gms | German Medical Science

Objective: Meningiomas represent about 20–30% of all primitive encephalic tumours. Meningiomas are benign tumours derived from the arachnoid villous structures of the meninges and are common in the central nervous system. Extracranial meningiomas are very rare in comparison to axial lesions, and the incidence of extracranial-extra-axial meningiomas ranges from 1% to 2% of all meningiomas. We report subcutaneous extracranial meningioma mimicking a lipoma in the scalp.

Method: A 35-year-old female presented with a subcutaneous mass of the left parietal scalp. The mass was present for 1 year but grew slowly. The patient had suffered head trauma 2 years ago and had no particular medical history. On examination, the mass was located on the left parietal side of the scalp. It was firm, elastic and immobile. Bone and intracranial invasion were excluded by CT scan and MRI. The tumour was removed under local anaesthesia. Macroscopically the tumour was 40mm x 25mm x 15mm large, yellowish-white, homogeneous and adherent. Total excision was made. The diagnosis of meningioma was confirmed by pathology.

Results: The tumor was successfully treated with surgery. Control CT scan demonstrated no residual tumor after the operation.

Conclusions: The scalp has many lesions, many diseases should be considered in the differential diagnosis. Particularly, lipoma, trichilemmal cyst, or tumor, squamous cell carcinoma, basal cell carcinoma, Merkel cell carcinoma, melanoma and olfactory neuroblastoma, angiofibroma, paraganglioma, aggressive psammomatoid-ossifying fibroma and cutaneous metastasis of carcinomas may present as a mass on the scalp. The treatment of extracranial meningiomas is total excision of the lesion. If you suspect preoperatively, you should use CT or MRI scan to exclude intracranial pathology. Extracranial meningioma should be considered in the differential diagnosis of subcutaneous masses in the scalp.