Wang Ke-DA, Su Yi-Bing, Zhang Yan
Department of Neurosurgery, Beijing Jishuitan Hospital, Beijing 100035, P.R. China.
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, P.R. China.
Oncol Lett. 2015 Nov;10(5):2765-2768. doi: 10.3892/ol.2015.3670. Epub 2015 Sep 3.
Meningiomas are slow-growing tumors, which are generally considered to be benign and rarely metastasize. Although cases of extracranial metastatic meningioma have previously been reported, multiple pulmonary metastases from a benign intracranial meningioma is particularly rare. In the present report, a case of recurrent transitional meningioma with multiple lung nodules, which were demonstrated to be metastatic meningioma, is presented. A 54-year-old female patient received surgical resection of the tumor located in the left base of the middle cranial fossa in 2006. Post-surgery pathological examination indicated a transitional meningioma of World Health Organization grade I. The tumor recurred at the original site 1 year and 3 months later and was completely surgically removed once again. Radiotherapy was administered following the second surgery. Gamma Knife was used to remove the recurrent tumor 18 months following the second surgery. Simultaneously, a chest computed tomography scan revealed multiple pulmonary nodules, which were demonstrated to be metastatic meningioma following wedge resection of the superior lobe of the right lung. The clinical behavior of meningioma does not always correlate with the classification of meningioma. A higher rate of cellular proliferation is not essential for extracranial metastasis, and an individual meningioma of any type may metastasize. Comprehensive examinations should be performed for patients with a history of recurrent intracranial meningioma to detect any distant metastases as early as possible, even when the primary tumor is benign.
脑膜瘤是生长缓慢的肿瘤,通常被认为是良性的,很少发生转移。虽然此前已有颅外转移性脑膜瘤的病例报道,但良性颅内脑膜瘤发生多发肺转移极为罕见。在本报告中,呈现了一例复发性过渡型脑膜瘤伴有多个肺结节,经证实为转移性脑膜瘤的病例。一名54岁女性患者于2006年接受了位于中颅窝左底部肿瘤的手术切除。术后病理检查显示为世界卫生组织I级的过渡型脑膜瘤。肿瘤在1年零3个月后于原部位复发,并再次被完全手术切除。第二次手术后进行了放疗。第二次手术后18个月,使用伽玛刀切除复发性肿瘤。同时,胸部计算机断层扫描显示多个肺结节,在对右肺上叶进行楔形切除后,证实为转移性脑膜瘤。脑膜瘤的临床行为并不总是与脑膜瘤的分类相关。较高的细胞增殖率并非颅外转移所必需,任何类型的单个脑膜瘤都可能发生转移。对于有复发性颅内脑膜瘤病史的患者,即使原发肿瘤是良性的,也应进行全面检查,以便尽早发现任何远处转移。