Rare case of dual lesion: intraosseous microcystic meningioma – case report and review of literature
- 1Department of Radiology, Zhejiang University School of Medicine First Affiliated Hospital, 79 Qingchun Road, Hangzhou, 310003 Zhejiang China
- 2Department of Pathology, Zhejiang University School of Medicine First Affiliated Hospital, 79 Qingchun Road, Hangzhou, 310003 Zhejiang China
Abstract
Introduction/background: Intraosseous microcystic meningioma is an exceptionally rare clinical entity, representing a diagnostic challenge due to its atypical osteolytic presentation and specific histological features. This case is unique because it occurs in a 43-year-old patient—younger than the reported median age—and highlights specific MRI "shine-through" effects that can assist in preoperative differentiation from aggressive bone malignancies.
Case presentation: A 43-year-old woman presented with a six-month history of intermittent parietal pain. Imaging revealed a 1.9 × 0.9 cm osteolytic defect in the right frontal bone with internal septations. MRI showed T2-hyperintensity and heterogeneous enhancement, but no restricted diffusion on ADC maps. The patient underwent gross total resection with dural repair and titanium mesh reconstruction. Histopathology confirmed a WHO Grade I microcystic meningioma, positive for EMA, SSTR2, and D2-40.
Conclusion: The main "take-away" is that intraosseous microcystic meningioma should be considered in the differential diagnosis of solitary osteolytic skull lesions. Multi-parametric MRI, specifically the absence of restricted diffusion despite high DWI signal (T2 shine-through), is a key indicator of this benign, fluid-rich subtype.
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BibTeX
@article{teng2026rare,
title = {{Rare case of dual lesion: intraosseous microcystic meningioma – case report and review of literature}},
author = {Haijuan Teng and Xuejie Li and Xiaoxia Zhang},
journal = {Journal of Medical Case Reports},
year = {2026},
month = aug,
doi = {10.1186/s13256-026-06354-8},
url = {https://doi.org/10.1186/s13256-026-06354-8},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Rare case of dual lesion: intraosseous microcystic meningioma – case report and review of literature
AU - Haijuan Teng
AU - Xuejie Li
AU - Xiaoxia Zhang
PY - 2026
DA - 2026/08/06
JO - Journal of Medical Case Reports
DO - 10.1186/s13256-026-06354-8
UR - https://doi.org/10.1186/s13256-026-06354-8
AB - Introduction/background: Intraosseous microcystic meningioma is an exceptionally rare clinical entity, representing a diagnostic challenge due to its atypical osteolytic presentation and specific histological features. This case is unique because it occurs in a 43-year-old patient—younger than the reported median age—and highlights specific MRI "shine-through" effects that can assist in preoperative differentiation from aggressive bone malignancies. Case presentation: A 43-year-old woman presented with a six-month history of intermittent parietal pain. Imaging revealed a 1.9 × 0.9 cm osteolytic defect in the right frontal bone with internal septations. MRI showed T2-hyperintensity and heterogeneous enhancement, but no restricted diffusion on ADC maps. The patient underwent gross total resection with dural repair and titanium mesh reconstruction. Histopathology confirmed a WHO Grade I microcystic meningioma, positive for EMA, SSTR2, and D2-40. Conclusion: The main "take-away" is that intraosseous microcystic meningioma should be considered in the differential diagnosis of solitary osteolytic skull lesions. Multi-parametric MRI, specifically the absence of restricted diffusion despite high DWI signal (T2 shine-through), is a key indicator of this benign, fluid-rich subtype.
SN - 1752-1947
ER -