Malignant intraventricular meningioma with spinal metastasis through the cerebrospinal fluid

Kamiya, Kazuko; Inagawa, Tetsuji; Nagasako, Ren

doi:10.1016/0090-3019(89)90181-x

Cited by 60 publications

(36 citation statements)

References 2 publications

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“…The survival of patients after diagnosis of spinal metastases was reported as 6 and 8 months. 1,9) In the present case, the meningioma was histologically classified as benign at the first operation, but exhibited unusually aggressive behavior after failed radiosurgery, and later exhibited clinical characteristics of malignancy such as spinal metastasis. Radiosurgery is an effective treatment modality for patients with intracranial meningiomas, as proven by excellent short-term radiosurgically demonstrated control rates, which approach or exceed 90%.…”

Section: Discussionmentioning

confidence: 61%

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Malignant Intracranial Meningioma With Spinal Metastasis -Case Report-

Kuroda

Kashimura

Ogasawara

et al. 2009

Neurol. Med. Chir.(Tokyo)

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A 48-year-old woman presented with a left cerebellopontine angle mass. Over a 93-month period, the patient underwent seven surgeries, two radiosurgeries, and one external beam radiotherapy. The tumor was histologically benign at the first operation, but exhibited unusually aggressive behavior after failed radiosurgery and demonstrated clinical characteristics of malignancy such as spinal metastasis. The patient underwent gamma knife radiosurgery (GKR) for recurrence after the first operation, despite the tumor being located in a resectable region. The tumor did not respond. Six months after the sixth surgery, the patient presented with progressive lower extremity paraparesis and sensory disturbance below the T11 dermatome. Magnetic resonance imaging revealed multiple intradural mass lesions located at the T2, T11-T12, and L2 levels. She died 4 months after the diagnosis of spinal metastases. Retrospectively, we speculate that if a tumor is located in a resectable region and Simpson grade I or II tumor resection is possible, direct surgery may be a safer option than GKR.

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Section: Discussionmentioning

confidence: 61%

“…1,3,4,[6][7][8][9][11][12][13][14]16,19) The risk of CSF dissemination of this tumor is not clear. Twelve of these 18 patients had undergone two or more surgical procedures.…”

Section: Discussionmentioning

confidence: 99%

Malignant Intracranial Meningioma With Spinal Metastasis -Case Report-

Kuroda

Kashimura

Ogasawara

et al. 2009

Neurol. Med. Chir.(Tokyo)

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“…Multiple meningiomas arising from the dura mater are probably caused by the inherent multicentricity of the dural foci, possibly influenced by hormonal factors. 5) Although multiple intraventricular meningiomas are unreported, such tumors have been known to coexist with spinal meningiomas, 12) vestibular schwannomas, and optic nerve sheath meningiomas that accompany NF 2. NF 2 was not present in our case.…”

Section: Discussionmentioning

confidence: 99%

Third Ventricular Meningioma -Case Report-

Wajima

Iida²,

Nishi³

2011

Neurol. Med. Chir.(Tokyo)

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A 63-year-old man presented with headache. Magnetic resonance imaging showed a mass lesion homogeneously enhanced with gadolinium, which occluded the route from the third ventricle to the aqueduct. The patient underwent surgery for removal of the tumor via the right frontal transcorticaltransventricular approach to the third ventricle via the transchoroidal route. Intraoperative diagnosis was meningioma. Total removal of the tumor was achieved in piecemeal fashion (Simpson grade 1). The histological diagnosis was meningothelial meningioma. The patient was discharged without neurological deficits. Third ventricle is a rare and difficult site to remove tumor totally. However, total removal was needed in this case of benign meningioma, so the operative strategy and the differential diagnosis before operation is considered to be very important.

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“…Therefore, a malignant intraventricular meningioma seldom occurs. To the best of our knowledge, only 11 cases have been described so far 5,6,9,12,14,15,22,25,29,30,32 ( Table 1). Ours seems to be the 12 th .…”

Section: Discussionmentioning

confidence: 99%

“…The probability of benign meningiomas to disseminate and metastatize to extraneural sites is not presumably related to the primary intracranial location of the tumor, the type of surgery or the extent of surgical resection 7 . Nevertheless, surgical removal may increase the risk of iatrogenic metastases of meningiomas with atypical histologies 1 , and malignant meningiomas could even disseminate without previous surgery 14 . Seeding through CSF does not seem to be related to surgery, given the great number of meningiomas operated on and the few reported cases of metastases via the CSF 14,25 .…”

Section: (A) Hepatic Ultrasound Examination Showing Hypoechoic Lesionmentioning

confidence: 99%

Anaplastic transformation of an atypical intraventricular meningioma with metastases to the liver: case report

et al. 2009

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SummaryObjective. Malignant intraventricular meningiomas are very rare. To the best of our knowledge, only eleven cases have been reported thus far. Seven of them developed cerebrospinal fluid (CSF) metastases. We present herein the first case of a malignant intraventricular meningioma with extraneural metastases.Clinical presentation. We report a 44 year-old-man with a history of progressive headache and disorientation. Magnetic resonance imaging (MRI) revealed a 5-cm homogeneously-enhancing mass in the right trigone.Intervention. The lesion was totally resected via a parietooccipital transcortical approach. Histological examination demonstrated an atypical meningioma. Thereafter, the tumor recurred twice. At first recurrence, the tumor was completely removed again and external radiotherapy was administered. At surgery at second recurrence, the tumor was more aggressive, invading the brain parenchyma. Histological examination showed anaplastic meningioma. The patient was readmitted to hospital with fever and pain in right hypochondrium. Abdominal ultrasound examination disclosed multiple hypoechoic liver lesions. Biopsy was consistent with liver metastases of a malignant meningioma. The patient died of acute liver failure seven months after initial diagnosis.Conclusion. Malignant intraventricular meningiomas are prone to recur and develop metastases, mainly through the CSF. Nevertheless, our case shows that extraneural metastases are also possible. Therefore, when systemic deterioration occurs in a patient with a malignant intraventricular meningioma, metastases to extraneural organs such as the liver must be ruled out.KEY WORDS: Intraventricular malignant meningioma. Acute liver failure. Anaplastic. Extraneural dissemination. Intraventricular meningioma. Liver metastases. Transformación anaplásica de un meningioma atípico intraventricular con metástasis hepáticas: caso clínico ResumenObjetivos. Los meningiomas malignos intraventriculares son muy infrecuentes. En la bibliografía existente sólo se han descrito once casos hasta ahora. Siete de ellos desarrollaron metástasis a través del líquido cefalorraquídeo (LCR). Presentamos el primer caso de un meningioma maligno intraventricular con metásta-sis extraneurales.Caso clínico. Paciente varón de 44 años de edad con una clínica de cefalea progresiva y desorientación. La resonancia magnética mostraba un proceso expansivo intracraneal en el trígono derecho con captación de contraste de forma homogénea.Intervención. Se practicó una resección total de la lesión a través de un acceso transcortical. El análisis histológico mostró un meningioma atípico. A pesar de la resección total, el tumor recidivó otras dos veces. Después de la primera recidiva, el tumor fue extirpado nuevamente y el paciente recibió radioterapia externa. En la segunda recidiva, el tumor se comportó de forma más agresiva, invadiendo el parénquima cerebral. El análisis histológico mostraba un meningioma anaplásico. El paciente fue ingresado nuevamente por fiebre y dolor en el hipocondrio derecho. Una ...

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Malignant intraventricular meningioma with spinal metastasis through the cerebrospinal fluid

Cited by 60 publications

References 2 publications

Malignant Intracranial Meningioma With Spinal Metastasis -Case Report-

Malignant Intracranial Meningioma With Spinal Metastasis -Case Report-

Third Ventricular Meningioma -Case Report-

Anaplastic transformation of an atypical intraventricular meningioma with metastases to the liver: case report

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