Multiple Extracranial Metastases of Atypical Meningiomas

Abstract

J Korean Neurosurg Soc 45 : [107][108][109][110][111] 2009 Meningiomas are usually benign neoplasms in which extracranial metastases occur very rarely. We report a case of multiple extracranial metastases of an atypical meningioma following a local recurrence. A 68-year-old man presented with left-side motor weakness and dysarthria for two weeks. A computed tomography (CT) scan and magnetic resonance imaging (MRI) showed an intraventricular tumor. We performed a total mass removal, and the histopathologic findings were consistent with benign meningioma. Eight months later, the meningioma recurred. We performed a reoperation and whole brain radiation therapy postoperatively. The histopathologic findings showed atypical meningioma. Six months later, CT and MRI revealed metastases to multiple vertebrae, lung, ribs and perirenal soft tissue so a decompressive laminectomy with mass removal was performed. The histopathologic findings of the spinal tumors showed atypical meningioma. The results from perirenal biopsies were consistent with metastatic meningioma. In conclusion, extracranial metastasis as well as local recurrence must be considered in atypical or anaplastic meningioma. There must be regular follow-ups. Finally, an evaluation of the chest, abdomen and bone is necessary, especially when related symptoms or signs develop.

Metastatic meningioma presenting as a malignant soft tissue tumour

“…Extracranial metastasis of meningioma occurs rarely with only a few case reports documenting deep soft tissue as a site of metastasis [4, 14–17]; it is not clear from many of these reports whether, as in our case, the metastasis involved soft tissue alone or whether other contiguous structures, such as lymph nodes and bone, were also involved. Doxtader et al [14] described an aggressive meningioma in an 8 year old patient with metastasis to cervical soft tissue and lymph nodes.…”

Coexistence of cervico-thoracic extradural en-plaque meningioma with multiple intracranial meningiomas

“…There is some evidence that surgical intervention may cause metastasis [25]. Metastatic parotid gland [26], lung, pleura [27], bone [28], lymph nodes [29] and skin [30] meningiomas have been reported in the literature.…”

Metastatic meningioma: The role of whole‑body diffusion-weighted imaging

“…The most frequent site of metastases is the lung, where lesions can be solitary (more usual with benign meningiomas) (2) or multiple (3,4). However, metastases also occur in the pleura (4).…”

“…The most frequent sites for metastases are the lungs, liver, bones and cervical lymph nodes. Remote metastases can occur in histologically benign and atypical or malignant meningiomas, with variable disease-free periods (1)(2)(3)(4)(5)(6).…”