Primary intrathoracic meningioma: histopathological, immunohistochemical and ultrastructural study of two cases

Falleni, Monica; Roz, Elena; Dessy, Enrico; Curto, Barbara Del; Braidotti, Paola; Gianelli, Umberto; Pietra, Giuseppe G.

doi:10.1007/s004280000387

Cited by 47 publications

(28 citation statements)

References 15 publications

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“…Extra-cranial metastases in cases of meningioma grade I (WHO) are rare and only ten such cases have been described in literature. In order of occurrence, the most common sites of metastases are lung, liver, lymph nodes and bone [6,7,11,16,18,27]. Moreover, most of such reports are clinical or radiological, without evidence of pathological data.…”

Section: Discussionmentioning

confidence: 97%

“Benign” metastatic meningioma: clinico-pathological analysis of one case metastasising to the lung and overview on the concepts of either primitive or metastatic meningiomas of the lung

et al. 2007

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Lung "metastases" of benign meningiomas are rarely described events of biological and clinical interest. We, here, report of a 70-year-old healthy woman found by CT scan to have multiple lesions, the two largest in the right lung on routine examination. Anamnesis revealed that the patient underwent a surgical resection of cerebral meningioma 12 years before. The larger lung lesion was a 3-cm node located in the right lung and was removed by wedge resection. Macroscopically, it showed well-defined borders, whitish colour and firm consistency; histologically, it was uniformly composed by spindle meningothelial cells arranged in fascicules including psammoma bodies. The morphological and immunohistochemical features of this lesion, together with the similarity with the original cerebral tumour and its indolent evolution, led to a final diagnosis of "benign" meningioma metastatic to the lung. Lung metastatic meningiomas may be a diagnostic challenge because of their unusual site of presentation and the possible confusion with primitive lung meningiomas or primary mesenchymal lung lesions. They represent a typical example of "benign" tumours that may implant to the lung similar to other tumours, definitely considered benign but reported to rarely present unusual secondary localization.

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Section: Discussionmentioning

confidence: 97%

“Benign” metastatic meningioma: clinico-pathological analysis of one case metastasising to the lung and overview on the concepts of either primitive or metastatic meningiomas of the lung

et al. 2007

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“…A previous series reported the time from initial diagnosis to discovery of metastases to be approximately 5 years. Some 60% of extracranial metastases from meningioma are found in the lung, while the liver, lymph nodes and bone are less common sites [4,[8][9][10][11]. Haematogenous spread of tumour cells as a result of venous sinus invasion is the most likely mechanism of metastasis [12].…”

Section: Discussionmentioning

confidence: 99%

Metastatic meningioma: positron emission tomography CT imaging findings

Brennan¹,

O’Connor²,

O’Regan³

et al. 2010

BJR

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ABSTRACT. The imaging findings of a case of metastasing meningioma are described. The case illustrates a number of rare and interesting features. The patient presented with haemoptysis 22 years after the initial resection of an intracranial meningioma. CT demonstrated heterogeneous masses with avid peripheral enhancement without central enhancement. Blood supply to the larger lesion was partially from small feeding vessels from the inferior pulmonary vein. These findings correlate with a previously published case in which there was avid uptake of fluoro-18-deoxyglucose peripherally with lesser uptake centrally. The diagnosis of metastasing meningioma was confirmed on percutaneous lung tissue biopsy. . Meningiomas are usually indolent, slow-growing tumours and surgery is curative in the majority of cases [2,3]. We present a rare case of a woman who had resection of an intracranial meningioma performed 22 years previously. The patient presented with haemoptysis and on imaging was found to have bilateral pulmonary lesions; these were confirmed as metastatic meningioma following CT-guided percutaneous biopsy. This report focuses primarily on the imaging features of a meningioma that metastasised to lung. Particular reference is given to CT and combined positron emission tomography and CT (PET/CT) appearances. The role of percutaneous lung biopsy in histological confirmation of the diagnosis is also briefly discussed. Case reportA 74-year-old woman presented with haemoptysis. She had a history of intracranial meningioma, resected 22 years previously in 1985. The patient had undergone two further resections for intracranial local recurrence in 1988 and 1992 (3 years and 7 years following initial resection, respectively). A chest radiograph revealed two well-circumscribed masses, one at each lung base without a pleural abnormality. CT scan of the thorax was performed and included unenhanced, arterial phase (25 s post-iv contrast administration) and portal venousphase (75 s post-iv contrast administration) imaging (Figure 1). CT demonstrated two well-circumscribed rounded lesions, which were peripherally located in the lungs: a 3.8 cm mass in the right lower lobe and a second 2.7 cm mass in the left lower lobe. The lesions had low-density centres (21 HU) that did not significantly enhance post-iv contrast administration (29 HU in arterial and portal venous phase images). The periphery of the lesions enhanced from 50 HU on the unenhanced images to 111 HU on the arterial phase images and de-enhanced to 83 HU on portal venous-phase images. The periphery of these lesions, therefore, enhanced avidly post-iv contrast administration; the lesions were noted to have prominent feeding vessels in their walls, which were fed by branches of the inferior pulmonary veins. CT scan of the brain (pre and post iv contrast administration) showed no evidence of recurrent or metastatic disease.Full-body combined fluoro-18-deoxyglucose (FDG) PET/CT imaging demonstrated avid FDG uptake within both lung lesions with standard uptake values (SUV)...

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“…Only 1 patient had non-specific symptoms [3]. In another patient the nodule was detected in staging for breast cancer [22]; and in the 2 remaining patients during follow-up for colonic adenocarcinoma [17] and tuberculosis, respectively [7].…”

Section: Patient Characteristicsmentioning

confidence: 99%