• Yasuhiro Takahashi, Masahiko Wanibuchi, Yusuke Kimura, Yukinori Akiyama, Takeshi Mikami, and Nobuhiro Mikuni.
• Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
• World Neurosurg. 2019 Jul 1; 127: 525-529.

BackgroundPrimary extracranial meningiomas are uncommon neoplasms. In particular, meningioma involving the hypoglossal canal is extremely rare, with only 4 cases reported in the literature so far. Given that each of these meningiomas originated in the juxtacondyle region with involvement of the hypoglossal canal, to the best of our knowledge, a meningioma that exists only within the hypoglossal canal has yet to be reported.Case DescriptionWe present a case of primary extracranial meningioma arising solely from the hypoglossal canal. A 62-year-old woman presented with long-term difficulty in tongue movement. Her tongue was deviated to the right, and neurologic examination revealed fasciculation and muscle wasting on the right side of the tongue. Computed tomography revealed a calcification in the right hypoglossal canal. Magnetic resonance imaging further demonstrated a hypointense tumor on both T1-weighted and T2-weighted images, with contrast enhancement in the right condyle. Total tumor removal was performed via a transcondylar approach, and histopathologic examination confirmed the presence of a transitional meningioma. No recurrence was observed at 14 months of follow-up. The patient's tongue atrophy was slightly improved, and the deviation completely disappeared.ConclusionsIn this extremely rare case of hypoglossal canal meningioma, total tumor removal via a transcondylar approach resulted in the recovery of hypoglossal nerve function.Copyright © 2019 Elsevier Inc. All rights reserved.

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