Cutaneous meningioma

Medical condition

Cutaneous meningioma

Other names| Rudimentary meningocele, heterotopic meningeal tissue
Specialty| Dermatology

Cutaneous meningioma, also known as heterotopic meningeal tissue, and rudimentary meningocele[1] is a developmental defect, and results from the presence of meningocytes outside the calvarium.[2]: 622

## Signs and symptoms

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Lesions appear as hard, subcutaneous lumps that might be pale or somewhat black in appearance.[3] Alopecic lesions[4][5] with overlaying hair tufts or even hypertrichosis have been reported.[6] Although usually painless, some people have reported experiencing discomfort or tenderness.[7][8]

## Causes

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While type II and type III tumors form later in life, type I tumors are congenital.[3]

## Diagnosis

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Since imaging studies and clinical characteristics are frequently equivocal, cytology, and particularly histology, is essential for determining the final diagnosis. Meningothelial cells arranged in a whorled pattern with lobules, nests, and sheets of oval or polygonal cells are the most prevalent histopathogical form. These cells display calcification foci (psammomma bodies) or hyaline structures (collagen bodies), which are highly useful diagnostic markers.[9][8]

The clinical differential diagnosis is extensive and includes, among other conditions, alopecia areata, nevus sebaceous, cyst, glioma, fibroma, hemangioma, lipoma, scar, and verrucous hamartoma.[3]

### Classification

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A commonly used categorization based on clinicopathological criteria was created by Lopetz et al. in 1974. They classified meningiomas of the skin into three categories:[7]

1. Congenital type, these grow from ectopic arachnoid caught in the dermis and subcutaneous tissue, and they appear on the scalp and paravertebral region from birth. These might be primitive meningoceles that have broken off from the central nervous system. Usually, type I cutaneous meningioma only affects the subcutaneous tissue.[7][10]
2. Ectopic soft tissue meningioma around the eyes, ears, nose, and mouth that spreads to the skin by contiguity. There are no known related meningiomas of neuraxis.[7][10]
3. Adult cases of neuroaxis-related meningioma tumors that spread to the dermis and subcutaneous tissue are significantly more common. They could result from trauma, any other surgical cause, or a bone deformity.[7][10]

## Treatment

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Complete surgical excision is the basis of treatment.[11]

## See also

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* Meningioma
* List of cutaneous conditions

## References

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1. ^ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 978-1-4160-2999-1.
2. ^ James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. ISBN 0-7216-2921-0.
3. ^ a b c Miedema, Jayson R.; Zedek, Daniel (2012-02-01). "Cutaneous Meningioma". Archives of Pathology & Laboratory Medicine. 136 (2). Archives of Pathology and Laboratory Medicine: 208–211\. doi:10.5858/arpa.2010-0505-rs. ISSN 0003-9985. PMID 22288971.
4. ^ Brantsch, K. D.; Metzler, G.; Maennlin, S.; Breuninger, H. (2009). "A meningioma of the scalp that might have developed from a rudimentary meningocele". Clinical and Experimental Dermatology. 34 (8). Oxford University Press (OUP): e792 – e794. doi:10.1111/j.1365-2230.2009.03519.x. ISSN 0307-6938. PMID 19817762.
5. ^ Miyamoto, Toru; Mihara, Motoyuki; Hagari, Yoshitaka; Shimao, Shuhei (1995). "Primary Cutaneous Meningioma on the Scalp: Report of Two Siblings". The Journal of Dermatology. 22 (8). Wiley: 611–619\. doi:10.1111/j.1346-8138.1995.tb03884.x. ISSN 0385-2407. PMID 7560462.
6. ^ Peñas, Pablo F. (1995-06-01). "Cutaneous Heterotopic Meningeal Nodules". Archives of Dermatology. 131 (6). American Medical Association (AMA): 731. doi:10.1001/archderm.1995.01690180111022. ISSN 0003-987X. PMID 7778931.
7. ^ a b c d e DA, Lopez; DN, Silvers; EB, Helwig (1974). "Cutaneous meningiomas--a clinicopathologic study". Cancer. 34 (3): 728–744\. doi:10.1002/1097-0142(197409)34:3<728::aid-cncr2820340332>3.0.co;2-u. ISSN 0008-543X. PMID 4851231.
8. ^ a b Ragoowansi, Raj; Thomas, Valerie; Powell, Barry (1998). "Cutaneous meningioma of the scalp: a case report and review of literature". British Journal of Plastic Surgery. 51 (5). Elsevier BV: 402–404\. doi:10.1054/bjps.1997.0204. ISSN 0007-1226. PMID 9771369.
9. ^ Ramos, Leonor; Coutinho, Ines; Cardoso, José Carlos; Garcia, Helena; Cordeiro, Margarida Robalo (2015). "Frontal cutaneous meningioma — Case report". Anais Brasileiros de Dermatologia. 90 (3 suppl 1). FapUNIFESP (SciELO): 130–133\. doi:10.1590/abd1806-4841.20153798. ISSN 0365-0596. PMC 4540529. PMID 26312695.
10. ^ a b c Kishore, Manjari; Kaushal, Manju; Bhardwaj, Minakshi; Sharma, Neha (2017). "Cutaneous meningioma: A cytomorphological diagnosis". Indian Dermatology Online Journal. 8 (3). Medknow: 201–204\. doi:10.4103/idoj.idoj_169_16. ISSN 2229-5178. PMC 5447342. PMID 28584759.
11. ^ Ouazzani, A.; de Fontaine, S.; Berthe, J.-V. (2007). "Extracranial meningioma and pregnancy: a rare diagnosis". Journal of Plastic, Reconstructive & Aesthetic Surgery. 60 (6). Elsevier BV: 622–625\. doi:10.1016/j.bjps.2006.01.054. ISSN 1748-6815. PMID 17485048.

## Further reading

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* Ojha, BK; Chandra, A; Rastogi, M; Husain, M; Husain, N; Singh, SunilK (2008). "Scalp meningioma". Indian Journal of Dermatology. 53 (4). Medknow: 196–198\. doi:10.4103/0019-5154.44799. ISSN 0019-5154. PMC 2763757. PMID 19882035.
* Waghmare, SwagatS; Chaturvedi, Kirti; Kachhawa, Dilip; Garg, Sunil (2016). "Cutaneous meningioma". Indian Journal of Dermatology, Venereology and Leprology. 82 (2). Medknow: 200–202\. doi:10.4103/0378-6323.173592. ISSN 0378-6323. PMID 26765130.

## External links

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Classification|

* ICD-11: 2A01.0Y
* SNOMED CT: 404021008

|

External resources|

* Scholia: Q5196703

* v
* t
* e

Skin cancer of the dermis

Dermis|

* Benign fibrous histiocytoma/dermatofibrosarcoma protuberans
* Dermatofibrosarcoma protuberans

Subcutaneous
tumors|

| Connective and
vascular|

* see Template:Soft tissue tumors and sarcomas, Template:Vascular tumors, Template:Myeloid malignancy (for mastocytosis)

|

Other|

| Urogenital|

* Hirsuties coronae glandis

|

Neuro|

* Solitary neurofibroma
* Cutaneous meningioma
* Ganglioneuroma
* Schwannoma
* Palisaded encapsulated neuroma
* Infantile neuroblastoma
* Cutaneous neurofibroma

Bone/cartilage|

* Chordoma
* Extraskeletal chondroma

Nevus|

* Nevus anemicus
* Nevus flammeus
* Nevus flammeus nuchae
* Nevus lipomatosus superficialis
* Nevus oligemicus
* Connective tissue nevus
* Midline nevus flammeus
* Porokeratotic eccrine ostial and dermal duct nevus

Histiocytoma|

* Pleomorphic undifferentiated sarcoma
* Plexiform fibrohistiocytic tumor
* Progressive nodular histiocytoma

* Teratoma
* Adenoma sebaceum
* Metastatic carcinoma
* Giant-cell tumor of the tendon sheath
* Glomus tumor
* Granular cell tumor
* Carcinoid
* Desmoid tumor
* Neurothekeoma
* Angiokeratoma
* Zosteriform metastasis
* Keratinizing metaplasia
* Epithelioid sarcoma

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