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Updated: Apr 8, 2026
Surgical Treatment of an Endolymphatic Sac Tumor
Published on: May 26, 2023
Benign Sacral Metastatic Meningioma: A Rare Entity
Michael J Strong1, Juanita Garces2, Wendell Tang3
1Department of Pathology, Tulane University School of Medicine, New Orleans, LA ; Tulane Cancer Center, Tulane University School of Medicine, New Orleans, LA.
Background:
Meningiomas are common intracranial tumors with a low metastatic rate. Those that do metastasize often show histopathologic signs of malignancy. In rare cases, the primary and secondary tumors are histologically benign.
Case Report:
We report the case of a 57-year-old female with a histologically benign intracranial meningioma that metastasized to the sacrum. The patient had a long history of intracranial meningioma with multiple recurrences. At each recurrence, histopathologic examination of the resected tumor showed no signs of malignancy. The sacral meningioma was biopsied and found to be histologically benign. The patient was treated with radiotherapy (54 Gy in 30 fractions), and her symptoms resolved. Six months later, the patient developed left leg weakness. Magnetic resonance imaging showed growth of her intracranial mass for which she underwent a craniotomy for tumor resection. Pathologic evaluation showed evidence of benign meningioma without atypical features. She recovered well from this procedure and returned to her baseline in several weeks.
Conclusion:
After treatment, the patient had no signs of radiographic progression in either location.
Insights
This case study highlights a rare instance of histologically benign intracranial meningioma metastasizing to the sacrum. Despite benign histology, the tumor recurred and spread, emphasizing the need for vigilance in meningioma management.
Area of Science:
- Neuro-oncology
- Pathology
Background:
- Meningiomas are common primary brain tumors.
- Metastasis from meningiomas is rare and often associated with malignant histology.
- Benign meningiomas rarely metastasize.
Observation:
- A 57-year-old female presented with a histologically benign intracranial meningioma.
- The patient experienced multiple recurrences of benign intracranial meningioma.
- A secondary, histologically benign meningioma was discovered in the sacrum.
Findings:
- The intracranial meningioma showed no signs of malignancy despite recurrences.
- The sacral meningioma was also histologically benign.
- Radiotherapy was administered for the sacral metastasis, and the intracranial tumor was resected.
Implications:
- This case underscores that histologically benign meningiomas can exhibit metastatic behavior.
- It highlights the importance of considering metastasis even with benign tumor histology.
- Long-term surveillance may be warranted for patients with recurrent benign meningiomas.
