Case 1. The patient, a 73-year-old woman, presented with a 10 month history of increasing proptosis and eyelid swelling of the right eye. Neuroradiologic findings were suggestive of an epidural meningioma. It seem to be extended to intra-orbital space with orbital bone erosion and there was hyperostosis with bone marrow invasion on right frontal bone. MRI revealed dumbbell-shaped mass, about 6 x 5cm sized, seen iso signal intensity on T1WI and heterogeneous iso signal intensity on T2WI with inhomogeneous enhancement. The postero-medial aspect of the mass seems to have unclear interface with brain parenchyme, which meant brain invasion. Case 2. A 63-year-old man, who had past history of head trauma and skull fracture 20 years ago, presented with a 7 years history of a subcutaneous lesion overlying the mid-frontal region of the scalp, which was 6 x 7cm non-tender, fixed, bony hard mass adherent to the pericranium. A CT scan of the head demonstrated the subcutaneous lesion with hyperostosis of the skull and there was no intra-cranial connection. Both patients underwent total excision of the mass, subsequently examined by histopathology. Conclusion. Ectopic meningiomas are rare tumors that develop from ectopic arachnoid tissue. The ectopic meningioma in Case 1 was suggested that it developed from an occasional arachnoid rest in supra-orbital wall (orbital roof). In Case 2, we suggest that this ectopic meningiomas origingated from meningeal tissue that had been trapped outside the central nervous system after the skull fracture 20 years ago. It was thought to be type 2 cutaneous meningioma of the classification by Lopez DA in 1974. Even though ectopic miningioma is locally invasive, the prognosis is good if the excision of the tumor is complete