Obiorah Ifeyinwa E, Ozdemirli Metin
Department of Pathology, MedStar Georgetown University Hospital, Washington, DC, USA.
Case Reports Hepatol. 2018 May 7;2018:1089394. doi: 10.1155/2018/1089394. eCollection 2018.
Meningiomas are slow growing neoplasms of the central nervous system (CNS). Most of the tumors are benign and distant metastasis from a benign meningioma is rare. Metastasis to the liver, although rare, usually presents with hypoglycemia or occurs in conjunction with a clinical history of an intracranial meningioma or following the resection of a prior CNS meningioma, thus making clinical diagnosis relatively easy. Here we present an unusual case of metastatic meningioma to the liver in a 54-year-old female who presented with an incidental liver mass by ultrasound. Her clinical history and physical examination were unremarkable. A partial hepatectomy revealed a meningioma on histology. Further investigation by imaging studies showed a frontal parasagittal dural mass which was confirmed to be a World Health Organization (WHO) grade 1 meningioma. To our knowledge, this is the first report of a clinically silent metastatic meningioma to the liver without either a concurrent or a previous history of meningioma. Precise diagnosis of this challenging case requires high clinical suspicion, histopathology, and immunohistochemistry.
脑膜瘤是中枢神经系统（CNS）生长缓慢的肿瘤。大多数肿瘤是良性的，良性脑膜瘤远处转移罕见。肝转移虽然罕见，但通常表现为低血糖，或与颅内脑膜瘤临床病史相关，或发生在先前中枢神经系统脑膜瘤切除术后，因此临床诊断相对容易。在此，我们报告一例54岁女性肝转移性脑膜瘤的罕见病例，该患者通过超声偶然发现肝脏肿块。其临床病史和体格检查无异常。部分肝切除术后组织学检查显示为脑膜瘤。影像学检查进一步发现额部矢状旁硬脑膜肿块，经证实为世界卫生组织（WHO）1级脑膜瘤。据我们所知，这是首例无并发或既往脑膜瘤病史的临床无症状性肝转移性脑膜瘤报告。准确诊断这一具有挑战性的病例需要高度的临床怀疑、组织病理学和免疫组化检查。
