Isolated Ectopic Cutaneous Atypical Meningioma of the Scalp: Another Mimicker of Primary Adnexal Tumor

Cutaneous meningiomas are rare tumors most commonly located in the skin and soft tissue of the scalp. They may be congenital (type I), acquired and derived from ectopic arachnoid tissue in the skin (type II), or arise through direct extension from an intracranial meningioma (type III). Despite their well-established documentation in the literature, they may escape recognition when classic features are not present. Herein, we present a case of a cutaneous atypical meningioma (≥4 mitotic figures/10 High Power Fields (HPF)) on the posterior scalp of a 31-year-old man with histologic features mimicking a malignant adnexal tumor. To our knowledge, this is the first case of isolated cutaneous meningioma mimicking an adnexal neoplasm. Thus, cutaneous meningiomas should be considered in the differential diagnosis of dermal and subcutaneous epithelioid neoplasms of the scalp.