gms | German Medical Science

64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. - 29. Mai 2013, Düsseldorf

A case of heterotopic brain tissue in the sphenoid ridge accompanied by a meningioma

Meeting Abstract

  • Ann-Katrin Bruns - Klinik für Neurochirurgie, Universitätsklinikum Münster
  • Malte Richters - Klinik für Neurochirurgie, Universitätsklinikum Münster
  • Astrid Jeibmann - Institut für Neuropathologie, Universitätsklinikum Münster
  • Markus Holling - Klinik für Neurochirurgie, Universitätsklinikum Münster
  • Walter Stummer - Klinik für Neurochirurgie, Universitätsklinikum Münster
  • Christian Ewelt - Klinik für Neurochirurgie, Universitätsklinikum Münster

Deutsche Gesellschaft für Neurochirurgie. 64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Düsseldorf, 26.-29.05.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. DocP 129

doi: 10.3205/13dgnc546, urn:nbn:de:0183-13dgnc5468

Veröffentlicht: 21. Mai 2013

© 2013 Bruns et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen ( Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.



Objective: Extracerebral neuroglial heterotopias are rare manifestations of cerebral tissue outside the brain. Their most common form is the so called nasal glioma. Further locations are the respiratory tract, soft tissue of the head and neck, the orbit and the middle ear. Some are associated with developmental anomalies as a split palate. As far as we know, heterotopic brain tissue within the bone of the skull hasn’t been described up to now.

Method: We present the case of a 58-year-old female suffering from an impaired vision of the right eye and a progressive protrusion of the eyeball. MRI showed a contrast-enhancing tumor of the right sphenoid ridge with dural thickening invading the sphenoid bone, suspicious of a meningioma. The tumor was resected via pterional craniotomy with decompression and reconstruction of the lateral orbit.

Results: The histopathological examination showed a meningothelial meningioma, WHO grade I, invading the sphenoid bone. It also showed a small amount of heterotopic brain tissue within the sphenoid bone, without any connection to neither the meningioma nor the normal brain tissue. The cerebral tissue was located within a medullary cavity, enclosing a fragment of bone. The astrocytes stained positive for GFAP, there were no malignant or atypical, but only reactive alterations of these cells. There were no signs for an artificial insertion.

Conclusions: Cerebral heterotopias, especially outside the midline, represent unusual conditions. Midline lesions, as the nasal glioma, are probably residuals of former encephaloceles, in fact, a connection to the brain can be revealed in quite a number of cases. The pathogenesis of extracranial non midline lesions, as in our case, is more questionable. They might as well be residuals of encephaloceles or a congenital bone defect. Or they base on a former trauma, inflammatory disease or surgery, although there is no hint for this in our special case. Another option is that they represent real neuroglial heterotopias, as it must be supposed for manifestations of the lung. The concomitant appearance of a heterotopia and a meningioma in this case are probably a coincidence, also it is debatable whether both, the broad tumor-extension within the bone and the heterotopia, might go back on alterations of the bone structure.