[A case of intracranial malignant meningioma with extraneural metastases].

A case of intracranial malignant meningioma with remote metastases to the bones is reported. A 66-year-old man with regrowth of right sphenoid ridge meningioma, whose meningioma had partially been removed 15 years before, was admitted to our clinic. The tumor was large enough to protrude into the lateral and third ventricles, and involved the right internal carotid, middle cerebral, anterior cerebral artery and optic nerve. The tumor had irregular contour, and was heterogeneously enhanced by Gd-DTPA on MRI. An operation was performed, but a part of the tumor around these main arteries could not be removed. Histopathological examination revealed anaplastic meningioma, resulting from malignant change. Radiotherapy was performed postoperatively and the patient was discharged. Seven months after the operation he complained of posterior nuchal, back, and lumbar pain. Radiological examination revealed multiple punched-out lesions in the ribs and vertebrae, which were histologically demonstrated to be metastases of intracranial anaplastic meningioma. Radiotherapy was carried out for the cervical vertebrae, but his symptoms persisted. He died of pneumonia 10 months after the operation.