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Metastatic malignant meningioma.

M L Slavin1

  • 1Department of Ophthalmology, Long Island Jewish Medical Center, New Hyde Park, NY 11042.

Journal of Clinical Neuro-Ophthalmology
|March 1, 1989
PubMed
Summary
This summary is machine-generated.

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A rare malignant meningioma mimicked metastatic disease. Bone scan imaging was crucial for diagnosis when CT and MRI failed, highlighting this aggressive tumor

Area of Science:

  • Neuro-oncology
  • Diagnostic Imaging
  • Pathology

Background:

  • Malignant lesions at the skull base, particularly metastatic tumors, often present with cranial neuropathies like abducens and trigeminal nerve dysfunction, Horner's syndrome, and reduced lacrimation.
  • Meningiomas are typically benign tumors, but a subset can exhibit malignant characteristics, necessitating accurate and timely diagnosis.

Observation:

  • A patient presented with symptoms suggestive of a malignant lesion in the middle cranial fossa.
  • Computed tomography (CT) and magnetic resonance imaging (MRI) were unable to detect the lesion.
  • A bone scan successfully identified the affected area, leading to further investigation.

Findings:

  • Biopsy confirmed the presence of an en plaque malignant meningioma.

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  • Histological features included cellular atypia, nuclear pleomorphism, marked mitoses, and brain invasion, confirming malignancy.
  • Pulmonary metastases were subsequently identified, indicating the aggressive nature of the tumor.

    • Implications:

    • This case underscores the importance of considering rare diagnoses like malignant meningioma, even when clinical presentation suggests common metastatic disease.
    • Bone scintigraphy can be a valuable tool in diagnosing skull base lesions when conventional cross-sectional imaging is inconclusive.
    • The findings highlight the potential for meningiomas, even those initially appearing benign, to exhibit aggressive behavior and metastasize.