A particularly fascinating presentation is that of the cutaneous meningioma. The first known reported case of this lesion was in 1904, (1) while its first description in the English literature was in 1956.
The widely used classification system for cutaneous meningioma was developed by Lopez et al.
(6,7) Because of this mechanism, rudimentary meningoceles and acoelic meningeal hamartomas most likely represent 2 ends of a spectrum, (6) and many authors simply prefer the term cutaneous meningioma. This developmental mechanism has been supported by the occasional finding of a sinus track connecting the central nervous system and the lesion upon surgical exploration, as well as the often midline location of the lesion.
(6) An important finding in this type of cutaneous meningioma is the lack of corresponding meningioma of the neuroaxis.
Type III cutaneous meningiomas are tumors that have extended into the dermis or subcutis from a meningioma that involves the neuroaxis (ie, a primary intracranial meningioma).
In an article published in 1992, the authors (14) collected age and site characteristics associated with 92 primary cutaneous meningiomas and found that these tumors tended to present in younger patients with an average age of 34 and a female to male ratio of 4:5.
Type II and III cutaneous meningiomas occur in adults as de novo lesions.
Kalfa et al (21) reported 2 cases associated with a diagnosis of cutaneous meningioma via fine-needle aspiration.
A third group (23) described the fine-needle aspiration findings as a secondary cutaneous meningioma on the scalp of a 45-year-old man with a lesion of 3 months' duration (type III cutaneous meningioma).