Scalp Metastases of Recurrent Meningiomas: Aggressive Behavior or Surgical Seeding?

Avecillas-Chasín, Josué M; Saceda-Gutiérrez, J.M.; Alonso-Lera, Pedro; Garcia-Pumarino, Ruben; Issa, Subhi; López, E.; Barcia, Juan A.

doi:10.1016/j.wneu.2015.02.041

Cited by 24 publications

(23 citation statements)

References 55 publications

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“…Extracranial metastases are also rare; meningiomas most commonly metastasise to the lungs, but can also metastasise to the liver, bone, pancreas, spleen and kidneys 8. There is a growing body of literature (mainly case reports) that has identified patients who have developed scalp metastases, often many years after the initial excision of the meningioma 5. A number of risk factors have been implicated in developing meningioma scalp metastases including multiple revision surgeries, immunosuppression, surgical wound complications with cerebrospinal fluid fistula and surgical seeding 1 5.…”

Section: Discussionmentioning

confidence: 99%

“…There is a growing body of literature (mainly case reports) that has identified patients who have developed scalp metastases, often many years after the initial excision of the meningioma 5. A number of risk factors have been implicated in developing meningioma scalp metastases including multiple revision surgeries, immunosuppression, surgical wound complications with cerebrospinal fluid fistula and surgical seeding 1 5. In this case, given the solitary right convex enhancing soft tissue mass identified on CT overlaid the craniotomy flap posteriorly and superiorly, and a residuum tumour within the sphenoid wing (figure 1), this is likely to represent a disseminated lesion extending from the tumour residuum rather than true metastasis; surgical seeding cannot be ruled out.…”

Section: Discussionmentioning

confidence: 99%

“…Approximately 1 in 1000 meningiomas are known to metastasise 4. However, scalp metastasis of recurrent meningiomas are much rarer 1 5. Proposed explanations for scalp meningiomas include true metastasis from a primary intracranial meningioma, ectopic arachnoid tissue or as a consequence of gene mutations due to previous radiotherapy and surgical seeding 5.…”

Section: Introductionmentioning

confidence: 99%

“…However, scalp metastasis of recurrent meningiomas are much rarer 1 5. Proposed explanations for scalp meningiomas include true metastasis from a primary intracranial meningioma, ectopic arachnoid tissue or as a consequence of gene mutations due to previous radiotherapy and surgical seeding 5. Genetic defects have been identified in meningiomas, including mutations of the neurofibromin 2 (NF2) gene and loss of chromosome 22q, and familial cutaneous meningiomas.…”

Section: Introductionmentioning

confidence: 99%

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Recurrent meningioma of the scalp after 13 years

Ashmore¹,

Clancy

Chumas

2016

BMJ Case Reports

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Meningiomas represent some of the most common types of tumour of the central nervous system. They are considered benign, with ∼1 in 1000 known to metastasise. We report a case of recurrent meningioma of the scalp 13 years following craniotomy to treat the primary. The recurrent tumour of the scalp was eventually excised 5 years later and the defect closed with an anterolateral thigh free flap in a joint procedure between the neurosurgeons and plastic surgeons. Histology of the scalp lesion confirmed a WHO grade I meningioma. Although a number of explanations for recurrent scalp meningiomas exist, the precise role of isolated genetic defects in scalp meningiomas is incomplete. The scalp meningioma in this case consisted of a complex karyotype suggestive of more aggressive disease. This case emphasises that cytogenetics may play a greater role in identifying more aggressive tumours than histology alone.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Recurrent meningioma of the scalp after 13 years

Ashmore¹,

Clancy

Chumas

2016

BMJ Case Reports

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show abstract

“…Metastasis has been reported in less than 1 per 1000 patients [1] and only 15 cases of scalp metastases have been described in literature [2]. Usually, the scalp metastasis is located near the craniotomy site.…”

Section: Introductionmentioning

confidence: 99%

Metastasis of Meningioma: A Rare Differential Diagnosis in Subcutaneous Masses of the Scalp

Lunger¹,

Ismail²,

Dalbert³

et al. 2017

Otolaryngol

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Scalp metastasis from atypical meningioma: A case report and literature review

Javed,

Khan,

Khalid

et al. 2024

Clinical Case Reports

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Key Clinical MessageScalp metastasis from atypical meningioma, though rare, underscores the importance of meticulous surgical techniques to prevent tumor cell implantation. Early detection and comprehensive management, including surgery and adjuvant therapy, are crucial for optimal outcomes.AbstractMeningiomas are tumors of the meninges that originate in the arachnoid layer from arachnoid cap cells. Atypical meningiomas, classified as WHO grade 2 tumors, tend to metastasize and recur if not surgically managed properly. Scalp metastasis is a rare occurrence that presents as a subcutaneous elevation. A 33‐year‐old patient presented with a complaint of a constant, dull pressure headache persisting for the past 12 months, exacerbated by exertion, along with seizures and neuropsychiatric symptoms. The patient had no significant medical history but had undergone surgery 4 years ago for a WHO grade 2 meningioma. The current brain MRI revealed a dural tail sign, along with masses on both the left and right sides of the frontal lobe, extending to involve the skin on the forehead and scalp. The patient underwent surgical resection and adjuvant radiation therapy. At the 12‐month follow‐up, no neurological deterioration or tumor recurrence was observed. A literature review on scalp metastasis in patients with atypical meningioma was also conducted, including eight articles published up to September 2023. The mechanism of metastasis development appears to be consistent in all eight reported cases, involving the implantation of tumor cells during resection. Therefore, there is a critical need for meticulous intra‐ and post‐operative surgical techniques to prevent such implantation.

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Scalp Metastases of Recurrent Meningiomas: Aggressive Behavior or Surgical Seeding?

Cited by 24 publications

References 55 publications

Recurrent meningioma of the scalp after 13 years

Recurrent meningioma of the scalp after 13 years

Metastasis of Meningioma: A Rare Differential Diagnosis in Subcutaneous Masses of the Scalp

Scalp metastasis from atypical meningioma: A case report and literature review

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