Recurrent Atypical Meningioma with Pleural Metastases

Abstract

Meningiomas are the most common primary intracranial tumors in adults. Although Grade I meningiomas are considered benign, Grade II/III (atypical and anaplastic) meningiomas are known to be locally aggressive, recurrent, and rarely present with distant metastases. We report a 40-year-old female with recurrent atypical meningioma (WHO Grade II) who presented with features suggestive of a massive right-sided pleural effusion. Imaging showed bilateral large pleural-based lesions, and histopathological examination and immunohistochemistry of the mass were consistent with metastatic atypical meningioma. A high index of suspicion is warranted to detect extracranial metastases, especially in patients with recurrent meningiomas and higher WHO grade of tumor.

Hydrolysis of polylactide in aqueous media

“…The biodegradation of PLA is a two-step process that includes an abiotic hydrolysis of the polymer matrix into oligomers and an assimilation of oligomers by microorganisms and their transformation into carbon dioxide and water. 3,4 Abiotic hydrolysis is often considered as the limiting step of PLA degradation. Because PLA is a condensation polymer, chain scission is highly dependent on the presence of water.…”

Recurrent Anaplastic Meningioma with Metastasis

“…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. 5 One study has even recommended systemic imaging in patients with recurrent tumors or concerning symptoms to detect extracranial metastasis and help in clinical decision making. 6 First line treatment for Grade 3 meningiomas is complete surgical resection followed by radiotherapy to minimize the chances of recurrence, 3,4 nevertheless despite complete surgical resection, the tumor does recur in 50-90% of cases.…”

“…They have a high local recurrence rate and rarely develop distant metastasis. 4,5 As extracranial metastasis is extremely rare, seen in less than 0.1-0.2 % of all meningiomas, 2,3 a high index of suspicion should be kept when encountered with such lesions in patients with recurrent atypical/anaplastic meningiomas.…”