Solitary lung meningioma with synchronous brain nodules: clinical and pathological features

Area of Science:

• Neuropathology
• Thoracic Surgery
• Oncology

Background:

• Meningiomas, typically benign tumors of the meninges, rarely exhibit metastatic potential.
• Pulmonary meningiomas are exceptionally rare primary lung neoplasms.
• Distinguishing pulmonary meningioma from metastatic disease is crucial for patient management.

Observation:

• A case of incidental pulmonary meningioma diagnosed in an ex-smoker with concurrent brain masses is presented.
• The patient's history of smoking complicated the differential diagnosis, raising suspicion for lung cancer with brain metastases.
• The incidental finding of a pulmonary mass required careful evaluation to determine its neoplastic origin.

Findings:

• The pulmonary mass was confirmed as a meningioma, a rare extacranial manifestation.
• Surgical decision-making was complex due to the possibility of primary lung cancer versus a benign pulmonary meningioma.
• Literature review indicates pulmonary meningiomas are infrequent and often asymptomatic.

Implications:

• This case underscores the importance of considering rare diagnoses even in patients with high-risk factors for common malignancies.
• Accurate diagnosis of pulmonary meningioma is essential to avoid unnecessary aggressive treatment for presumed metastatic lung cancer.
• Further research into the pathogenesis and clinical behavior of pulmonary meningiomas may improve diagnostic and therapeutic strategies.