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Clinical Vignette: Intraosseous Meningioma—A Mimicry of Paget's Disease?

Jayaraj, Kandaswamy ; Martinez, Salutario ; Freeman, Alan ; Lyles, Kenneth W.

Journal of bone and mineral research, 2001-06, Vol.16 (6), p.1154-1156 [Periódico revisado por pares]

Washington, DC: John Wiley and Sons and The American Society for Bone and Mineral Research (ASBMR)

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  • Título:
    Clinical Vignette: Intraosseous Meningioma—A Mimicry of Paget's Disease?
  • Autor: Jayaraj, Kandaswamy ; Martinez, Salutario ; Freeman, Alan ; Lyles, Kenneth W.
  • Assuntos: Intraosseous meningioma
  • É parte de: Journal of bone and mineral research, 2001-06, Vol.16 (6), p.1154-1156
  • Notas: ObjectType-Article-2
    SourceType-Scholarly Journals-1
    ObjectType-Feature-1
    content type line 23
  • Descrição: We evaluated a healthy male 59-year-old business executive for a swelling on the left side of the head. In 1991, he noticed some ill-defined sensations on the left side of his head. After a clinical examination and skull X-ray, the executive was diagnosed with Paget's disease of the bone involving the skull. At that time, his alkaline phosphatase (ALP) was 80 IU/liter. He was examined periodically without any treatment. The patient continued to see an enlargement of the left side of his head and decided to have a reevaluation in 1993. At this time, his skull X-ray was read as normal and the computed tomography (CT) scan showed sclerosis in the frontoparietal region with involvement of both the tables and the diploe, which was felt to be consistent with Paget's disease. His ALP was 100 IU/liter in 1993, 118 IU/liter in 1994, and 95 IU/liter in 1995. He moved to Pinehurst, NC in 1995 where he used etidronate for 6 months. His postdidronel treatment ALP read as 80 IU/liter. In 1996, the patient had a bone scan that revealed increased uptake only in the skull, which was thought to be monostotic Paget's disease of the skull. The patient began using alendronate at the time and his ALP went down to 61 IU/liter in 1997. During this time the swelling on his head continued to grow, and he came to us in June 1998 for evaluation. On examination, the frontoparietal region appeared to be the size of a grapefruit that felt smooth and bony hard and lacked warmth or tenderness. He suffered a mild bilateral hearing loss and no other bony involvement with any focal neurological signs. Several bone radiologists examined a series of skull X-ray films from 1993, 1996, and 1998. The radiologists felt that it was a focal lesion rather than a diffuse process based on the typical appearance of the lesion on the skull X-ray. A repeat CT scan showed that the lesion was consistent with intraosseous meningioma. The patient underwent a frozen section biopsy, which confirmed the CT findings. The defect was repaired by a wide excision and did well for the year after the operation.
  • Editor: Washington, DC: John Wiley and Sons and The American Society for Bone and Mineral Research (ASBMR)
  • Idioma: Inglês
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  • Realização: ABCD-USP USP   Logos de Redes Sociais: Freepik

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