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Open Access 01-12-2021 | Meningioma | Case report

Low-grade intracranial meningioma with bilateral pulmonary metastases incidentally detected postpartum: a case report and review of the literature

Authors: Parviz Mardani, Arash Safarian, Anita Ashari, Sarina Pourjafar, Mohammad Hossein Anbardar, Negar Azarpira, Masoud Vafabin, Shahaboddin Yousefi

Published in: Journal of Medical Case Reports | Issue 1/2021

Abstract

Introduction

Meningiomas are the most commonly encountered intracranial tumors, usually showing indolent behavior. Extra-axial spreading and distant metastases are seldom detected in these tumors, and lung metastasis from a low-grade meningioma is a rare event.

Case presentation

This case report aimed to present the clinical, imaging, and pathological features of a 37-year-old Caucasian pregnant woman with bilateral lung metastases incidentally detected during preoperative workup ahead of surgery for a primary intracranial meningioma. The possible metastatic routes and risk factors of dissemination to the pulmonary circulation were discussed as well.

Conclusion

Metastasis must be considered in patients with intracranial meningiomas accompanied by venous sinus invasion and extension through the calvarium. Thorough paraclinical investigations are suggested in such cases.

Vakil H, Tran L, Lewis GD, Cykowski MD, Butler EB, Teh BS. Biopsy proven metastatic meningioma: a case report and review of the literature. Rep Pract Oncol Radiother. 2019;24(6):528–32.PubMedPubMedCentralCrossRef

Wang M, Zhan R, Zhang C, Zhou Y. Multiple pulmonary metastases in recurrent intracranial meningioma: case report and literature review. J Int Med Res. 2016;44(3):742–52.PubMedPubMedCentralCrossRef

He L, Yu S, Wang L. Rapid recurrence and malignant transformation of a benign meningioma after pregnancy: a case report. Br J Neurosurg. 2020;1:1–3.CrossRef

Yekeler E, Dursun M, Yilmazbayhan D, Tunaci A. Multiple pulmonary metastases from intracranial meningioma: MR imaging findings (case report). Diagn Interv Radiol. 2005;11(1):28–30.PubMed

Kessler RA, Garzon-Muvdi T, Yang W, Weingart J, Olivi A, Huang J, et al. Metastatic atypical and anaplastic meningioma: a case series and review of the literature. World Neurosurg. 2017;101:47–56.PubMedCrossRef

Pettersson-Segerlind J, Mathiesen T, Elmi-Terander A, Edström E, Talbäck M, Feychting M, et al. The risk of developing a meningioma during and after pregnancy. Sci Rep. 2021;11(1):9153.PubMedPubMedCentralCrossRef

Erman T, Hanta I, Haciyakupoğlu S, Zorludemir S, Zeren H, Göçer AI. Huge bilateral pulmonary and pleural metastasis from intracranial meningioma: a case report and review of the literature. J Neurooncol. 2005;74(2):179–81.PubMedCrossRef

Hortobágyi T, Bencze J, Murnyák B, Kouhsari MC, Bognár L, Marko-Varga G. Pathophysiology of meningioma growth in pregnancy. Open Med (Wars). 2017;12:195–200.PubMedPubMedCentralCrossRef

Laviv Y, Ohla V, Kasper EM. Unique features of pregnancy-related meningiomas: lessons learned from 148 reported cases and theoretical implications of a prolactin modulated pathogenesis. Neurosurg Rev. 2018;41(1):95–108.PubMedCrossRef

10.

Lusis EA, Scheithauer BW, Yachnis AT, Fischer BR, Chicoine MR, Paulus W, et al. Meningiomas in pregnancy: a clinicopathologic study of 17 cases. Neurosurgery. 2012;71(5):951–61.PubMedCrossRef

11.

12.

Telugu RB, Chowhan AK, Rukmangadha N, Patnayak R, Phaneendra BV, Mowliswara Prasad BC, et al. Estrogen and progesterone receptor in meningiomas: an immunohistochemical analysis. J Cancer Res Ther. 2020;16(6):1482–7.PubMed

13.

Aumann JL, van den Bosch JM, Elbers JR, Wagenaar SJ. Metastatic meningioma of the lung. Thorax. 1986;41(6):487–8.PubMedPubMedCentralCrossRef

14.

LeMay DR, Bucci MN, Farhat SM. Malignant transformation of recurrent meningioma with pulmonary metastases. Surg Neurol. 1989;31(5):365–8.PubMedCrossRef

15.

Hishima T, Fukayama M, Funata N, Mochizuki M, Hayashi Y, Koike M, et al. Intracranial meningioma masquerading as a primary pleuropulmonary tumor. Pathol Int. 1995;45(8):617–21.PubMedCrossRef

16.

Murrah CP, Ferguson ER, Jennelle RL, Guthrie BL, Holman WL. Resection of multiple pulmonary metastases from a recurrent intracranial meningioma. Ann Thorac Surg. 1996;61(6):1823–4.PubMedCrossRef

17.

Adlakha A, Rao K, Adlakha H, Perry A, Crotty TB, Scheithauer BW, et al. Meningioma metastatic to the lung. Mayo Clin Proc. 1999;74(11):1129–33.PubMedCrossRef

18.

Figueroa BE, Quint DJ, McKeever PE, Chandler WF. Extracranial metastatic meningioma. Br J Radiol. 1999;72(857):513–6.PubMedCrossRef

19.

Travitzky M, Libson E, Nemirovsky I, Hadas I, Gabizon A. Doxil-induced regression of pleuro-pulmonary metastases in a patient with malignant meningioma. Anticancer Drugs. 2003;14(3):247–50.PubMedCrossRef

20.

Psaras T, Pantazis G, Steger V, Meyermann R, Honegger J, Beschorner R. Benign meningioma developing late lung metastases: case report and review of the literature. Clin Neuropathol. 2009;28(6):453–9.PubMedCrossRef

21.

Alexandru D, Glantz MJ, Kim L, Chamberlain MC, Bota DA. Pulmonary metastases in patients with recurrent, treatment-resistant meningioma: prognosis and identification by ¹¹¹Indium-octreotide imaging. Cancer. 2011;117(19):4506–11.PubMedCrossRef

22.

Sabet A, Ahmadzadehfar H, Herrlinger U, Wilinek W, Biersack HJ, Ezziddin S. Successful radiopeptide targeting of metastatic anaplastic meningioma: case report. Radiat Oncol. 2011;6:94.PubMedPubMedCentralCrossRef

23.

Nakayama Y, Horio H, Horiguchi S, Hato T. Pulmonary and pleural metastases from benign meningeal meningioma: a case report. Ann Thorac Cardiovasc Surg. 2014;20(5):410–3.PubMedCrossRef

24.

Ocque R, Khalbuss WE, Monaco SE, Michelow PM, Pantanowitz L. Cytopathology of extracranial ectopic and metastatic meningiomas. Acta Cytol. 2014;58(1):1–8.PubMedCrossRef

25.

Frydrychowicz C, Holland H, Hantmann H, Gradistanac T, Hoffmann KT, Mueller W, et al. Two cases of atypical meningioma with pulmonary metastases: a comparative cytogenetic analysis of chromosomes 1p and 22 and a review of the literature. Neuropathology. 2015;35(2):175–83.PubMedCrossRef

26.

Dalle Ore CL, Magill ST, Yen AJ, Shahin MN, Lee DS, Lucas CG, et al. Meningioma metastases: incidence and proposed screening paradigm. J Neurosurg. 2019;132(5):1447–55.PubMedCrossRef

27.

Sathirareuangchai S, Kakazu K, Tauchi-Nishi P, Morris P, Sae-Ow W. Low grade intracranial meningioma presenting with pulmonary metastasis: case report and literature review. Pathol Res Pract. 2019;215(7):152390.PubMedCrossRef

28.

Asioli S, Senetta R, Maldi E, D’Ambrosio E, Satolli MA, Bussolati G, et al. “Benign” metastatic meningioma: clinico-pathological analysis of one case metastasising to the lung and overview on the concepts of either primitive or metastatic meningiomas of the lung. Virchows Arch. 2007;450(5):591–4.PubMedCrossRef

29.

Baisden BL, Hamper UM, Ali SZ. Metastatic meningioma in fine-needle aspiration (FNA) of the lung: cytomorphologic finding. Diagn Cytopathol. 1999;20(5):291–4.PubMedCrossRef

30.

Brennan C, O’Connor OJ, O’Regan KN, Keohane C, Dineen J, Hinchion J, et al. Metastatic meningioma: positron emission tomography CT imaging findings. Br J Radiol. 2010;83(996):e259–62.PubMedPubMedCentralCrossRef

31.

Fabi A, Nuzzo C, Vidiri A, Ciccarese M, Felici A, Cattani F, et al. Bone and lung metastases from intracranial meningioma. Anticancer Res. 2006;26(5b):3835–7.PubMed

32.

Kanzaki R, Higashiyama M, Fujiwara A, Tokunaga T, Maeda J, Okami J, et al. Surgical resection of pulmonary metastases from meningioma: report of a case. Surg Today. 2011;41(7):995–8.PubMedCrossRef

33.

Kodama K, Doi O, Higashiyama M, Horai T, Tateishi R, Nakagawa H. Primary and metastatic pulmonary meningioma. Cancer. 1991;67(5):1412–7.PubMedCrossRef

34.

Kovoor JM, Jayakumar PN, Srikanth SG, Indira B, Devi MG. Solitary pulmonary metastasis from intracranial meningiothelial meningioma. Australas Radiol. 2002;46(1):65–8.PubMedCrossRef

35.

Lambertz N, Koehler J, Schulte DM, Kuehl H, Wohlschlaeger J, Hense J, et al. Multivisceral systemic metastases from an intracranial anaplastic meningioma: a case report and review of literature. Clin Neurol Neurosurg. 2011;113(7):592–5.PubMedCrossRef

36.

Pramesh CS, Saklani AP, Pantvaidya GH, Heroor AA, Naresh KN, Sharma S, et al. Benign metastasizing meningioma. Jpn J Clin Oncol. 2003;33(2):86–8.PubMedCrossRef

37.

Shin MS, Holman WL, Herrera GA, Ho KJ. Extensive pulmonary metastasis of an intracranial meningioma with repeated recurrence: radiographic and pathologic features. South Med J. 1996;89(3):313–8.PubMedCrossRef

38.

Som PM, Sacher M, Strenger SW, Biller HF, Malis LI. “Benign” metastasizing meningiomas. AJNR Am J Neuroradiol. 1987;8(1):127–30.PubMedPubMedCentral

39.

Tao CY, Wang JJ, Li H, You C. Malignant intraventricular meningioma with craniospinal dissemination and concurrent pulmonary metastasis. World J Surg Oncol. 2014;12:238.PubMedPubMedCentralCrossRef

40.

Tao LC. Pulmonary metastases from intracranial meningioma diagnosed by aspiration biopsy cytology. Acta Cytol. 1991;35(5):524–8.PubMed

41.

Tworek JA, Mikhail AA, Blaivas M. Meningioma: local recurrence and pulmonary metastasis diagnosed by fine needle aspiration. Acta Cytol. 1997;41(3):946–7.PubMed

42.

Lee GC, Choi SW, Kim SH, Kwon HJ. Multiple extracranial metastases of atypical meningiomas. J Korean Neurosurg Soc. 2009;45(2):107–11.PubMedPubMedCentralCrossRef

43.

Kim J, Kim KH, Kim YZ. The clinical outcome of hydroxyurea chemotherapy after incomplete resection of atypical meningiomas. Brain Tumor Res Treat. 2017;5(2):77–86.PubMedPubMedCentralCrossRef

44.

Kaley TJ, Wen P, Schiff D, Ligon K, Haidar S, Karimi S, et al. Phase II trial of sunitinib for recurrent and progressive atypical and anaplastic meningioma. Neuro Oncol. 2015;17(1):116–21.PubMedCrossRef

Title: Low-grade intracranial meningioma with bilateral pulmonary metastases incidentally detected postpartum: a case report and review of the literature
Authors: Parviz Mardani
Arash Safarian
Anita Ashari
Sarina Pourjafar
Mohammad Hossein Anbardar
Negar Azarpira
Masoud Vafabin
Shahaboddin Yousefi
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Meningioma
Metastasis
Meningioma
Radiotherapy
Thoracotomy
Published in: Journal of Medical Case Reports / Issue 1/2021
Electronic ISSN: 1752-1947
DOI: https://doi.org/10.1186/s13256-021-03093-w

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Low-grade intracranial meningioma with bilateral pulmonary metastases incidentally detected postpartum: a case report and review of the literature

Abstract

Introduction

Case presentation

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Case presentation

Conclusion

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