Mandible / maxilla
Benign tumors / tumorlike conditions
Meningioma

Author: Anthony Martinez, M.D. (see Authors page)
Editor: Kelly Magliocca D.D.S., M.P.H.

Revised: 20 October 2017, last major update September 2017

Copyright: (c) 2002-2017, PathologyOutlines.com, Inc.

PubMed Search: Mandible meningioma

Cite this page: Martinez, A. Meningioma. PathologyOutlines.com website. http://pathologyoutlines.com/topic/mandiblemaxillameningioma.html. Accessed December 13th, 2017.
Definition / general
  • Benign neoplasm of meningothelial (arachnoid) cells
  • Meningiomas involving the mandible / maxilla are extremely rare
  • See meningioma for full CNS WHO grading criteria
Essential features
  • Benign neoplasm of meningothelial (arachnoid) cells
  • Primary extracranial menigiomas are rare and only account for 2% of all meningiomas
Terminology
  • Meningioma
  • Extracranial meningioma
  • Ectopic meningioma
  • Extradural meningioma
  • Extracalvarial meningioma
Epidemiology
  • Rare, around 15 cases of primary extracranial meningiomas of the jaw in the literature
  • Slightly more common in women
    • 1:1.2 ratio of W:M
  • Mean age of patients is 43 years
    • Women tend to present at an older age (49 years) than men (37 years)
Sites
  • More common in the mandible than maxilla
Etiology
  • Extracranial meningiomas are thought to arise by two main mechanisms:
    • Primary extracranial meningiomas from displaced embryonic rests of arachnoid cells or from multipotential mesenchymal cells
    • Secondary extracranial meningiomas from direct extension of an intracranial mass
Clinical features
  • Can present as swelling or fullness
  • May also present incidentally without symptoms
Diagnosis
  • Diagnosis dependent on clinical, radiologic and pathologic correlation
Radiology description
  • On plain films and CT can present as a lytic lesion with or without cortical destruction
Radiology images

Images hosted on other servers:

Lesions of the left mandible

Axial CT image

MR imaging showing lesion with low signal intensity

Various images

Prognostic factors
Case reports
Treatment
  • Surgical excision
Microscopic (histologic) description
  • Round to spindled, uniform nuclei with syncytial cytoplasm often arranged in whorls or fascicles
  • Intranuclear psuedoinclusions often present
  • Can have psammomatous calcifications (psammoma bodies)
Microscopic (histologic) images

Images hosted on other servers:

H&E magnification ×90

H&E magnification ×200

Ectopic meningioma of the mandible

Various images

Positive stains
  • EMA
  • PR
  • Somatostatin receptor 2A
Negative stains
Molecular / cytogenetics description
  • Mutations or deletions of NF2 gene are seen in sporadic meningiomas and are associated with monosomy 22
Differential diagnosis
Board review question #1
What cytogenetic abnormality is associated with meningioma?

  1. Del 5p
  2. Monosomy 21
  3. Monosomy 22
  4. Trisomy 21
Board review answer #1
C. Monosomy 22

  1. Del 5p is for cri du chat.
  2. Monosomy 21 is very rare, and full monosomy 21 is probably not compatible with life
  1. Trisomy 21 is for Down syndrome