Mi^iV M&idLsL

epithelial neoplasms {814,873,1109, 1781,2019,2221,2599}. They should be distinguished from intracranial menin-giomas with extracranial/extraspinal extension into the sinonasal tract {721, 814,2599}. Any age can be affected, and there is a slight female predilection. Men tend to be younger than women by about a decade.


Sinonasal tract meningiomas involve both the nasal cavity and paranasal sinuses more frequently than either location alone. Most tumours are left-sided {814,873,1109,1781,2019,2221,2599}.

Clinical features

Symptoms include a mass (often polypoid), nasal obstruction, epistaxis, sinusitis, pain, headache, seizure, exophthalmos, periorbital edema, visual disturbance, ptosis, and facial deformity {814,873,1109,1781,2019,2221,2599}. Symptoms are present for an average of 4 years.


The tumours range up to 8 cm, with a mean of about 3 cm. They may infiltrate bone and rarely ulcerate the mucosa. The cut surface is grey-white, tan or pink, gritty, firm to rubbery. Calcifications and fragments of bone are frequently visible.

Tumour spread and staging

Primary extra-cranial meningiomas have not been reported to metastasize {814, 873,2019,2599}.


Sinonasal meningiomas can exhibit a variety of histological patterns, most commonly meningotheliomatous, characterized by lobules of cells with whorl formation, indistinct cell borders, and bland nuclei with delicate chromatin {1329,2599}. Intranuclear pseudoinclusions and psammoma bodies are common. Other variants can also occur in the sinonasal tract, such as transitional, metaplastic (lipidized cells within tumour), and psammomatous type {1329}.


Meningiomas are immunoreactive for epithelial membrane antigen and vimentin, but usually negative for cytok-eratin, although rare lesions can exhibit focal and weak cytokeratin immunoreac-tivity. They are frequently positive for progesterone receptor (50%) and occasionally for oestrogen receptor (25%). Glial fibrillary acidic protein and smooth muscle actin are negative.

Differential diagnosis

The differential diagnoses include carcinoma, melanoma, aggressive psammo-matoid ossifying fibroma and follicular dendritic cell sarcoma/tumour {2599, 2771}.


Meningiomas are derived from arachnoid cap cells located extra-cranially within the sheaths of nerves or vessels.

Prognosis and predictive factors

Complete surgical extirpation is sometimes difficult, and accounts for the up to 30% recurrence rate {1109,2019,2599}. The rare deaths are related to compromise of mid-facial structures or complications of surgery, rather than the aggressive nature of the tumour. Histologic features (such as hypercellu-larity, nuclear pleomorphism, necrosis), proliferation index and progesterone receptor status do not influence prognosis {1138,1139,1426,1666,2599}.

Was this article helpful?

0 0
Naturally Cure Your Headaches

Naturally Cure Your Headaches

Are Headaches Taking Your Life Hostage and Preventing You From Living to Your Fullest Potential? Are you tired of being given the run around by doctors who tell you that your headaches or migraines are psychological or that they have no cause that can be treated? Are you sick of calling in sick because you woke up with a headache so bad that you can barely think or see straight?

Get My Free Ebook

Post a comment