Sir,
We read with much great interest the article of Salunke et al.[1] Bone formation in meningiomas can be scattered, focal (eccentric or centrally). The latter is the case in our patient, a 50-year-old male who was referred for magnetic resonance imaging (MRI) from the temporal bone because of daily head pressure and tinnitus. MRI showed an incidental high-density lesion with central calcification and moderate perilesional edema at the right border of the lesion, most probably a planum sphenoidale meningioma [Figure 1].
Figure 1.
(a) Hyperintense (T2 - magnetic resonance imaging) lesion, with a diameter of 36 mm, with a hypointense center (T2 - magnetic resonance imaging), suggesting central calcification/ossification. (b) Dried pineapple slices resembling the meningioma pattern
Surgical resection revealed a lesion with central calcification/ossification, firmly attached to the olfactory nerves. Histopathology disclosed a meningothelial meningioma [Figure 2].
Figure 2.
Mainly meningothelial meningioma but the presence of psammoma bodies, bone spicules, and osteoblasts suggests the metaplastic bone formation in the tumor (H and E, ×10)
The lesion resembled a dry pineapple slice with crenelated central margin due to the central ossification in contrast with osteoblastic meningiomas with diffuse ossification with chicken-wire pattern or with eccentric ossification with turtle-shell pattern.[1,2]
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References
- 1.Salunke P, Aggarwal A, Futane S, Nada R, Gochhait D. Osteoblastic meningioma with turtle shell: Different entity from calcified meningioma. Asian J Neurosurg. 2016;11:450. doi: 10.4103/1793-5482.145151. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Huang J, Petersson F. Intracerebral metaplastic meningioma with prominent ossification and extensive calcification. Rare Tumors. 2011;3:e20. doi: 10.4081/rt.2011.e20. [DOI] [PMC free article] [PubMed] [Google Scholar]