This . Preoperatively, they may be differentiated from spinal metastases and lymphomas because of the presence of a "dural tail" sign and calcifications. The MRI sequences revealed a well-defined fusiform extraconal soft tissue mass of the superolateral aspect of the left orbit, adjacent to the greater sphenoid wing, isointense on T1WI, and FLAIR, and slightly hyperintense on T2WI with intense and homogeneous enhancement on postcontrast sequences.. Dural thickening with enhancement of the anterior aspect of the middle cranial fossa extending to . CT features of hyperostosing meningioma en plaque AJR Am J Roentgenol. PMID: 3118666 DOI: 10.2214/ajr.149.5.1017 Abstract Hyperostosis of the sphenoid ridge or convexity of the skull associated . ACR American College of Radiology; GI Gastrointestinal; PCR Polymerase Chain Reaction; BP Blood Pressure; HIV Human Immunodeficiency Virus; Patients with neurofibromatosis type 2 (NF-2) have a 50% chance of developing one or more meningiomas. Radiology showed a large osteosclerotic lesion in the right frontal bone. Radiology images. A, CT scan with infusion shows an enhancing meningiomatous plaque (arrow) along middle cranial fossa on left. Sporadic meningioma is usually considered as a benign tumor, accounting for approximately 20% of intracranial tumors and tends to affect middle-aged females. Conclusion: Extradural spinal lipomatous meningiomas (i.e., "en-plaque") are rare and typically result in rapid clinical deterioration. Prognostic factors. The prevalence of meningioma en plaque is reported to be 2-9% of all meningiomas [4]. It contacts the optic chiasm and posteriorly mildly thickens the prepontine dura and anterior right tentorium. Medicine Neurologia medico-chirurgica A 56-year-old man presented with a meningioma associated with hyperostotic bone containing little tumor cell infiltration. Associated enhancing dural tail is seen. As these tumours are indolent, there occurs a long interval between onset of symptoms and diagnosis. Meningiomas occur anywhere around the cerebral convexities, along the falx and tentorium, and on the skull base. The lesion measures about 9 X 9 X 3 cm in its maximal CC, AP and TS diameters . Visual disturbances, often more severe ion one eye but both are commonly involved. En-plaque-meningioma (EPM) is defined by its characteristic flat 'carpet-like' growth along the bony contour. Extraaxial neoplasms arise from the supporting tissues of the meninges (meningioma) and the nerves passing from central to peripheral (schwannoma). Plain radiographs may demonstrate hyperostosis, which may be present in up to 44% of patients. They are the most common type of primary extradural meningiomas 6. All Acronyms. Scribd is the world's largest social reading and publishing site. The radiological diagnosis may be difficult, while ultrasonography helps to define their extradural location facilitating planning for gross total anterior/posterior excision where indicated. What does MEP stand for? This lesion surely has the appearance of a meningioma: these tumors can be hypointense on T2 due to a fibrocollageneous matrix or calcifications and frequently produce reactive edema in the adjacent white matter of the brain. a axial t2-weighted mr image of a well-circumscribed meningioma indenting the cortex with a small cleft of csf. Methods: Eighteen patients with sphenoid wing en plaque meningiomas surgically treated between January 1998 and December 2008 were included. In some cases, the dura appears normal and the tumor is then considered to be a primary intraosseous meningioma. Those in the cervical spine are more likely to be located anteriorly compared to those in the thoracic spine 6 . Plain radiograph usually normal of the literature. Planum Sphenoidale Meningioma. Differential diagnosis includes fibrous dysplasia, osteoma, and osteoblastic metastasis. Search options. There were 9 en plaque meningiomas, 4 dumbbell-shaped meningiomas, and 1 fusiform/ovoid meningioma. Meningioma enplaque is a rare clinical-biological form of meningioma, characterized by carpet-like growth along the meninges, and invasion of dura along with underlying bone hyperostosis [4]. These are the two most common extraaxial and most common non-glial tumors. Meningiomas are most often located lateral to the spinal cord (60-70%) 11,12. . Conclusions What is an en plaque tumor? en plaque: extensive regions of dural thickening The cut surface reflects the various histologies encountered, ranging from very soft to extremely firm in fibrous or calcified tumors. MEP abbreviation stands for Meningioma En Plaque. There are a number of characteristic imaging features of meningiomas on magnetic resonance imaging (MRI) that allow an accurate diagnosis, however there are a number of atypical features that may be diagnostically challenging. Gustav K. von Schulthess. Acronym Meaning; How to Abbreviate; . EPM may also be associated with hyperostosis. 49:1325) 53 year old man presented with white-yellow papules and plaques over his elbows, knees and arms (QJM 2016 . Brain MRI also helps identify cystic lesions in meningiomas; a mushroom-like appearance reflects tumor invagination in the brain parenchyma. They are usually light tan in coloring, although again this will depend on histological subtypes. typical meningioma. Contributed by Renal cyst is a generic term commonly used in description of any predominantly cystic renal lesion.The majority of parenchymal cystic lesions represent benign epithelial cysts; however, malignancy such as renal cell carcinoma may also present as a cystic lesion 8.. Meningiomal involvement of the IAC occurs in two forms: meningioma truly originating in the IAC and meningioma extending into the IAC from an adjacent location. The epidural meningiomas extended over 2-5 spinal segments (mean, 3.2 spinal segments). A soft epidural mass was seen in 12/14 (86%) patients. There is infratemporal extension of soft-tissue tumor (arrowheads). En plaque meningiomas refer to a specific meningioma macroscopic appearance characterized by diffuse and extensive dural involvement, usually with extracranial extension into calvarium, orbit, and soft tissues. Meningiomas. EPM is three to six times more common in females than in males. Abstract and Figures. Keywords: Extradural; meningioma; spine Submitted May 03, 2017. It was described for the first time in 1927 by Pardee and Knox as a meningeal process in plaque without exudation [1] [2]. MRI secretory meningioma. [ 1] MRI more accurately evaluates en plaque and posterior fossa meningiomas, which may be missed on CT scanning. Extent of surgery and WHO grading (J Neurosurg 2015;122:4, Neuro Oncol 2016;18:863) Only 1.8-3.2% of all meningiomas are located at foramen magnum (FM). Histology showed an intraosseous lesion containing dense fibrous tissue in which there were scattered cells that expressed epithelial membrane antigen and progesterone receptor. 5.-Case 6. Conclusions: Spinal extradural "en-plaque" meningiomas have been mainly reported in women and at the cervical region, and show extension to many spinal levels as well as diffuse dural infiltration. Figure 22a: Axial contrast-enhanced T1-weighted MR images of meningioma. Evaluation The tumour was partially resected and 3 years after operation has not recurred. An extradural spinal meningioma, an extremely rare entity, is still a diagnostic dilemma on radiology as the radiologic findings overlap with many other common extradural spinal masses. These features differentiate it from the more common Meningioma En-masse [ 10, 18 ]. When chordomas metastasize (spread) to other parts of the body, or if they grow large and begin to press on critical parts of the brain, they can become life threatening.Even when chordomas have not spread, they can grow very large and damage nerves in the spine and brain, causing disability that may be permanent.The range of possible symptoms may include: pain in . Se han sugerido mltiples etiologas picos (31,3%) y un meningioma benigno (1,7%) se exten- para la formacin de quistes en meningiomas: rpido cre- dieron extracranealmente a travs del foramen oval o del cimiento, degeneracin qustica, secrecin directa de flui- foramen rotundum 29. do por clulas tumorales, necrosis isqumica y la . CT scanning, however, clearly depicts bony hyperostosis, which may be difficult to . En plaque meningiomas are often associated with the most florid bony hypertrophy, and can, as in this case, be associated with bony invasion. Accepted for publication Jul 18, 2017. doi: 10.21037/jss.2017.08.11 Total surgical resection is difficult and therefore these tumors have high recurrence rates. Multiple meningiomas are most often associated with NF2 6. Terminology Inferiorly, the tumor extends into Meckels cave almost completely filling it. Meningiomas are the most common non-glial tumour of the central nervous system (CNS). Contributed by Chunyu Cai, M.D., Ph.D. MRI benign meningioma. The tumor grows over the suprasellar region, displacing the posterior pituitary bright spot up and to the left. The patient presented with a growing mass on his right forehead and exophthalmos. A patient with en plaque meningioma can present with thoracic spinal cord and nerve root compression which usually follows an episode of meningitis, while the patient was receiving antitubercular chemotherapy. What is the abbreviation for Meningioma En Plaque? Although enlargement and involvement of the internal auditory canal (IAC) is a common sign of schwannomas of the CPA [ 2, 4 ], these features can also be seen in meningioma [ 5 ]. Molecular markers 1 Department of Diagnostic Radiology, Northwestern University Medical School, Chicago, IL. Meningioma en plaque represents a morphological subgroup within the meningiomas defined by a carpet or sheet-like lesion that infiltrates the dura and sometimes invades the bone. Juerg Hodler Rahel A. Kubik-Huch Gustav K. von Schulthess Editors. The term 'meningioma en plaque (MEP)' was coined by Cushing and Eisenhardt in 1938 to differentiate these uncommon sheet-like meningiomas from the more common globular variety, 'meningioma en masse'. Sporadic meningioma constitutes about 90% of benign meningioma while atypical and anaplastic type accounts for 5% and 3%, respectively. Discussion Meningioma en plaque (MEP) is a tumor of limited thickness that grows along the planes of the meninges and, in some Fig. Most meningiomas are solitary lesions (98%). This is a descriptive paper about the clinical presentation and radiological observations in a cohort of eight patients in whom a diagnosis of en-plaque tuberculoma was made based on the MRI brain and subsequently confirmed by Polymerase Chain Reaction (PCR) assay of Cerebrospinal Fluid (CSF) for Mycobacterium tuberculosis. c unenhanced ct illustrating the adjacent hyperostosis of the En plaque meningiomas represent 2-9% of all meningiomas and they are mainly located in the sphenoid wing. Is chordoma life threatening? . 2 article feature images from this case 14 public playlist include this case (a) Image demonstrates the lesion to have a broad-based component against the posterior petrous surface (arrowhead) and an en plaque component extending into the IAC and along the posterior surface of the mastoid (arrows). These tumors are thought to have a collar-like or sheet-like growth along the dura mater, different from the usual globular meningiomas. The lesion is associated with evident hyperostosis of the right temporo-fronto-parietal as well as the greater wing of sphenoid bones with transgression across that sclerotic bone into the subgalial and temporalis regions. MRI en plaque meningioma. En plaque Tuberculoma is a rare manifestation, with dural insertion, that appears as a solid mass that morphologically resembles a meningioma plaque or meningeal metastases [6] [7]. En-plaque meningiomas are well seen on CT scans and appear as a very prominent area of hyperostosis that often demonstrates no discernible soft component. Diseases of the Brain, Head and Neck, Spine 2020-2023 Diagnostic Imaging IDKD Springer Series Series Editors Juerg Hodler Department of Radiology University Hospital of Zrich Zurich, Switzerland Rahel A. Kubik-Huch . These tumors can invade the lateral wall of the cavernous sinus, superior orbital fissure, floor of the middle cranial fossa, and the extracranial infratemporal fossa. b coronal post-contrast t1-weighted image showing uniform enhancement, an enhancing-thickened dural tail and hyperostosis of the overlying calvarium. The IAC is not expanded. Computed tomography (CT) taken 4 years previously revealed only hyperostosis without intracranial lesion. 1987 Nov;149(5):1017-23. doi: 10.2214/ajr.149.5.1017. en plaque adjective Referring to a flattened lesion that is often whitish and has a fibrous consistency, which is located on an organ's surface; as in "en plaque meningioma", "en plaque mesothelioma", etc. En plaque meningiomas of the sphenoid wing, also called spheno-orbital meningiomas, present with such ocular manifestations. Meningiomas are a relatively common finding on brain imaging, with a prevalence of 53 per 100,000 people [].The World Health Organisation (WHO) classifies them based on their histological characteristics and recurrence risk as grade I, benign (80%), grade II, atypical (18%) and grade III, anaplastic/malignant (2%) [5, 6].Recurrence rates are between 7-25%, 29-52% and 50-94% . [3,15] MRI of spine is the investigation of choice and it will demonstrate the lesion as intradural extramedullary long segmental mass . Occur at the anterior cranial base overlying the cribiform plate of the ethmoid bone, frontosphenoid suture and planum sphenoidale. MRI is widely used as the imaging of choice for spinal disorders and may reveal either a clinically insignificant incidental abnormality or a significant lesion, unrelated to the spine, which may explain the patient's symptoms. Intraosseous meningioma, also referred to as primary intraosseous meningioma , is a rare subtype of meningioma that accounts for less than 1% of all osseous tumors. MRI atypical meningioma. They constitute 2-4 % of all intracranial meningiomas. Dural calcification was seen in 8/14 (57%) tumors. 4 case questions available Annotated images mri En-plaque tumour growth of meningiomas can be difficult to detect by radiological evaluation.
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