Primary cutaneous meningioma of the scalp: a case report and review of literature.

Meningiomas of the skin are rare tumors that can pose considerable diagnostic challenges to the pathologist. This study presents a case of primary cutaneous meningioma in a newly born baby girl that presents with a subcutaneous nodule on the left posterior occipital scalp. A Magnetic Resonance Imaging examination failed to detect any communication between the tumor site and the meninges. The mass was excised and intra -operatively, there was no evidence of connection between the tumor and the underlying tissues. Microscopically, the tumor was composed of banal looking, mitotically inactive spindle-shaped cells with a whorled configuration. Some cells were concentrically arranged around blood vessels. Immunohistochemical studies were positive for epithelial membrane antigen and vimentin. Immunostains for cytokeratin, S-100 protein, vascular (CD34 and CD31) and muscle markers (Desmin and smooth muscle actin) were negative. The diagnosis of cutaneous meningioma was established. A review of literature was presented.

Type 1-primary cutaneous meningioma of the scalp.

Type 1-primary cutaneous meningioma is a rare and often clinically unsuspected lesion of the scalp, forehead or paravertebral region which occurs at birth or during childhood. The pathogenesis of these lesions still remains uncertain. Several authors have emphasized that type 1-cutaneous meningiomas are not real tumors but sequestrated meningoceles or heterotopic meningeal nodules of the skin. Nevertheless, the search for an intracranial or intravertebral connection should be carried out. We describe the clinical and pathological features of a congenital type 1-meningioma of the vertex. No cranial defect or intracranial tumor was found. However, the cutaneous lesion was directly linked to a large cranial vein. The purpose of this study was to illustrate this rare lesion and to indicate the possible surgical risks and the pathological characteristics.

[A case of congenital brain tumor diagnosed during follow-up of neonatal intracranial hemorrhage].

We describe a three-year-old girl whose growing congenital brain tumor may have been responsible for her perinatal intracranial hemorrhage. The patient, born after an uneventful pregnancy and delivery, had an intracranial hemorrhage in the right frontal area, including the basal ganglia, as a newborn. Her only symptoms at that time were vomiting and fever. She improved both, clinically and neuroradiologically during the following weeks, and except for mild left hemiparesis, the patient developed with no other apparent neurological deficits. However, a follow-up brain CT scan at 3 years of age, disclosed a heterogeneous tumor with a 5 cm diameter in the same right frontal area as the neonatal hemorrhage. The tumor was surgically removed, and diagnosed as a benign mixed tumor composed of differentiated astrocytoma and meningioma elements. It is conceivable that the brain tumor may have been growing rather slowly since an early fetal stage. This case indicates the need of being aware that neonatal intracranial hemorrhages may be caused by bleeding of congenital brain tumors.

Congenital extracranial meningioma.

The authors report a case of congenital meningioma in a newborn. This tumour is extremely rare and only six cases have been reported in the literature. Those reported cases were mainly intracranial. This is the first case of a neonatal extracranial meningioma that was evaluated preoperatively by computed tomography and magnetic resonance imaging.

Meningiomatosis cranii in childhood: a case report.

Tumors of the meninges in infancy and childhood are unusual; childhood meningiomatosis is thought to be more common in neurocutaneous diseases. The case presented here is one of multiple recurrent and de novo benign meningeal tumors in a child who has no other signs or symptoms of a neurocutaneous syndrome.

Congenital brain tumors.

The most common brain tumor that was present or produced symptoms at birth was teratoma. In this series of congenital tumors, teratomas occurred over 5 times more frequently than the second most common type, astrocytoma. They were often immature because of primitive neural elements and, rarely, a component of mixed malignant germ cell tumors. Incidence between sexes was nearly identical among histologic types that were reported at least 10 times, except for choroid plexus papilloma, which exhibited a male predominance. Four of five meningiomas occurred in males and 4 of 5 sarcomas in females. The predilection of neonatal brain tumors for supratentorial locations was also observed in this series of tumors present at birth. Teratomas occurred above the tentorium almost exclusively and all craniopharyngiomas and 14 of 16 choroid plexus tumors occurred supratentorially. At birth, large head or tense fontanel was a presenting sign in at least 55% of patients. Neurologic symptoms as initial symptoms were comparatively rare. Teratomas and craniopharyngiomas are tumors believed to arise because of developmental defects and these were the tumors that most often occurred with other anomalies. Anomalies were usually located in the head, with cleft lip or palate being most frequent. Prognosis for patients with brain tumors at birth was very poor, usually because of the massive size of the tumor. However, if small and favorably located, tumors were resected successfully. The most favorable outcomes were with choroid plexus tumors where aggressive treatment led to disease-free survival.

Meningioma in a neonate: case report.

A 10-day-old female with a parasagittal meningioma presenting as a subcutaneous tumor is reported. Meningiomas within the 1st month of life are rare. The clinical and pathological characteristics of congenital meningioma are reviewed.

Giant congenital meningioma in a newborn.

The authors report the case of a giant meningioma in a 5-day-old newborn. Congenital meningiomas are extremely rare. Five newborns with meningiomas have been reported in the literature to date. This is the first case of a newborn with a giant meningioma with supra- and infratentorial and intraorbital components.

Sex hormone receptors in a congenital meningioma.

The authors report a case of a congenital meningioma in a male infant in whom receptor binding sites for progesterone were significantly elevated.

Meningiomas in a male fetus from a hormonally dysequilibrated mother.

Congenital multiple meningiomas in a male fetus of 37 cm length are reported. The tumor was histologically a highly vascular meningioma. An unbalanced level of hormones before and at the beginning of the mother's pregnancy could be ascertained, which resulted in gestational abnormality.

Congenital meningeal sarcoma--a case report.

A 30-year-old multigravida woman was admitted to the obstetrical unit in the third trimester of gestation, because of a large-for-date uterus. Repeated ultrasonic examinations over a 2-week period revealed an increase in biparietal diameter far too large to be normal. This progressive asymmetrical hydrocephalus was diagnosed as caused by an intracranial space-occupying lesion in the middle cranial fossa. Because of the only minimal thickness of the cerebral cortex prognosis was judged so poor, that labor was induced. A stillborn female infant was delivered vaginally after an ultrasonically guided transabdominal and later transcervical encephalocentesis. Autopsy revealed hydrocephalus and section through the fixed brain showed that the mentioned mass was an undifferentiated meningeal sarcoma that filled the left middle cranial fossa. Microscopically the sarcoma was invading the brain tissue. Definitions of the term "congenital brain-tumors" vary among authors. "Congenital" can be interpreted as "derived from embryonal tissue" or as "originating in utero". Congenital intracranial neoplasms are very rare. Antenatally intracranial tumors have been reviewed by Wells, Solitare and Farwell. Only a few cases of congenital brain tumors arising in the meninges have been reported in these reviews. The genesis of the tumor is explained as derived from multipotential cells. The undifferentiated type of a meningeal sarcoma has a poor prognosis. Most meningeal sarcoma present with progressive hydrocephalus.(ABSTRACT TRUNCATED AT 250 WORDS)

Congenital meningioma.

The clinical, operative and autopsy findings associated with a huge meningioma in an 8-month-old boy are described. Especially noteworthy are the patient's age, the size of the tumour and the poorness of neurological symptoms.