A dry pineapple slice like lesion in the anterior skull base

Sir,

We read with much great interest the article of Salunke et al.[[1]] Bone formation in meningiomas can be scattered, focal (eccentric or centrally). The latter is the case in our patient, a 50-year-old male who was referred for magnetic resonance imaging (MRI) from the temporal bone because of daily head pressure and tinnitus. MRI showed an incidental high-density lesion with central calcification and moderate perilesional edema at the right border of the lesion, most probably a planum sphenoidale meningioma [[Figure 1]].

Figure 1: (a) Hyperintense (T2 - magnetic resonance imaging) lesion, with a diameter of 36 mm, with a hypointense center (T2 - magnetic resonance imaging), suggesting central calcification/ossification. (b) Dried pineapple slices resembling the meningioma pattern

Surgical resection revealed a lesion with central calcification/ossification, firmly attached to the olfactory nerves. Histopathology disclosed a meningothelial meningioma [[Figure 2]].

Figure 2: Mainly meningothelial meningioma but the presence of psammoma bodies, bone spicules, and osteoblasts suggests the metaplastic bone formation in the tumor (H and E, xlQ)

The lesion resembled a dry pineapple slice with crenelated central margin due to the central ossification in contrast with osteoblastic meningiomas with diffuse ossification with chicken-wire pattern or with eccentric ossification with turtle-shell pattern.[[1]],[[2]]

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Publication History

Article published online:
09 September 2022

• References

• 1 Salunke P, Aggarwal A, Futane S, Nada R, Gochhait D. Osteoblastic meningioma with turtle shell: Different entity from calcified meningioma. Asian J Neurosurg 2016;11:450.
• 2 Huang J, Petersson F. Intracerebral metaplastic meningioma with prominent ossification and extensive calcification. Rare Tumors 2011;3:e20.