Metastatic Atypical and Anaplastic Meningioma: A Case Series and Review of the Literature

Kessler, Remi A.; Garzón-Muvdi, Tomás; Yang, Wuyang; Weingart, Jon; Olivi, Alessandro; Huang, Judy; Brem, Henry; Lim, Michael

doi:10.1016/j.wneu.2017.01.070

Cited by 71 publications

(69 citation statements)

References 39 publications

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“…However, distant metastasis of anaplastic meningioma is rare. In a study of 168 cases of atypical and anaplastic meningioma, Kessler et al [ 2 ] found that the rate of extracranial metastases was about 3%. Corniola et al [ 13 ] reported a case of anaplastic meningioma with pulmonary metastasis 2 years after surgery, resulting in the patient's death.…”

Section: Discussionmentioning

confidence: 99%

“…Anaplastic meningioma is a rare type of malignant meningioma, accounting for less than 5% of all meningiomas. [ 1 , 2 ] The diagnostic criterion for anaplastic meningioma is that the tumor should have at least one of the following characteristics: carcinoma-, sarcoma-, or melanoma-like morphology, and a high mitotic index (≥20/10 high-power fields). [ 1 ] It commonly occurs in the convex surface of the cerebrum, and in rare cases, in the parietal region, [ 3 ] brain parenchyma, [ 4 ] and spinal cord.…”

Section: Introductionmentioning

confidence: 99%

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A rare subtype of meningioma

et al. 2018

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Rationale:Anaplastic meningioma, a rare subtype of meningioma, has malignant morphological characteristics and a World Health Organization (WHO) grade of III.Patient concerns:In this report, we present findings from 6 cases of anaplastic meningioma.Diagnoses:Pathological examination of the tumors, including hematoxylin and eosin staining and immunohistochemical staining, was performed. Of the six cases of anaplastic meningioma, two were recurrent tumors from original seminoma with a WHO grade of I. Histologically, three cases had carcinoma-like morphology, one case had sarcoma-like morphology, and two had two kinds of tissue structures: carcinoma-like tumor cell nests and areas with spindle tumor cells. Necrosis was detected in most cases (5/6). Ki67 index was high and varied from 20% to 70%.Interventions:All the patients received surgery. 3 patients received adjuvant radiotherapy. 1 patient received chemotherapy.Outcomes:4 patients had no recurrence at follow-up of 19, 30, 46 and 54 months after the last surgery. 1 patient had recurrence 3 months after the last surgery. 1 patient died 12 days after the last surgery.Lessons:This malignant subtype can be secondary to a WHO grade I meningioma after a long quiescent period. Necrosis was common in the tumor tissues, and Ki67 index was usually high. For patients with a history of meningioma, including benign cases, regular physical examination is important for early detection of tumor recurrence and malignant transformation.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A rare subtype of meningioma

et al. 2018

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“…The differential diagnosis includes other skull tumors such as metastatic carcinoma [7], osteomyelitis [8], granuloma [9], plasmacytoma [10], meningioma [11], anaplastic meningioma [12], meningeal sarcoma [13], sarcomatoid carcinoma [14], etc.…”

Section: Differential Diagnosismentioning

confidence: 99%

Role of Ultrasound in a Rare Case of Primary Lymphoma of the Cranial Vault

Farina¹,

Iannace²,

Conti³

et al. 2020

SN Compr. Clin. Med.

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The primary lymphoma of the skull is very rare. We describe a case of a 48-year-old woman with a palpable, soft, painless swelling of the soft tissues of the right frontal region, in absence of neurological symptoms. The ultrasonography showed the presence of solid, very vascularized, subcutaneous, and intra-thecal tissue and bone erosion of the internal and external cranial theca. A CT scan of the skull, thorax, and abdomen was performed to exclude further manifestations of the disease and an MRI examination of the brain to exclude involvement of the intracranial structures. CT and MRI confirmed the presence of the intrathecal and extra-thecal mass that infiltrated the external and internal cranial theca, the scalp, and the epidural region without infiltration of the cerebral cortex. The patient underwent mass removal surgery and histological analysis, which allowed the diagnosis of non-Hodgkin B cell lymphoma.

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Section: Introductionmentioning

confidence: 99%

“…Meningiomas metastases are rare, occurring in less than 1% of all cases [1][2][3]. However, the rate of metastasis increases to 2% for World Health Organization (WHO) grade II meningiomas, and is nearly 9% for WHO grade III meningiomas [4], most frequently in the lungs, liver, lymph nodes, or bone [3,5,6]. Recent studies have shed light on the genomic, epigenomic, and transcriptomic signatures of intracranial meningiomas [7][8][9][10], but little is known about the molecular features underlying meningioma metastases.…”

Section: Introductionmentioning

confidence: 99%

DNA methylation profiling demonstrates superior diagnostic classification to RNA-sequencing in a case of metastatic meningioma

Vasudevan

Castro

Lee

et al. 2020

acta neuropathol commun

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Meningiomas are the most common primary intracranial tumors, but meningioma metastases are rare. Accordingly, the clinical workup, diagnostic testing, and molecular classification of metastatic meningioma is incompletely understood. Here, we present a case report of multiply recurrent meningioma complicated by liver metastasis. We discuss the patient presentation, imaging findings, and conventional histopathologic characterization of both the intracranial lesion and the metastatic focus. Further, we perform multiplatform molecular profiling, comprised of DNA methylation arrays and RNA-sequencing, of six stereotactically-guided samples from the intracranial meningioma and a single ultrasound-guided liver metastasis biopsy. Our results show that DNA methylation clusters distinguish the liver metastasis from the intracranial meningioma samples, and identify a small focus of hepatocyte contamination with the liver biopsy. Nonetheless, DNA methylation-based classification accurately identifies the liver metastasis as a meningioma with high confidence. We also find that clustering of RNAsequencing results distinguishes the liver metastasis from the intracranial meningiomas samples, but that differential gene expression classification is confounded by hepatocyte-specific gene expression programs in the liver metastasis. In sum, this case report sheds light on the comparative biology of intracranial and metastatic meningioma. Furthermore, our results support methylation-based classification as a robust method of diagnosing metastatic lesions, underscore the broad utility of DNA methylation array profiling in diagnostic pathology, and caution against the routine use of bulk RNA-sequencing for identifying tumor signatures in heterogeneous metastatic lesions.

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Metastatic Atypical and Anaplastic Meningioma: A Case Series and Review of the Literature

Cited by 71 publications

References 39 publications

A rare subtype of meningioma

A rare subtype of meningioma

Role of Ultrasound in a Rare Case of Primary Lymphoma of the Cranial Vault

DNA methylation profiling demonstrates superior diagnostic classification to RNA-sequencing in a case of metastatic meningioma

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