Primary pulmonary malignant meningioma with lymph node and liver metastasis in a centenary woman, an autopsy case
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Catherine Weber1, Sophie Pautex, Gilbert B Zulian
1Division of Primary Care, University Hospital Geneva, Geneva, Switzerland.
Abstract:
Primary meningiomas arising outside the central nervous system are very rare. They have been reported in the head and neck region, in the thorax, the retroperitoneum, and the pelvis. Usually, they behave as slow-growing tumors with a good prognosis. Herein, we report an autopsy case of a 108-year-old woman, known for a right-sided slowly growing lung nodule for 39 years. Death was attributed to cachexia. At post-mortem, a 15-cm mass was present in the right inferior lobe of the lung, associated with an ipsilateral hilar lymphadenopathy, and another 10-cm mass in the liver. Histology revealed a WHO grade III meningioma. No tumor was observed in the cranial cavity. This case illustrates a rare location of meningioma and highlights its biological behavior, with a very slow progression from a most probably benign tumor to a malignant lesion with metastasis over four decades.
Insights
Extracranial meningiomas are rare. This autopsy case details a 108-year-old woman with a lung mass progressing over 39 years to a malignant meningioma (WHO grade III) with liver metastasis.
Area of Science:
- Neuropathology
- Oncology
- Pulmonology
Background:
- Primary meningiomas typically originate within the central nervous system.
- Extracranial meningiomas are exceptionally rare, with reported occurrences in the head, neck, thorax, retroperitoneum, and pelvis.
- These tumors usually exhibit slow growth and a favorable prognosis.
Observation:
- An autopsy was performed on a 108-year-old woman with a 39-year history of a slowly growing right lung nodule.
- A 15-cm mass was found in the right inferior lung lobe with ipsilateral hilar lymphadenopathy.
- A 10-cm liver mass was also identified; no intracranial tumor was present.
Findings:
- Histological examination revealed a WHO grade III meningioma in both the lung and liver masses.
- The tumor demonstrated a prolonged, slow progression over four decades.
- Metastatic spread to the liver was confirmed.
Implications:
- This case highlights an extremely rare presentation of meningioma in the lung.
- It underscores the potential for extracranial meningiomas to exhibit aggressive malignant behavior and metastasize over extended periods.
- The findings emphasize the importance of considering meningioma in the differential diagnosis of slow-growing, unexplained masses in extraneural locations.
