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Malignant intraventricular meningioma with craniospinal dissemination and concurrent pulmonary metastasis
Chuan-Yuan Tao, Jia-Jing Wang, Hao Li
1Department of Neurosurgery, West China Hospital, Sichuan University, 37 Guoxue Alley, 610041 Chengdu, Sichuan, China. tcy106@163.com.
Background:
Malignant intraventricular meningiomas are quite rare and may spread along the craniospinal axis or extraneurally. However, simultaneous cerebrospinal dissemination and distal extraneural metastasis has seldom been reported.
Case Presentation:
A 51-year-old woman presented with recurrent anaplastic meningioma in the trigone of right lateral ventricle over a 1.5-year period. Suggested radiotherapy was refused after each operation. The patient showed a local relapse and dissemination around the previous tumoral cavity and along the spinal canal during the last recurrence. Left pulmonary metastasis was also found. She died despite multiple lesion resections.
Conclusions:
Malignant intraventricular meningiomas are an uncommon subset of intracranial meningiomas, and have a great potential for intraneural and extraneural metastasis. Systemic investigation for metastasis is required after surgery, especially for those without adjuvant therapies.
Insights
Malignant intraventricular meningiomas rarely spread both within the central nervous system and to distant organs. This case highlights the aggressive nature of these rare brain tumors and the need for thorough metastasis evaluation.
Area of Science:
- Neuro-oncology
- Pathology
Background:
- Malignant intraventricular meningiomas are rare intracranial tumors with a propensity for cerebrospinal and extraneural spread.
- Simultaneous cerebrospinal dissemination and distal extraneural metastasis are seldom reported in the literature.
Observation:
- A 51-year-old woman with recurrent anaplastic meningioma in the right lateral ventricle trigone presented with local relapse and spinal dissemination.
- Pulmonary metastasis was also identified during the final recurrence.
- The patient's condition worsened despite multiple surgical interventions and refusal of radiotherapy.
Findings:
- This case illustrates the aggressive behavior of malignant intraventricular meningiomas.
- The tumor exhibited both leptomeningeal spread and distant extraneural metastasis (pulmonary).
Implications:
- Malignant intraventricular meningiomas possess a significant potential for both intraneural and extraneural metastasis.
- Comprehensive systemic evaluation for metastasis is crucial post-surgery, particularly in patients foregoing adjuvant therapies like radiotherapy.
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