Solitary pulmonary metastasis after meningioma surgery of the head: a case report

Abstract

Background Meningioma is the most common type of benign primary brain tumor that is rarely associated with distant metastasis. No established treatment strategy for metastatic meningiomas exists to date. Herein, we report a case of solitary pulmonary metastasis of meningioma detected 2 years after neurosurgical resection of the primary tumor. Case presentation A 75-year-old male patient underwent neurosurgical resection of a convexity meningioma (World Health Organization grade II atypical meningioma), followed by postoperative radiotherapy for the residual tumor. Two postoperative years later, a solitary 10-mm pulmonary nodule in the left lower lung lobe was detected on chest computed tomography. The patient underwent video-assisted thoracoscopic left lower lobectomy for suspected pulmonary metastasis of meningioma. The pathological diagnosis was solitary pulmonary metastasis of meningioma. No sign of further recurrence was noted at 8 months postoperatively. Conclusions We present a rare and unique surgical case of solitary pulmonary metastasis of meningioma. Further investigation is necessary to establish the standardized treatment strategy for metastatic meningiomas.

Recurrent Anaplastic Meningioma with Metastasis

“…The mechanism of developing metastasis is not clearly understood, but it may be attributed to hematogenous spread or even spread via the cerebrospinal fluid. 1,2 Metastatic meningioma although a rare entity but is well documented and the metastasis may present as any other metastasis or even as a primary tumor of the site involved. Hence, it is important to keep a high index of suspicion especially in patients with recurrent and high grade meningiomas, to reach the correct diagnosis.…”

“…Once the tumor recurs locally or metastasizes, no standard treatment guidelines have been established or agreed upon. 2,3,7 However, multiple treatment strategies have been used with pulmonary metastasis, including surgical resection, adjuvant radiotherapy, chemotherapy and even cytoreductive surgery and hyperthermic intrathoracic chemotherapy. 7 Summary: Our case is a 53-year-old male whose meningioma recurred and transformed into a higher grade 16 years after initial resection.…”

“…Meningioma is the commonest primary brain tumor in adults, constituting 30% of all intracranial tumors. [1][2][3] These arise from arachnoid cap cells located in arachnoid villi. The majority of meningiomas originate from brain meninges, but 10% of all cases originate from spinal cord meninges.…”

“…WHO Grade 2, atypical meningioma represents 5-7% and WHO Grade 3, anaplastic, or malignant meningioma represent 1-3%. 1,2 Grade 3 meningiomas behave aggressively with the worst prognosis. They have a high local recurrence rate and rarely develop distant metastasis.…”

Metastasis of Malignant Intracranial Meningioma to the Lung: Report of a Case and Review of the Relevant Literature

“…We reviewed cases of intracranial meningioma with pulmonary metastasis from the literature. The characteristics of the patients, intracranial meningioma, and pulmonary metastases are summarized in Table 1 [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. This rare scenario is more frequently observed in the fifth-to-seventh decades of life, and tumors are usually located in the parasagittal region.…”