Search

Purpose: To report a rare case of isolated intraconal meningioma. Case Report: A 24-year-old woman presented with painless proptosis in her left eye which started and progressed during her pregnancy about 10 months ago. Hertel exophthalomometry revealed anterior displacement of the globe with 4 mm of proptosis which was remarkable. Magnetic resonance imaging (MRI) demonstrated an intraconal circumscribed oval-shaped mass with hypointense signals on T1- weighted images and hyperintense signals on T2-weighted images, mimicking cavernous hemangioma. This mass, however, was free of any connections to optic nerve or bones. Due to the imaging characteristics, more prevalent diagnoses like cavernous hemangioma were placed on the top of the differential diagnoses list. However, during the surgical excision, the tumor’s consistency and gross features were not compatible with cavernous hemangioma. The pathologic findings instead determined meningotheliomatous meningioma, a very rare condition, which was far from our expectations prior to the surgery. Conclusion: Ectopic orbital meningiomas are rare tumors that are not easily diagnosed without postoperative histopathology. Despite its low prevalence, they should be considered in the differential diagnosis list of intraconal masses with hypointense signals on T1-weighted images and hyperintense signals on T2- weighted images.

Primary heterotopic meningiomas are lesions that are not associated with a cranial nerve foramen, vertebral canal, or intracranial structure. The most common histopathological subtype is meningeal epithelioma. In clinical practice, primary heterotopic nasal meningioma occurs relatively rarely, and its most common pathological type is psammomatous meningioma, whereas nasal fibrous meningioma is infrequent. In our case, a 31-year-old male patient was admitted to the hospital with “progressive nasal obstruction on the right side for half a year.” Computed tomography examination of the paranasal sinuses revealed a polyploid mass in the right nasal cavity. The patient underwent surgical resection of the mass under nasal endoscopy. Histopathological examination confirmed that the mass was an ectopic meningioma of the nasal cavity. The patient was regularly followed up for 2 years without recurrence of the tumor. Primary heterotopic fibrous meningioma of the nasal cavity is clinically rare but should be considered as a differential diagnosis for hemangioma of the nasal cavity, inverted papilloma, and nasal polyp. The final diagnosis is based on pathology and immunohistochemistry analysis results.

Extracranial meningioma is very rare with few cases reported, especially in the oral cavity. Its diagnosis is considered a challenge owing to the unusual site of occurrence. We report, to the best of our knowledge, the first case of extra-cranial meningioma as a primary tumor in the hard palate with no detected intracranial extension. A 59-year-old Egyptian female patient presented with a 22-year history of a large painless swelling at the right side of the hard palate, which could not be seen on radiographs. An incisional biopsy was taken and, after assessment with a panel of immunohistochemical markers, the lesion was diagnosed as extracranical grade I mengiothelial meningioma. The patient did not show up for surgical excision and follow-up was not performed because of the lose of contact with the patient. Intraoral meningioma is a rare tumor. Immuohistochemical markers are important for confirming this diagnosis.

Primary ectopic meningioma of the middle ear is relatively rare in clinical practice. It is often difficult to distinguish it from chronic otitis media or otitis media with effusion due to its similar and atypical clinical symptoms. We report a case of epithelial tympanic ectopic meningioma with the main complaints of otalgia, aural fullness, and hearing loss. It was accidentally discovered during tympanotomy due to the symptoms of recurring refractory secretory otitis media. This article briefly reviews the relevant literature in recent years, summarizes the characteristics of primary ectopic tympanic meningioma with intact tympanic membrane, and emphasizes the diagnosis and treatment strategy of the middle ear mass.

An ectopic meningioma, such as a primary pulmonary meningioma (PPM), is a rare type of tumor that primarily originates outside of the central nervous system. A 65-year-old female patient underwent a thoracoscopic lung wedge resection of the right lower lobe for a micro solid nodule detected via computed tomography. The histologic result revealed a PPM. PPMs manifested with micro solid nodules are a very rare occurrence in clinical practice. Increased awareness of the clinical and pathological characteristics of this rare disease can assist thoracic surgical teams to apply adequate management.

An 80-year-old male with a previous history of thymoma and kidney cancer underwent a 18F fluorodeoxyglucose (FDG) positron emission tomography (PET)/contrast-enhanced computed tomography (CT) scan: two pulmonary nodules were discovered, both characterized by an increased glucose uptake. Of them, only one showed mild contrast enhancement. Both nodules were surgically resected: the first nodule was a benign meningioma and the second one was a malignant meningioma. This case study shows that malignancy of meningioma in the lung is not correlated with 18F FDG uptake and the contrast enhancement, thus suggesting that PET/CT may represent a suboptimal imaging modality for the evaluation of these lesions.

Rationale: Primary aldosteronism due to aldosteronoma is the most common form of secondary hypertension, with an estimated prevalence of 4% of hypertensive patients in primary care and around 10% of referred patients. Diagnosis is a clinical challenge with simultaneous occurrence of primary ectopic meningioma in the adrenal gland. To our knowledge this is the first reported case of simultaneous occurrence of aldosteronomas and ectopic meningioma in the adrenal gland based on literatures. Patient concerns: A 30-year-old man presented with resistant hypertension for one year. The computed tomographic scans were suggestive of left adrenal gland hyperplasia. Intervention: The patient underwent partial unilateral laparoscopic adrenalectomy. Diagnosis: The histopathological examination of the resected sample confirmed primary ectopic meningioma in adrenal gland and aldosterone producing adenoma (APA). The saline load test, captopril test, and plasma aldosterone/renin ratio were indicative of primary aldosteronism (PA). Outcomes: The patient had controlled blood pressure postoperatively. Lessons: The patient was diagnosed with PA due to APA and nonfunctional primary ectopic meningioma in the adrenal gland which is very rare and dealt with unilateral laparoscopic adrenalectomy.

Ectopic meningioma is a generally rare type of benign tumor that very rarely occurs in the lung. Here, we report the cytological findings of a primary pulmonary meningioma with a particular focus on immunohistochemical (IHC) assessment. A healthy 60‐year‐old woman visited our hospital with an asymptomatic nodule in the right lower lung lobe. She had no particular past‐history and no other tumors in the central nervous system or elsewhere according to an imaging examination. Transbronchial fine‐needle aspiration cytology revealed clusters of spindle cells in a whorled formation and psammoma bodies. The tumor cells exhibited spindle‐shaped cytoplasm, small fusiform or round nuclei and numerous intranuclear cytoplasmic inclusions. IHC staining of the cytological specimen revealed that the tumor cells were positive for epithelial membrane antigen, negative for thyroid transcription factor‐1 and p40, and equivocal for claudin‐1. Progesterone receptor immunoreactivity of cytology specimen resulted negative at first by manual method but retrieved positive by an autostainer. Following segmentectomy, the pathological diagnosis was a meningothelial meningioma. The patient has remained well without recurrence for 36 months postoperatively. Because the cytological preparation exhibited characteristic findings of meningioma, a correct diagnosis based on pre‐operative cytological findings with appropriate IHC would be possible. Here, we report the cytological and IHC features of this case and highlight the importance of IHC‐quality assurance.

In August 2016, an 11-year-old boy presented to the authors’ institution with a right orbital tumor that was located superotemporally (superolaterally) and adherent to the sclera. The patient’s past medical history revealed that he had undergone 2 previous craniotomies elsewhere in June 2008 and July 2010 for a superomedially located orbital lesion that had been histopathologically diagnosed as a neurothekeoma. After the second craniotomy, the patient underwent adjuvant intensity modulated radiotherapy (IMRT) to the right medial orbit. At the authors’ institution, total excision of the orbital tumor was performed via an anterior conjunctival orbitotomy. Histopathological examination revealed a rhabdoid meningioma. Review of the histopathology obtained at the time of previous tumor excisions showed that the lesion was misdiagnosed as neurothekeoma and instead represented a meningioma from the beginning. The patient was started on a regimen of oral sunitinib and remained free of recurrence at 1.5 years of follow-up. Ectopic meningioma of the orbit is a rare entity. Rhabdoid meningioma is a rarely seen subtype of meningioma, accounting for 1%–3% of all intracranial meningiomas. To the best of the authors’ knowledge, this is the first case of an ectopic orbital rhabdoid meningioma reported in the literature. They suspect that tumor seeding during the previous surgeries might have played a role in the occurrence of the tumor in an orbital location not targeted by IMRT.

Introduction: Ectopic meningiomas are rare tumors which can be encountered by all surgical specialties. Patients and methods: We report on two different cases, a contemporary one and a historical one, highlighting the diversity of clinical presentations and prognoses of these lesions. Furthermore epidemiological aspects, clinical features, and diagnostic and therapeutic work-up in patients with an ectopic meningioma are reviewed. Results: Typically, ectopic meningiomas present as gradually expanding lesions, causing a variety of symptoms by their mass effect. Diagnosis is based on histological characteristics, which are similar to those of intracranial meningiomas. Treatment is primarily surgical. Conclusions: The cases we report are at different ends of the clinical and prognostic spectrum. Therapeutic options for different clinical scenarios are discussed.

Ectopic meningioma occurring in the region of parapharyngeal space is rare in clinical practice and brings great challenge in its diagnosis. This report details such a case in a 14-year-old girl with neurofibromatosis Type 2, which is a highly infrequent association. The clinical manifestations, imaging findings, and pathological manifestations are described, and the relevant literature is reviewed to highlight characteristic imaging findings of ectopic meningiomas.

Summary Primary extradural meningioma, also known as ectopic meningioma, is uncommon and represents ∼2% of all meningiomas. Malignant primary extradural meningioma is even more rare. The rarity of cases means the condition is not readily suspected or diagnosed. In this report, we present one case of primary extradural meningioma in elderly patients who presented with a scalp nodule and another highly suspected case. Both patients underwent surgical resection of the tumors. Histological study and immunostaining confirmed the diagnosis. We also conducted a literature review regarding similar cases. Surgical resection with a wide margin remains the first choice of treatment.

Certain nasal neoplasms, such as ectopic menigioma, present as nasal polyps, together with similar symptoms. The present study reports the diagnosis and treatment of ectopic meningioma in the bilateral nasal olfactory cleft in order to improve the diagnosis and treatment of ectopic meningioma in the nasal cavity. By retrospectively analyzing the clinical data and reviewing the associated literature, a detailed introduction to the clinical manifestation, diagnosis and treatment of ectopic meningioma of the nasal cavity was ascertained. The tumor was removed from the sinus by functional endoscopy surgery. Regular follow-up appointments were scheduled every three months, with no evidence of recurrence to date. The olfactory recovery and nasal ventilation were normal subsequent to surgery. Meningiomas are infrequently occurring tumors with unpredictable clinical behavior. A clear understanding of the etiology and appropriate diagnostic and management principles may aid in overcoming the challenges of treating primary extracranial meningiomas.

Ectopic meningiomas are a very rare tumor entity. We present a case of a meningioma arising in the mandible of a young woman and initially supposed to be a radicular cyst. Histopathological and immunhistochemical evaluation showed typical cell characteristics of a meningioma. Only six cases of ectopic meningiomas in the mandible have been described in the literature until now, mainly in women at an advanced age and with surgical removal of all tumors. For the first time, no surgical excision has been performed in this case and follow-up control after 12 months showed no significant progression or increasing clinical complaints. Hence, surgical removal seems non-urgent. In conclusion, unclear lesions of the jaws, even if they seem to be clear following diagnostics, should be evaluated by incisional biopsy and histopathological evaluation.

Meningioma originates from arachnoid cap cells and is usually dura-based and slow growing. They account for 15% to 20% of primary brain tumors. Primary intraosseous meningioma (PIM) is a type of ectopic meningioma, and has been rarely reported. PIMs have been reported to constitute less than 2% of meningiomas, and are usual reported in the frontotemporal regions of the calvarium [1], orbits, and anterior cranial fossa. Frequently, patients with PIM of the orbit complain of aesthetic problems. We report a case of PIM of the orbit. A 54-year-old female had presented with gradually progressive exophthalmos of 5 months duration (Fig. 1). The patient had no pain or visual symptom, and there was no previous ocular trauma history. Ophthalmologic and neurologic examinations were normal finding except for 5 mm of exophthalmos. Facial computed tomography (CT) scan revealed thickening of cortical bone of the orbital wall at the right sphenoid wing (Fig. 2). The radiologic diagnosis of preoperative facial CT was fibrous dysplasia of the right lateral orbital wall and right skull base. Fig. 1 Preoperative view. Fig. 2 Preoperative facial computed tomography. Lateral eyebrow and subciliary incision were followed by parallel upper and lower ostectomies at the lateral orbital rim. The osteomised bone segment was excised to create enough space to approach the main mass at the right sphenoidal bone and part of the orbit lateral wall. The bony mass was removed with a high-speed drill and oscillating saw. The osteomised orbital rim segment was repositioned using fixation devices. The main mass consisted of fragile abnormal bone, resembling that of fibrous dysplasia. Histopathologic examination confirmed the diagnosis of meningioma. In microscopic views, oval and spindle shaped cells formed lobules between woven bones. Nuclei frequently exhibited central clearing and whorls were viewed. Cytoplasm and surrounding collagen were immunohistochemically positive for epithelial membrane antigen, and negative for glial fibrillary acidic protein (GFAP), cytokeratin (AE1/AE3), and Ki-67 (Fig. 3). At 3 months after surgery, exophthalmos was reduced to 2 mm, that is, into the relatively normal range (Fig. 4). On postoperative CT, most of the bone mass was removed but minimal amount of mass remained (Fig. 5). Although secondary surgery for complete resection of the mass was planned at 12 months after surgery, the patient was satisfied with the aesthetic results and was not willing to undergo additional surgery. Fig. 3 Epithelial membrane antigen positive finding (magnification, ×100, epithelial membrane antigen immunostain). Fig. 4 Postoperative view. Fig. 5 Postoperative facial computed tomography. Extradural meningiomas are uncommon, and more than 90% of extradural meningiomas occur in the head and neck [2]. Nevertheless, many other locations have been reported, such as, scalp, calvaria, orbit, paranasal sinus, neck, lung, mediastinum, skin, and finger. The differentiation of PIM and intradural meningioma depends on the presence of dural invasion. Hoye et al. [3] defined PIM as not involving the dura, but Lang et al. [2] did not treat dural invasion as an exclusive criteria and regarded main mass location, growth direction, and dural displacement pattern to be of greater importance. The majority of PIMs of the skull base and orbital walls present with pain, exophthalmos, and deformity. PIMs are generally benign and slow growing, but a higher proportion are associated with malignant change than standard meningioma [2]. These tumors are characterized by an intraosseous mass growth leading to significant hyperostosis involving the sphenoid wing, orbital roof, lateral orbital wall, and the middle fossa cranial base and a thin, usually soft-tissue growth at the dura. Several hypotheses have been proposed for the origin of PIM. Azar-Kia et al. [4] suggested that PIM arises from arachnoid cap cells trapped in the cranial suture during birth. In the reports issued by Lang et al. [2] and Crawford et al. [5] 8% and 64%, respectively, were suture related masses. It has also been proposed that PIM arises from dura and arachnoid entrapment caused by previous trauma. The third hypothesis is extradural meningioma arise from multipotent mesenchymal cells, which could explain masses located far from the head and neck. PIM is the condition most commonly confused with fibrous dysplasia. Both PIM and fibrous dysplasia expand bone and have a "ground glass" appearance. However, in intraosseous meningioma, there is irregularity of the cortical bone. In fibrous dysplasia, on the other hand, the bone is enlarged but follows the normal position and intact cortical bone. Surgical resection is required for symptomatic PIM. Excision of the tumor with reconstruction of bone as required is the choice of operation. Operations must be designed to achieve symmetry of both eyes, as proper facial symmetry and tumor resection are important for achieving successful aesthetic outcomes. In conclusion, we reported a rare case of PIM of the orbit that present with progressive exophthalmos. Surgical resection was performed to lessen avoidable morbidity. The patient was satisfied with the aesthetic results achieved.

Aim Meningioma is a benign intracranial tumor. Occurrence of ectopic meningioma in maxillary alveolar ridge is very rare. Our aim is to add another case of ectopic meningioma in the maxillary alveolar ridge to the literature. Background Meningioma is a benign tumor that originates from meningocytes found in arachnoid villous structures of the meninges. The tumor is rarely seen in extracranial locations from the oral cavity. Case description We report on a 51-year-old edentulous woman with an ectopic meningioma on the right maxillary alveolar ridge. The patient had complained of dull pain and discharge from the right maxillary alveolar region. On clinical examination, we observed a lobulated lesion 2 × 2 cm in size. Radiographic examination showed ill-defined radiolucency with irregular radiopaque areas. We also noted oroantral communication from the root of the lesion into to the maxillary sinus with bony destruction. We closed the oroantral communication by a buccal advancement flap. The histopathological diagnosis of the specimen was transitional type grade I meningioma. The patient's 5-year follow-up was uneventful. Conclusion The histological subtype of the meningioma dictates the mode of surgery. Hence, resection is not considered the treatment of choice for grade I lesions. It is important to keep in mind that meningioma is the differential diagnosis of the intraosseous mandible tumors. Clinical Significance Ectopic meningioma is very rare. Meningioma should be considered as a differential diagnosis in clinical lesion. In the literature review, this is the fifth case report and review of the literature. How to cite this article Simsek HO, Komerik N. Ectopic Meningioma in the Maxillary Alveolar Ridge: Report of a Case with a Review of the Literature. Int J Experiment Dent Sci 2012;1(2):98-101.

Extranodal follicular dendritic cell sarcoma (FDCS) of the pharyngeal region is a rare malignant tumor recognized in recent years, with approximately 37 cases so far reported in the literature. It is often not considered at the initial evaluation and may be misdiagnosed in a small biopsy specimen. We report 4 cases of extranodal FDCS, 2 cases in the nasopharynx that were diagnosed as undifferentiated carcinomas because they were characterized by syncytial epithelial cells with sheet or nest-like distribution and 2 cases in the tonsil and soft palate that were characterized by vaguely concentric whorls consisting of spindle to ovoid cells. The latter case was diagnosed as ectopic meningioma. The analysis of all cases from the literature and ours shows that 58% (21/36) of the cases are misdiagnosed initially, often as undifferentiated carcinoma or meningioma, which the differential diagnoses should be mostly focused on. With a median follow-up of 27 months, the recurrence, metastasis, and mortality rates are 23%, 21%, and 3%, respectively, suggesting that extranodal FDCS of the pharyngeal region remains a low-grade sarcoma. Radical surgery is recommended, whereas there is no evidence to support adjuvant therapy.

Primary ectopic meningiomas occurring in the mediastinal region are extremely rare. So far, only five cases of primary mediastinal meningioma have been reported in the literatures. The imaging characteristics and the clinicopathological significance of mediastinal psammomatous meningioma have not been detailed. Here, we report the case of a 42-year-old male with primary posterior mediastinal psammomatous meningioma. The clinical features, imaging, and pathological findings are carefully analyzed, and the relevant literatures were reviewed.

Rationale: Intradiploic meningiomas are a subset of extradural meningiomas that arise in the skull. They are mostly localized in the frontoparietal and orbital regions, and they are often mistaken for primary bone tumors. Patient concerns: The patient was a 48-year-old man with headache and a 12-year history of frontal cranium occupation, which was first discovered in 2005 and enlarged in 2009. The patient had a history of fracture in his frontal cranium 12 years ago. The computed tomography and magnetic resonance imaging revealed an occupation and intracranial invasion in frontal cranium. And the angiography showed an occlusion at the anterior part of sagittal sinus. Interventions: Bilateral frontal craniotomy, intracranial tumor resection, and cranioplasty were performed. Diagnosis: Histologic examination confirmed an intradiploic ectopic meningioma (World Health Organization Grade I). Outcomes: He was discharged with no neurological deficits 3 days after surgery. At the 6-month clinical follow-up, there was no tumor recurrence or other complaints. Lessons: In this study, we present the case of a frontal intradiploic meningioma with progressive intracranial invasion and review the radiographic and clinical findings of patients with primary intraosseous meningioma.

異所性の髄膜腫は髄膜腫全体の1％以下と言われており、特に皮膚に原発する皮膚髄膜腫はまれな疾患である。われわれは68歳、女性のひたいに、外傷を契機として発生したと考えられる皮脂髄膜腫を経験した。組織学的に束状や渦巻き状に増生した腫瘍細胞を認め、砂粒休(psammomabody)と呼ばれる石灰化小体も見られた。免疫組織染色ではEMA|場性で、髄J英腫と診断した。

We present a rare case of primary extracranial meningioma in a 36-year-old man, who had a solitary multinodular mass located in the plantar muscle of the foot. The histology of specimens from simple excision was typical of meningioma, showing bland spindle cell proliferation with a whorl pattern. Immunohistochemical analysis demonstrated that the tumor cells showed diffuse and strong positivity for epithelial membrane antigen as well as moderate reactivity for cytokeratin and vimentin. Ultrastructurally, the tumor cells were characterized by thin bipolar cytoplasmic processes and joined by multiple small desmosomes. There were frequent pinocytotic vesicles and a distinct external lamina on the cell surface. These findings suggest that this primary ectopic meningioma, arising in the soft tissue, may have been derived from perineurial cells of the peripheral nerve, but was morphologically distinguishable from perineurioma. Primary extracranial meningioma should be included in the differential diagnosis of soft-tissue spindle cell tumors, especially those of peripheral nerve origin.

Meningioma is a well-recognized tumour of the central nervous system. However, extracranial non-dural or ectopic meningiomas are rare and in most of the reported cases, meningiomas are diagnosed only after histopathologic examination. Over the last 5 years, the authors have seen three cases. In these case reports, they discuss the salient features of these lesions, which can aid the preoperative diagnosis and management of these patients. One of the cases is a rarity, owing to the extreme extracranial position which allowed the pressure of the tumour abrade the adjacent structures. In one case, reconstruction of the skull bone using polymeric materials (Acrylic matter) was necessary. In the other two cases, titanium plates and screws were used to reconstruct the jaw.

Introduction Extra-cranial meningioma or ectopic meningioma is a rare tumor. This tumor has been reported in various anatomic sites in the head and neck, mediastinum, skin and soft tissues. We report a rare case of ectopic meningioma in the submandibular region detected by using fine-needle aspiration cytology, histopathology and immunohistochemistry. This case represents another unusual site for extra-cranial meningioma, which prompted us to report it. Case presentation An 18-year-old Dravidian woman presented with swelling in the right submandibular region. The computed tomographic scan findings were suggestive of a neoplastic mass lesion in the right submandibular region. Fine-needle aspiration cytology led to the differential diagnosis of a monomorphic adenoma of a salivary gland or an ectopic meningioma. The patient underwent excision of the submandibular gland and tumor. The histological examination and immunohistochemistry studies confirmed that the lesion was an extra-cranial meningioma. At her two-year follow-up examination, there was no recurrence of the tumor. Conclusion Our experience with this case indicates that, although rare, meningioma should be entertained in the differential diagnosis of a mass lesion in the head and neck region.

Primary ectopic meningiomas are extremely rare tumors of controversial origin and they are usually limited to the head and neck region. Its occurrence at the mediastinum is even rarer. There has not been any official report regarding primary mediastinal malignant meningioma until today. Because of its rarity and potential value, we report here a case of primary mediastinal malignant meningioma, which turns out to be the first reported case of this type of meningioma. The clinical features, treatment plans, pathological findings, as well as prognosis of a case of primary mediastinal malignant meningioma were carefully analyzed and the literature on ectopic meningioma was reviewed. The diagnosis of ectopic meningioma can only be established based on microscopic and immunohistochemical findings. Surgery is the treatment of choice for ectopic meningioma and postoperative radiotherapy should be managed for patients with suspected invasive meningioma.

Ectopic meningioma outside the skull and spinal column is uncommon. We report a cutaneous meningioma of the scalp in a 77-year-old man. A review of types and their management options are discussed. We also highlight that in certain carefully selected cases, these lesions can be treated conservatively.

We report a case of intraorbital meningioma. Operative findings and histopathological examination revealed the tumoc to be meningothelial meningloma and to be located entirely outside the optic dura. This case demonstrates the occurrence of primary intraorbital ectopic meningioma, and the tumor was removed through a modified Dolenc approach. The primary intraorbital ectopic meningioma is discussed and the surgical approach to the orbital apex region is reviewed.

Meningioma is a tumour most commonly located intracranially that may rarely extend extracranially. Ectopic meningioma presenting as parapharyngeal mass is a rare entity. We report a case of an 18-year-old female who presented with a complaint of swelling below the right angle of mandible associated with difficulty in swallowing for the last 3 months. The swelling measured 1.5 × 1 cm and was firm, fixed, non-pulsatile, non-transilluminant and non-tender. Computer tomography revealed a heterogenous enhancing mass with foci of calcification in parapharyngeal space without any intracranial component. Intraoral fine needle aspiration cytology was performed. A cytological diagnosis of spindle cell lesion of neural origin with the closest possibility of meningioma was rendered. Excision biopsy confirmed the diagnosis of ectopic parapharyngeal meningioma. It is important for clinicians and pathologists to be aware of this entity at the unusual site.

Conjunctiva has two components; a clear mucous membrane and subepithelial stroma consisting of fibrovascular connective tissue that thickens in the fornix and thins at the limbus. Neo­ plasms can arise in the conjunctiva from both epithelial and sub­ epithelial connective tissue. Nevi are the most common, and, fi­ brous tumors of any type are rare in the conjunctiva. A solitary fibrous tumor (SFT) is a rare mesenchymal tumor characterized by spindle cells, fibrotic cells, and branching vasculature. SFT occurs mainly in the serosal cavities, but it is also found in the nasal cavity and thyroid gland. To date, about 60 cases of SFT of the eye have been reported with most of them in the orbit, and only one in the conjunctiva. We report here on the second reported case of a SFT arising in the conjunctiva, which clinically and histologically resembles conjunctival nevus, glomangioma, ectopic meningioma, and a hybrid neurogenic­myogenic tumor such as mesectodermal leio­ myoma. CASE REPORT