Abstract:

Extracranial meningiomas are rare tumors that occur in soft tissue or skin on the scalp and along the vertebral axis. The etiology of extracranial meningiomas is unknown, although four hypotheses have been postulated according to World Health Organization: (i) meningothelial cells carried along nerve sheaths as they exit the skull or vertebral column; (ii) ectopic arachnoidal cap cells; (iii) meningothelial cells displaced during trauma, and (iv) pluripotent mesenchymal cells capable of under going meningothelial differentiation or metaplasia. Extracranial meningiomas can be presented at all ages, with bimodal peaks occurring in the second decade of life and in the fifth to seventh decades. There is a slight female predominance. Located swelling in the neck for almost a year, 46-year-old female patient was made mass excision. Macroscopically the mass was 1 cm in greatest dimension, nodular in appearance, cross-sectional face-cream-white color and solid. In microscopic examination, tumor, composed of large oval-round nucleated cells and hyaline stroma were observed. Tumor surrounding thin fibrous pseudocapsule and a plurality of peripheral nerve sections were observed around it. In the stroma psammom body like calcifications were observed. Tumor cells were positive for vimentin, S100, progesterone receptor, cytokeratin and focally epithelial membrane antigen; and negative for glial fibrillary acidic protein, and actin. Based on these findings the patient was diagnosed as extracranial meningioma. Slow growing and with very good prognosis of these tumors, surgical excision is the treatment of choice and do not require further treatment. In the differential diagnosis of soft tissue tumors, extracranial meningiomas should always be considered. It can be skipped because it is rare, so we have found the value to present this case.

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