Inouss M, Rhoul C, Kharkhach A, Bouhout T, Serji B
Faculty of Medicine and Pharmacy, Mohammed Ist University, Oujda, Morocco; Department of oncological Surgery, Regional oncology Center, Mohammed VI University Hospital Oujda, Morocco.
Faculty of Medicine and Pharmacy, Mohammed Ist University, Oujda, Morocco; Department of oncological Surgery, Regional oncology Center, Mohammed VI University Hospital Oujda, Morocco.
Int J Surg Case Rep. 2025 Jul 20;134:111707. doi: 10.1016/j.ijscr.2025.111707.
Meningiomas are the most common primary intracranial tumors and are typically benign. However, high-grade variants are rare and have a greater risk of recurrence and distant metastasis. Recognizing these exceptional metastatic presentations is essential for accurate diagnosis and management.
We report the case of a 60-year-old female patient diagnosed with an anaplastic cerebellar meningioma. Follow-up imaging revealed a growing adrenal mass. Histopathological and immunohistochemical analyses confirmed that it was a metastasis from the primary meningioma.
Distant metastases from meningiomas occur in less than 1 % of cases, most commonly involving the lungs, bones, or liver. Adrenal involvement is exceptionally rare. High-grade tumors, particularly after surgical manipulation, may disseminate via hematogenous or lymphatic routes. Diagnosis relies on histological and immunohistochemical confirmation. There is no standardized treatment, but surgical resection of metastases remains the preferred option when feasible. Systemic and targeted therapies may be considered in selected cases. Multidisciplinary management is essential given the rarity and complexity of such cases.
Although extremely rare, adrenal metastasis should be considered in patients with high-grade meningiomas and new distant lesions. Early identification and tailored management strategies may improve outcomes.
脑膜瘤是最常见的原发性颅内肿瘤，通常为良性。然而，高级别变异型罕见，且复发和远处转移风险更高。认识到这些特殊的转移表现对于准确诊断和管理至关重要。
我们报告一例60岁女性患者，诊断为间变性小脑脑膜瘤。随访影像学检查发现肾上腺肿物增大。组织病理学和免疫组化分析证实其为原发性脑膜瘤转移灶。
脑膜瘤远处转移发生率不到1%，最常见累及肺、骨或肝脏。肾上腺受累极为罕见。高级别肿瘤，尤其是在手术操作后，可能通过血行或淋巴途径播散。诊断依赖于组织学和免疫组化证实。目前尚无标准化治疗方法，但在可行时，手术切除转移灶仍是首选方案。在特定病例中可考虑全身治疗和靶向治疗。鉴于此类病例的罕见性和复杂性，多学科管理至关重要。
尽管肾上腺转移极为罕见，但对于高级别脑膜瘤和新出现远处病变的患者应考虑这种情况。早期识别和制定个性化管理策略可能改善预后。
