Transcranial Mirror Tumors Without Bone Or Dura Mater Erosion Two Cases Reports

Résumé

Background: The existence of craniocerebral tumours with both intracranial and extra-cranial components generally occurs through a skull base hole or via bone erosion. We report two cases of tumours with a contiguous intracranial and extra cranial dual component without macroscopic contact between the two parts. We consider and discuss about same hypothesis put forward to explain this particular tumor appearance. Clinical presentations: Case 1: a 65-year-old male patient had a right parasagittal frontal meningioma with extra-cranial component without bone erosion visible on the CT Scan and per operatively. He underwent complete extra-cranial part excision, osteotomy and partial excision of the intracranial component with favourable outcome. The histopathology revealed a grade II meningothelial meningioma in both two parts. Fig 1: pre-operative double components frontal méningioma CT Scan with absence of bone erosion and per operative bone aspect. Case 2: a 16-year-old boy presenting a right parietal tumor of bony origin with a second intra-parechymal lesion opposite. The patient underwent osteotomy removing the extra-cranial part and complete excision of the intra-parenchymal mass. The dura mater separating the two components being macroscopically intact. The neurosurgical postoperative course was globally uneventful. Fig 2: pre-operative CT Scan of parietal osteosarcoma and bone flap removed with accompanied extra cranial and intracranial mass. Conclusion: These two clinical cases show a particular aspect of cranio-cerebral tumours of different origin and nature with however a tendency to similarity by their non-erosion character and the existence of the components located in mirror manner each other without macroscopically direct contact.