Ectopic Meningioma Masquerading as a Parotid Mass: A Diagnostic Dilemma Resolved by Fine Needle Aspiration Cytology

Amit Kumar Yadav

Abstract


Meningiomas are common tumors of the central nervous system arising from arachnoid cells. Rarely, they may be extracranial also, known as ectopic meningiomas. Parotid masses are very commonly seen in clinical practice. However, ectopic meningioma presenting as a parotid mass is extremely rare. Cytology literature on ectopic meningiomas consists of case reports only. However, there is no report of ectopic meningioma presenting as a parotid mass being diagnosed on FNAC. The author reports a case of a 70-year-old female who presented with a swelling in the left parotid region since 3 months. It measured 4×3 cm. A clinical diagnosis of a parotid tumor was made. CT scan showed a mass involving the left parotid gland and extending via parapharyngeal space up to the base of the skull. A diagnosis of parotid tumor with extensive local spread was given. FNAC smears showed cells present in loosely cohesive clusters and syncytial fragments. At places whorling arrangement of cells was seen. The cells were oval to spindle shaped with elongated nuclei. Intranuclear inclusions were seen. Psamomma bodies were also observed. Based on these findings, a diagnosis of ectopic meningioma involving parotid gland was made. The diagnosis was confirmed on histopathological examination. The case is being reported because of its extreme rarity. The clinicians and pathologists should be aware that rarely ectopic meningioma can manifest as a parotid mass. 


Keywords


Meningioma, Ectopic meningioma, Parotid mass, Fine needle aspiration cytology

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References


Kershisnik M, Callender DL, Batsakis JG. Pathology consultation, extracranial, extraspinal meningiomas of the head and neck. Ann Otol Laryngol 1993; 102: 967-70. 2. Thompson LDR, Gyure KA. Extracranial sinonasal tract meningiomas. A clinicopathologic study of 30 cases with a review of the literature. Am J Surg Pathol 2000; 24: 640-50. 3. Friedman CD, Costantino PD, Teitelbaum B et al. Primary extracranial meningiomas of the head and neck. Laryngoscope 1990; 100: 41-48. 4. Wolff M, Rankow RM. Meningioma of the parotid gland: an insight into the pathogenesis of extracranial meningiomas. Hum Pathol 1971; 2(3): 453-59. 5. Nichols RD, Knighton RS, Chason JL et al. Meningioma in the parotid region. Laryngoscope 1987; 97(6): 693-96. 6. Walther LE, Mentzel T, Meyer R et al. Extracranial meningioma of the parotid gland. HNO 1999; 47(6): 573-76. 7. Rushing EJ, Bouffard JP, McCall S et al. Primary extracranial meningiomas: An analysis of 146 cases. Head and Neck Pathol 2009; 3: 116-30. 8. Dhingra S, Mohindra S, Gupta SK et al. Intracranial meningioma presenting as a parapharyngeal tumour – A unique extracranial presentation. Int J Pediatr Otorhinolaryngol 2011;6: 325–8. 9. Solares J, Lacruz C. Fine needle aspiration cytology diagnosis of an extracranial meningioma presenting as a cervical mass. Acta Cytol 1987; 31(4): 502-24. 10. Agrawal P, Dey P, Saikia UN et al. Fine-needle aspiration cytology of orbital meningiomas. Diagn Cytopathol 2012; 40(11): 967-69. 11. Gupta AP, Parate RC. Fine-needle aspirationcytology of jugular foramen meningioma presenting as parapharyngeal mass. Indian J Pathol Microbiol 201; 54(2): 398-99.


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