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Neural Tumours

Heterotopic Meningeal Lesions:

Pathology of Ectopic Meningothelial Hamartoma and Cutaneous Meningioma

Dr Sampurna Roy MD          

 

                                                                                                                      

 

 

Classification of Cutaneous Meningeal Lesion:

 

1.  Ectopic Meningothelial Hamartoma :

Site: Scalp (occipital region) and spinal cord.

Clinical presentation: Congenital lesion.

Presents as cutaneous lump in children. No true defect of skull or spinal column is present.
 

Microscopic features:

Lesion is characterized by narrow ectatic pseudovascular spaces lined by epithelioid meningothelial cells present in the dermis and subcutis.

Immunohistochemically, these cells were negative for factor VIII-related antigen and Ulex europaeus lectin but were strongly positive with vimentin and epithelial membrane antigen antibodies, this latter being in keeping with the immunohistochemical profile of meningothelial cells.

Abnormally dense collagen is present in the backround.

Irregular strands and clusters of meningothelial cells and variable numbers of psammoma bodies may be present in the collagenous stroma.

Scattered multinucleate cells may be present.
     

2. Cutaneous Meningioma :

Site: Around sensory organs of the head.

Example: Paranasal, orbital and aural.

Clinical presentation: Presents as a discrete nodule in adults.

Microscopic features:

The tumour is well circumscribed and more cellular.

It is composed of meningothelial cells together with spindle cell areas.

Psammoma bodies and meningeal whorls may be present.

3. Type III lesion :

This lesion represents direct extension or distant metastasis of central nervous system meningioma.

The tumour spreads into the skin and subcutaneous tissue usually at the site of previous surgery.

Immunohistochemistry: S100 protein, EMA and Vimentin are positive.

 

Further reading:

The pathology of extracranial scalp and skull masses in young children.

Primary ectopic meningioma.

Primary Intraorbital Ectopic Meningioma

Primary ectopic meningioma of the maxillary sinus

Primary meningioma of the nasopharynx

Primary calvarial ectopic meningiomas

Primary Intraorbital Ectopic Meningioma

Primary ectopic meningioma of the neck: MR features.

Type 1- primary cutaneous meningioma of the scalp.

Meningeal hamartoma of the scalp. A variant of primary cutaneous meningioma.

Hamartoma of the scalp with ectopic meningothelial elements. A distinctive benign soft tissue lesion that may simulate angiosarcoma.

 

 

 

Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)


 

 

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