Meningioma Metastatic to the Lung

Abstract

Meningiomas constitute 15% to 18% of all primary intracranial and intraspinal tumors. Distant extracranial metastases are reported to occur in fewer than 1 in 1000 cases. Of 1992 primary intracranial meningiomas seen at Mayo Clinic Rochester from 1972 through 1994, we identified 3 (0.15%) with documented extracranial metastasis. A review of the literature suggests that previous craniotomy, venous sinus invasion, local recurrences, histological malignancy, and papillary morphology may be risk factors for systemic spread, as demonstrated in our cases. Although rare, metastatic meningioma should be considered in the differential diagnosis of abnormal findings on chest radiography in patients with known or suspected intracranial meningioma.

Múltiplas metástases pulmonares de meningioma benigno

“…Metastatic lesions are also normally of a benign nature (6) . Metastases occur most frequently in the lungs (60%), the liver (34%), cervical lymph nodes (18%), long bones, pelvis and skull (11%), pleura (9%), vertebrae (7%) and central nervous system (5%) (6,9) . Hematogenic dissemination may explain the incidence of pulmonary metastases (9) .…”

“…Metastases occur most frequently in the lungs (60%), the liver (34%), cervical lymph nodes (18%), long bones, pelvis and skull (11%), pleura (9%), vertebrae (7%) and central nervous system (5%) (6,9) . Hematogenic dissemination may explain the incidence of pulmonary metastases (9) . A review of the literature indicates that previous craniotomy, invasion of venous sinuses, local recurrence, histological malignancy and papillary morphology may be risk factors for systemic expansion (6) .…”

“…A review of the literature indicates that previous craniotomy, invasion of venous sinuses, local recurrence, histological malignancy and papillary morphology may be risk factors for systemic expansion (6) . It has been more frequently suggested that the occurrence of metastases are due to local recurrence of the tumor after resection (9) . In the case of our patient, although she was submitted to resection of the intracranial tumor, recurrence of the meningioma was observed immediately after surgery, which is a risk factor for the occurrence of metastases.…”

“…In a Mayo Clinic report, three cases (0.15%) of extracranial metastases were documented between 1972 and 1994. Most patients with metastases of meningiomas are adults between 40 and 60 years of age (9) . Pulmonary metastases are rarely accompanied by local symptoms (9) .…”

“…Approximately 3% of benign meningiomas and 78% of atypical tumors recur within five years. Malignant meningiomas are rare, with an incidence ranging from 2% to 10% (9) . Due to the slow progress of the meningiomas and the favorable prognosis after resection, surgery is the treatment of choice (6) .…”