, Volume 45, Issue 11, pp 799–803 | Cite as

The CT triad of malignancy in meningioma—redefinition, with a report of three new cases

  • S. B. GroverEmail author
  • A. Aggarwal
  • P. Singh Uppal
  • R. Tandon
Diagnostic Neuroradiology


The CT triad of extracranial soft-tissue tumour, underlying osteolysis and an intracranial tumour was reported as a sign of malignancy in meningioma, by Younis and Sawaya in 1992. We report the clinical and CT spectrum of three new cases with a similar triad, confirmed to be malignant meningioma. However, we redefine this sign and suggest that this triad is an unequivocal indicator of malignancy in meningioma, provided metastases have been excluded.


Malignant meningioma Extracranial tumour Osteolysis Computed tomography 


  1. 1.
    Ray C, Nijensohn E, Aduana V, McDonald L (1993) CT, MRI and angiographic findings of a highly aggressive malignant meningioma—a case report. Clin Imaging 17: 59–63PubMedGoogle Scholar
  2. 2.
    Husaini TA (1970) An unusual osteolytic meningioma. J Pathol 101: 57–58PubMedGoogle Scholar
  3. 3.
    McWhorter JM, Ghatak NR, Kelly DL (1976) Extracranial meningioma presenting as lytic skull lesion. Surg Neurol 5: 223–224PubMedGoogle Scholar
  4. 4.
    Muthukumar N (1997) Primary calvarial meningiomas. Br J Neurosurg 11: 388–392CrossRefPubMedGoogle Scholar
  5. 5.
    Younis G, Sawaya R (1992) Intracranial osteolytic malignant meningiomas appearing as extracranial soft-tissue masses. Neurosurgery 30: 932–935PubMedGoogle Scholar
  6. 6.
    Young PH (1983) Solitary subcutaneous meningioma appearing as a osteolytic skull defect. South Med J 76: 1039–1040PubMedGoogle Scholar
  7. 7.
    Ghobashy A, Tobler W (1994) Intraosseous calvarial meningioma of the skull presenting as a solitary osteolytic skull lesion: case report and review of literature. Acta Neurochir (Wien) 129: 105–108Google Scholar
  8. 8.
    Changhong L, Naiyin C, Yuehuan G, Lianzhong Z (1997) Primary intraosseous meningiomas of the skull. Clin Radiol 52: 546–549PubMedGoogle Scholar
  9. 9.
    Lee WH, Tu YC, Liu MY (1988).Primary intraosseous malignant meningioma of the skull. Case report. Neurosurgery 23: 505–508PubMedGoogle Scholar
  10. 10.
    Partington MD, Scheithauer W, Piepgras DG (1995) Carcinoembryonic antigen production associated with an osteolytic meningioma. J Neurosurg 82: 489–492PubMedGoogle Scholar
  11. 11.
    Servo A, Porras M, Jaaskelainen J, Paetau A, Haltia M (1990) Computed tomography and angiography do not reliably discriminate malignant meningiomas from benign ones. Neuroradiology 32: 94–97PubMedGoogle Scholar
  12. 12.
    Mahmood A, Caccamo DV, Tomecek FJ, Malik GM (1993) Atypical and malignant meningiomas: a clinicopathological review. Neurosurgery 33: 955–963PubMedGoogle Scholar
  13. 13.
    Radner H, Katenkamp D, Reifenberger G, Deckert M, Pietsch T, Wiestler OD (2001) New developments in the pathology of skull base tumors. Virchows Arch 438: 321–335PubMedGoogle Scholar
  14. 14.
    Winck RR, Scheithauer BW, Wick MR (1989) Meningioma, meningeal hemangiopericytoma (angioblastic meningioma), peripheral hemangiopericytoma and acoustic schwannoma. A comparative immunohistochemical study. Am J Surg Pathol 13: 251–261PubMedGoogle Scholar
  15. 15.
    Shiino A, Nakasu S, Matsuda M, Handa J, Morikawa S, Inubushi T (1999) Noninvasive evaluation of the malignant potential of intracranial meningiomas performed using proton magnetic resonance spectroscopy. J Neurosurg 91: 928–934PubMedGoogle Scholar
  16. 16.
    Jaaskelainen J, Haltia M, Servo A (1986) Atypical and anaplastic meningiomas: radiology, surgery, radiotherapy and outcome. Surg Neurol 25: 233–242PubMedGoogle Scholar
  17. 17.
    Lee TT, Landy HJ (1998) Spinal metastases of malignant intracranial meningioma. Surg Neurol 50: 437–441CrossRefPubMedGoogle Scholar
  18. 18.
    Nabeya Y, Okazaki Y, Watanabe Y, et al (1998). Metastatic malignant meningioma of the liver with hypoglycemia: report of a case. Surg Today 28: 953–958CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • S. B. Grover
    • 1
    • 2
    Email author
  • A. Aggarwal
    • 2
  • P. Singh Uppal
    • 2
  • R. Tandon
    • 3
  1. 1.New DelhiIndia
  2. 2.Department of Radiodiagnosis and ImagingVardhman Mahavir Medical College and Safdarjung HospitalNew DelhiIndia
  3. 3.Department of PathologyUniversity College of Medical Sciences and Guru Tegh Bahadur HospitalDelhiIndia

Personalised recommendations