Department of Thoracic Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari-ku, Osaka, 537-8511, Japan.
Surg Today. 2011 Jul;41(7):995-8. doi: 10.1007/s00595-010-4409-7. Epub 2011 Jul 12.
Meningiomas rarely metastasize, and little information on pulmonary metastasectomy from meningioma has been documented. We herein report a case of a potentially curative resection for meningioma that metastasized to the lung. A 67-year-old woman was admitted to our hospital because of two masses in the right lung. In 1993, when the patient was 52 years old, she underwent a craniotomy for an atypical meningioma. The meningioma recurred once in the local site and was re-excised in 1997. In 2008, a screening chest X-ray detected two lung nodules in the right lung field. A computed tomographic scan demonstrated round masses with sharp borders, in the right S2 (2.2 cm in diameter) and S4 (1.1 cm in diameter) regions. A whole-body [(18)F]2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography/CT examination revealed intense focal FDG uptake (maximum standard uptake value [SUV(max)] = 6.9) in the larger mass, and weak FDG uptake (SUV(max) = 2.3) in the smaller mass. A wedge resection of S2 and a middle lobectomy of the right lung were performed, and the final diagnosis was pulmonary metastases from an intracranial meningioma. The patient is presently doing well 20 months after the surgery without any signs of recurrence. Our case demonstrates that surgery should be considered when pulmonary metastases are deemed completely resectable by a preoperative radiological examination, and that a good clinical outcome can be achieved.
脑膜瘤很少发生转移,关于脑膜瘤肺转移的肺转移切除术的资料很少。我们在此报告一例肺转移脑膜瘤的潜在可治愈性切除。一名 67 岁女性因右肺两个肿块而入院。1993 年,患者 52 岁时,因非典型脑膜瘤行开颅手术。脑膜瘤局部复发一次,于 1997 年再次切除。2008 年,胸部 X 射线筛查发现右肺野有两个肺结节。CT 扫描显示右 S2(直径 2.2 厘米)和 S4(直径 1.1 厘米)区域边界锐利的圆形肿块。全身[18F]2-氟-2-脱氧-D-葡萄糖(FDG)正电子发射断层扫描/CT 检查显示较大肿块中 FDG 摄取强烈(最大标准摄取值[SUV(max)]=6.9),较小肿块中 FDG 摄取较弱(SUV(max)=2.3)。行 S2 楔形切除术和右肺中叶切除术,最终诊断为颅内脑膜瘤肺转移。术后 20 个月,患者无复发迹象,目前情况良好。我们的病例表明,当术前影像学检查认为肺转移完全可切除时,应考虑手术,并且可以获得良好的临床结果。