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[Isolated pleural metastases from an atypical meningioma]
M Yacoub1, J-M Naccache, M Kujas
1Service d'Anatomie Pathologique, Hôpital Avicenne, 125 route de Stalingrad, 93009 Bobigny.
Introduction:
Less than 2 per 1,000 meningiomas are complicated by extra-cranial metastases. These are most often found in the lung parenchyma, liver or lymph nodes. They almost always occur in anaplastic meningiomas (grade III according to OMS) and much more rarely in atypical meningiomas (grade II).
Case Report:
We report a case of pleural metastases from a primary frontal atypical meningioma with no other extra-cranial spread.
Conclusion:
Poorly differentiated meningioma presents many morphological and immuno-histochemical similarities to malignant mesothelioma. For this reason the diagnosis of pleural metastase from a meningioma cannot be made without knowledge of the primary meningeal tumour and its histological type.
Insights
Extra-cranial metastases from meningiomas are rare, typically occurring in advanced grades. This case highlights pleural metastases from an atypical meningioma, emphasizing diagnostic considerations.
Area of Science:
- Neuro-oncology
- Pathology
- Thoracic Oncology
Background:
- Meningiomas are tumors arising from the meninges.
- Extra-cranial metastases from meningiomas are uncommon, occurring in less than 2 per 1,000 cases.
- Metastases are most frequently observed in the lungs, liver, or lymph nodes, and are associated with higher-grade tumors (WHO grade III and II).
Observation:
- This report details a rare instance of pleural metastases originating from a primary frontal atypical meningioma (WHO grade II).
- The patient presented with no other detectable extra-cranial spread.
- This specific presentation is unusual given the typical metastatic patterns.
Findings:
- The histological and immunohistochemical features of poorly differentiated meningiomas can mimic those of malignant mesothelioma.
- Accurate diagnosis of pleural metastases from meningioma requires knowledge of the primary tumor's histology.
- Distinguishing meningioma metastases from primary pleural malignancies is crucial for appropriate patient management.
Implications:
- This case underscores the importance of considering meningioma as a potential source of pleural lesions, especially in patients with a history of meningioma.
- Diagnostic protocols should include thorough evaluation of the primary meningeal tumor's characteristics.
- Further research may be warranted to elucidate the mechanisms and prognostic factors associated with rare extra-cranial meningioma metastases.