Metastatic meningioma to the eleventh dorsal vertebral body: total en bloc spondylectomy. Case report and review of the literature

Delgado-López, Pedro David; Martín-Velasco, Vicente; Castilla-Díez, José Manuel; Fernández-Arconada, O.; Corrales-García, Eva María; Galacho-Harnero, A.; Rodríguez-Salazar, Antonio; Pérez-Míes, Belén

doi:10.1016/s1130-1473(06)70346-3

Cited by 25 publications

(11 citation statements)

References 34 publications

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“…Atypical and malignant meningiomas (only 1.7–4.2% of all meningiomas) differ from benign lesions according to several histological features, such as increased mitotic activity (>4 mitotic figures in atypical and >20 mitoses in malignant, per 10 hpf), increased cell density, presence of nuclear pleomorphism, loss of architectural cell disposition, existence of tumoral necrosis and brain invasion, papillary transformation and carcinoma, melanoma, or sarcomatous appearance ( Table 1 ). Type II (atypical, clear cell, and choroid variants) and III (rhabdoid, papillary, and anaplastic variants), and the presence of brain invasion in either benign or malignant meningiomas, seem to favor metastatic spread ( 8 , 9 ). Immunohistochemical analyses of a nuclear protein related to cell proliferation, Ki-67 proliferative index, or of molecular markers such as CDKN2A deletion, along with a 9p21 deletion, are also useful in evaluating the potential of meningioma recurrence and/or metastases ( 4 ).…”

Section: Discussionmentioning

confidence: 99%

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Vertebral metastases from intracranial meningioma

Zaghouani

Yahyaoui

Chabchoub

et al. 2014

Acta Radiologica Short Reports

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Section: Discussionmentioning

confidence: 99%

“…A few cases of spinal metastases have been published to date. Some of them were intra-arachnoidian and others were intraosseous; located in C-2 ( 15 ), T-1 ( 16 ), T-10 ( 17 ), T-11 ( 8 ), L-2 ( 17 ), L-5 ( 18 ), and sacrum ( 19 ). They can even be multiple.…”

Section: Discussionmentioning

confidence: 99%

Vertebral metastases from intracranial meningioma

Zaghouani

Yahyaoui

Chabchoub

et al. 2014

Acta Radiologica Short Reports

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“…Malignant meningiomas have an incidence of metastases of approximately 43% 8 . 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 .…”

Section: (A) Hepatic Ultrasound Examination Showing Hypoechoic Lesionmentioning

confidence: 99%

“…In fact, even though some cells could become loose during surgery and seed throughout the subarachnoidal space 27,30 , meningiomas metastatize more frequently outside the central nervous system. Benign intraventricular meningiomas, despite being in contact with the CSF of the ventricles while growing, paradoxically tend to metastatize out of the central nervous system 7,11 , with only one case reported of metastasis through the CSF 27 . On the other hand, the aggressiveness of an intraventricular meningioma is likely to be related to its probability to disseminate via the CSF, as in 7 out of the 11 cases were metastatic implants in different subarachnoidal locations (spinal cord, cerebellopontine angle, quadrigeminal cisterns, fourth ventricle, pontine base, etc.)…”

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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“…[1345678101114151617] The incidence of extracranially metastasizing meningiomas seems to be less than 1:1000. [7] If distant metastases occur, they usually affect the lungs, bones, spinal canal, liver, or kidneys.…”

Section: Introductionmentioning

confidence: 99%

Paraneoplastic symptoms caused by extracranial meningioma metastases?

Mindermann

2016

Surg Neurol Int

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Background:There are only few reports on distant metastases of cranial meningiomas WHO I. In one-third of the cases, distant metastases seem to be clinically silent. This is the first case of distant metastases which may have manifested with a paraneoplastic syndrome.Case Description:A 52-year-old white male patient was diagnosed with distant metastases to the bones and liver 11 and 12 years following craniotomy and removal of a tentorial meningioma WHO I. At that time, the patient had developed paresthesia, unsteady gait, and a slight cognitive impairment, which in retrospect had no other explanation than that of a paraneoplastic syndrome. Eighteen years following craniotomy, a small intracranial tumor rest is under control following two single session radiosurgery treatments. At present, the patient has a multitude of bone and liver metastases, which seem to cause his paraneoplastic symptoms.Conclusion:Screening for malignancies in patients with paraneoplastic symptoms and a history of cranial meningioma should include screening for distant metastases from the meningioma.

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Metastatic meningioma to the eleventh dorsal vertebral body: total en bloc spondylectomy. Case report and review of the literature

Cited by 25 publications

References 34 publications

Vertebral metastases from intracranial meningioma

Vertebral metastases from intracranial meningioma

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

Paraneoplastic symptoms caused by extracranial meningioma metastases?

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