title: Metastatic rhabdoid meningioma of the parotid - Mimicking primary salivary gland neoplasm.
abstract: BACKGROUND
  Tumors involving the parotid are predominantly primary with metastatic lesions forming a miniscule population. Meningioma metastasizing to the parotid is extremely rare and hence can often be mistaken for the more common primary salivary gland neoplasms.
  
  
  METHODS
  A 59-year-old male presented with a swelling in the left parotid region. Fine needle aspiration cytology was suggestive of myoepithelial predominant pleomorphic adenoma. A superficial parotidectomy performed revealed a tumor composed of rhabdoid cells with abundant finely granular eosinophilic cytoplasm raising a possibility of myoepithelioma. Immunohistochemistry for myoepithelial markers was negative. A critical review elicited a history of surgical excision of a recurrent rhabdoid meningioma twice. A possibility of metastasis was considered and a second panel of immunomarkers demonstrated vimentin and epithelial membrane antigen positivity. Neuroimaging studies demonstrated a space occupying lesion in the frontal lobe suggestive of a recurrent/residual tumor. In view of the history, neuroradiology, histopathology and immunohistochemistry, a final diagnosis of metastatic rhabdoid meningioma to the parotid was rendered.
  
  
  CONCLUSIONS
  Morphologically, metastatic rhabdoid meningioma may mimic a primary or metastatic carcinoma, melanoma and sarcoma. Accurate diagnosis can be made by careful clinical evaluation and histopathological examination of the tumor. These tumors are composed of rhabdomyoblast like cells with abundant eosinophilic cytoplasm. The present case demonstrated characteristic histopathological features confirmed by immunohistochemistry.
  
  
  CONCLUSIONS
  Rhabdoid meningioma is an aggressive tumor with a high propensity to recur and metastasize. The present case highlights the importance of clinical, radiological and histopathological correlation to accurately diagnose these rare entities.
authors.affiliation: Department of Neurosurgery, Kasturba Medical College, Manipal University, India.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Parameshwaran Nair
authors.affiliation: Department of Neurosurgery, Kasturba Medical College, Manipal University, India.
authors.lastname: Vinod
authors.affiliation: Department of General Surgery, Kasturba Medical College, Manipal University, India.
authors.forename: Yashdeep
authors.initials: Y
authors.lastname: Sarma
authors.affiliation: Department of Pathology, Kasturba Medical College, Manipal University, India.
authors.forename: Bhavna
authors.initials: B
authors.lastname: Nayal
authors.affiliation: Department of Pathology, Kasturba Medical College, Manipal University, India.
authors.forename: Sumeet
authors.initials: S
authors.lastname: Kaur Dil
authors.affiliation: Department of Neurosurgery, Kasturba Medical College, Manipal University, India.
authors.forename: Pradeep Kumar
authors.initials: PK
authors.lastname: Tripathi
keywords: Parotid metastasis; Rhabdoid meningioma