Department of Thoracic Surgery, General Hospital of Southern Theater Command, PLA, Guangzhou, China.
Department of Pathology, General Hospital of Southern Theater Command, PLA, Guangzhou, China.
Cancer Rep (Hoboken). 2024 Jun;7(6):e2123. doi: 10.1002/cnr2.2123.
Primary pulmonary meningioma (PPM) is an exceedingly rare neoplasm originating in the meninges within the lung. Despite sharing similarities with its central nervous system (CNS) counterparts, PPM presents unique diagnostic challenges and therapeutic considerations owing to its infrequent occurrence.
This case report describes a 73-year-old male who underwent chest computed tomography (CT), which revealed a mass in the posterior basal segment of the right lower lobe, suggestive of a low-grade malignant tumor approximately 30-40 mm in size. Single-port video-assisted thoracoscopic surgery (VATS) was performed to resect the mass via localized lesion excision (lung wedge resection). Intraoperative frozen section pathology indicated a low-grade malignant epithelial tumor, leading to a decision for maximal lung function preservation, considering the patient's advanced age. The surgical team opted for a localized excision to ensure negative margins. Histopathological analysis confirmed the diagnosis of epithelioid PPM, a rare subtype even among PPM cases (World Health Organization [WHO] Grade I). The patient was discharged 9 days after surgery without complications and resumed normal daily activities 1 month postoperatively. The rarity of PPM precludes a standardized treatment protocol, with surgical resection as the primary approach. However, the efficacy of adjunctive therapies remains uncertain due to limited evidence.
This case report contributes to a better understanding of PPM and emphasizes the importance of a comprehensive diagnostic evaluation and individualized treatment planning for this rare entity.
原发性肺脑膜瘤（PPM）是一种极为罕见的起源于肺内脑膜的肿瘤。尽管与中枢神经系统（CNS）的脑膜瘤有相似之处，但由于其罕见的发生，PPM 存在独特的诊断挑战和治疗考虑。
本病例报告描述了一名 73 岁男性，其接受了胸部计算机断层扫描（CT），显示右肺下叶后基底段有一个肿块，大小约为 30-40mm，提示为低度恶性肿瘤。单孔电视辅助胸腔镜手术（VATS）用于通过局部病变切除（肺楔形切除术）切除肿块。术中冷冻切片病理提示为低度恶性上皮性肿瘤，考虑到患者年龄较大，决定最大限度地保留肺功能。手术团队选择局部切除以确保切缘阴性。组织病理学分析证实诊断为上皮样 PPM，即使在 PPM 病例中也是罕见亚型（世界卫生组织[WHO]I 级）。患者术后 9 天无并发症出院，术后 1 个月恢复正常日常活动。由于证据有限，PPM 的治疗方案尚无标准，手术切除是主要方法。然而，辅助治疗的疗效仍不确定。
本病例报告有助于更好地了解 PPM，并强调了对这种罕见实体进行全面诊断评估和个体化治疗计划的重要性。
