Primary Extracranial Meningiomas of the Head and Neck
Giuseppe Emmanuele Umana,
Gianluca Scalia,
Atul Vats,
Gianluca Pompili,
Fabio Barone,
Maurizio Passanisi,
Francesca Graziano,
Rosario Maugeri,
Maria Grazia Tranchina,
Sebastiano Cosentino,
Massimo Ippolito,
Santino Ottavio Tomasi,
Giuseppe Raudino,
Bipin Chaurasia,
Domenico Gerardo Iacopino,
Giovanni Federico Nicoletti,
Salvatore Cicero,
Lidia Strigari,
Rosario Emanuele Perrotta
Affiliations
Giuseppe Emmanuele Umana
Trauma Center, Gamma Knife Center, Department of Neurosurgery, Cannizzaro Hospital, 95125 Catania, Italy
Gianluca Scalia
Department of Neurosurgery, Highly Specialized Hospital and of National Importance “Garibaldi”, 95125 Catania, Italy
Atul Vats
Neurosurgery Department, James Cook University Hospital, Middlesbrough TS1, UK
Gianluca Pompili
Department of General Surgery and Medical and Surgery Specialities, Section of Plastic Surgery, University of Catania—“Cannizzaro” Hospital, 95125 Catania, Italy
Fabio Barone
Trauma Center, Gamma Knife Center, Department of Neurosurgery, Cannizzaro Hospital, 95125 Catania, Italy
Maurizio Passanisi
Trauma Center, Gamma Knife Center, Department of Neurosurgery, Cannizzaro Hospital, 95125 Catania, Italy
Francesca Graziano
Department of Neurosurgery, Highly Specialized Hospital and of National Importance “Garibaldi”, 95125 Catania, Italy
Rosario Maugeri
Neurosurgical Clinic, AOUP “Paolo Giaccone”, Postgraduate Residency Program in Neurological Surgery, Department of Experimental Biomedicine and Clinical Neurosciences, School of Medicine, 90128 Palermo, Italy
Maria Grazia Tranchina
Department of Pathological Anatomy, Cannizzaro Hospital, 95125 Catania, Italy
Sebastiano Cosentino
Trauma Center, Gamma Knife Center, Nuclear Medicine Unit, Department of Advanced Technologies, Cannizzaro Hospital, 95125 Catania, Italy
Massimo Ippolito
Trauma Center, Gamma Knife Center, Nuclear Medicine Unit, Department of Advanced Technologies, Cannizzaro Hospital, 95125 Catania, Italy
Santino Ottavio Tomasi
Department of Neurological Surgery, Christian Doppler Klinik Paracelsus Medical University, 5020 Salzburg, Austria
Giuseppe Raudino
Center Humanitas ICC, Misterbianco, Ortho-Neuro, 95125 Catania, Italy
Bipin Chaurasia
Department of Neurosurgery, Neurosurgery Clinic, Birgunj 44300, Nepal
Domenico Gerardo Iacopino
Neurosurgical Clinic, AOUP “Paolo Giaccone”, Postgraduate Residency Program in Neurological Surgery, Department of Experimental Biomedicine and Clinical Neurosciences, School of Medicine, 90128 Palermo, Italy
Giovanni Federico Nicoletti
Department of Neurosurgery, Highly Specialized Hospital and of National Importance “Garibaldi”, 95125 Catania, Italy
Salvatore Cicero
Trauma Center, Gamma Knife Center, Department of Neurosurgery, Cannizzaro Hospital, 95125 Catania, Italy
Lidia Strigari
Department of Medical Physics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40122 Bologna, Italy
Rosario Emanuele Perrotta
Department of General Surgery and Medical and Surgery Specialities, Section of Plastic Surgery, University of Catania—“Cannizzaro” Hospital, 95125 Catania, Italy
Meningiomas represent the most common benign histological tumor of the central nervous system. Usually, meningiomas are intracranial, showing a typical dural tail sign on brain MRI with Gadolinium, but occasionally they can infiltrate the skull or be sited extracranially. We present a systematic review of the literature on extracranial meningiomas of the head and neck, along with an emblematic case of primary extracranial meningioma (PEM), which provides further insights into PEM management. A literature search according to the PRISMA statement was conducted from 1979 to June 2021 using PubMed, Web of Science, Google Scholar, and Scopus databases, searching for relevant Mesh terms (primary extracranial meningioma) AND (head OR neck). Data for all patients were recorded when available, including age, sex, localization, histological grading, treatment, possible recurrence, and outcome. A total of 83 published studies were identified through PubMed, Google Scholar, and Scopus databases, together with additional references list searches from 1979 to date. A total of 49 papers were excluded, and 34 manuscripts were considered for this systematic review, including 213 patients. We also reported a case of a 45-year-old male with an extracranial neck psammomatous meningioma with sizes of 4 cm × 3 cm × 2 cm. Furthermore, whole-body 68Ga-DOTATOC PET/CT was performed, excluding tumor spread to other areas. Surgical resection of the tumor was accomplished, as well as skin flap reconstruction, obtaining radical removal and satisfying wound healing. PEMs could suggest an infiltrative and aggressive behavior, which has never found a histopathological correlation with a malignancy (low Ki-67, 68Ga-DOTATOC PET/CT should be considered in the patient’s global assessment. Surgical removal is a resolutive treatment, and the examination of frozen sections can confirm the benignity of the lesion, reducing the extension of the removal of healthy tissue surrounding the tumor.
