Benign or Malignant? Extensive Pulmonary Metastasis of an Intracranial Meningioma-Unique Radiographic and Histopathologic Features

Roman Leonid Kleynberg ； Leonid Markus Kleynberg ； Vera M Kleynberg

《International Journal of Case Reports and Images (IJCRI)》 3卷9期 (2012/09) Pp. 17-20

https://doi.org/10.5348/ijcri-2012-09-175-CR-5

並列摘要

Introduction: Meningiomas are slow growing benign tumors of the central nervous system. Although local recurrence does occasionally occur, extracranial metastasis of meningiomas is exceedingly rare and rarely reported, occurring in less than 1 per 1000 cases. Most commonly, metastasis occurs to the lung, and most cases of pulmonary cases are detected incidentally, followed by liver, lymph nodes, and bones. Case Report: A 67-year-old Caucasian male with a past medical history of intracranial meningioma status-post resection and radiation treatment who developed multiple pulmonary metastases 29 years following complete cranial tumor resection. He presented to our hospital with respiratory failure and subsequent imaging revealed multiple pulmonary nodules in his chest. These lesions were biopsied: the final diagnosis was metastatic malignant meningioma. He developed mitral valve endocarditis and passed away from multi-system organ failure. Discussion: Extracranial metastasis of meningiomas is rare, occurring in approximately 0.1% of all meningioma cases. Several factors that are commonly associated with metastatic meningiomas include previous intracranial surgery for meningioma, dural sinus invasion, malignant histology, local recurrence, and a high Ki-67 labeling index. Conclusion: A doctor must be able to obtain a good history in the initial evaluation of a patient–the facts of which can help in narrowing down the list of differential diagnosis. Therefore, although distant metastases is a rare event, the possibility of pulmonary metastasis nevertheless is real and must not be ignored in patients with a past history of meningioma presenting with pulmonary symptoms.

並列關鍵字

Pulmonary metastasis ； Intracranial meningioma