Bhargava P, McGrail K M, Manz H J, Baidas S
Division of Hematology-Oncology, Lombardi Cancer Center, Georgetown University Medical Center, Washington, DC 20007, USA.
Am J Clin Oncol. 1999 Apr;22(2):199-202. doi: 10.1097/00000421-199904000-00022.
Tumor-to-tumor metastasis is rare. The authors report a case of a 52-year-old man with a 1-year history of a right parasaggital meningioma, whose clinical signs were consistent with enlarging meningioma. In preparation for surgery, the routine preoperative chest radiograph revealed a lung mass. Fine-needle aspiration of the mass revealed adenocarcinoma. The patient underwent surgical excision of the intracranial mass, which was thought to be a meningioma. However, pathologic examination revealed a transitional meningioma extensively infiltrated with deposits of metastatic carcinoma from the patient's primary lung tumor. Metastasis to meningioma was therefore responsible for the rapid enlargement of the long-standing meningioma, and caused the first clinical manifestation of primary lung carcinoma. Recurrent metastasis developed at the surgical site 5 weeks later, requiring surgical excision and postoperative radiation to prevent further recurrence. This is a highly unusual presentation for lung carcinoma and, to the authors' best knowledge, is the first such case reported. A review of the published literature revealed 20 other cases of lung carcinoma metastatic to meningioma, which were incidentally discovered on surgery or autopsy.
肿瘤转移至肿瘤的情况较为罕见。作者报告了一例52岁男性患者，其右侧矢状窦旁脑膜瘤病史1年，临床症状与脑膜瘤增大相符。在准备手术时，术前常规胸部X线片显示肺部有一肿块。对该肿块进行细针穿刺活检显示为腺癌。患者接受了颅内肿块的手术切除，该肿块原被认为是脑膜瘤。然而，病理检查显示为过渡型脑膜瘤，广泛浸润有来自患者原发性肺癌的转移癌沉积物。因此，肺癌转移至脑膜瘤导致了长期存在的脑膜瘤迅速增大，并引发了原发性肺癌的首次临床表现。5周后手术部位出现复发转移，需要再次手术切除并术后放疗以防止进一步复发。这是肺癌一种非常罕见的表现，据作者所知，这是首例报道的此类病例。对已发表文献的回顾发现另外20例肺癌转移至脑膜瘤的病例，这些病例是在手术或尸检时偶然发现的。
