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Published on: June 7, 2020
Lung metastases from intracranial bleeding meningioma: A case report
1Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, P.R. China Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL Medical Imageology Department, The First Clinical Medical School, Medical College of Soochow University, Jiangsu, P.R. China.
Rationale:
Meningioma is slow-growing benign neoplasm that derived from the meningothelial cells of the arachnoid mater, and it is the most common type of primary brain tumor. Although cases of extracranial metastatic meningioma have been reported previously, few cases have reported the concurrent occurrence of primary meningioma with intratumoral bleeding and lung metastases. Here we report a case of meningioma with concurrent intratumoral bleeding and lung metastases.
Patient Concerns:
The patient was admitted to our hospital with sudden left limb paralysis combined with complaints of headache and dizziness.
Diagnoses:
Histopathological results confirmed the lung metastases derived from intracranial bleeding meningioma.
Interventions:
The magnetic resonance imaging (MRI) of brain and computed tomography (CT) of brain and lung were performed.
Outcomes:
CT and MRI of brain showed an intracranial mass associated with intratumoral hemorrhage. Then, multiple lung metastases were observed in the right lung via CT images. The intracranial mass was excised through craniotomy firstly, and a thoracoscopic biopsy was performed 1 month later. The patient was hospitalized again after 1 year because of suddenly epilepsy and received effective symptomatic treatment until symptoms were relieved. Then the patient is lost to follow-up.
Lessons:
When meningiomas occurred nearby venous sinuses with aggressive behavior, a careful whole-body examination is recommended in order to find distant metastasis as early as possible.
Insights
This case report details a rare instance of meningioma with both intratumoral bleeding and lung metastases. Early whole-body examination is crucial for aggressive meningiomas to detect distant spread.
Area of Science:
- Neuro-oncology
- Radiology
- Pathology
Background:
- Meningioma, the most common primary brain tumor, arises from arachnoid mater cells.
- While extracranial metastases are known, concurrent intratumoral bleeding and lung metastases are exceptionally rare.
Observation:
- A patient presented with sudden left limb paralysis, headache, and dizziness.
- Brain MRI and CT revealed an intracranial mass with intratumoral hemorrhage.
- CT scans identified multiple lung metastases in the right lung.
Findings:
- Histopathology confirmed lung metastases originated from the intracranial bleeding meningioma.
- Surgical resection of the intracranial mass was followed by a lung biopsy.
- The patient later experienced epilepsy, receiving symptomatic treatment.
Implications:
- Aggressive meningiomas, especially those near venous sinuses, warrant thorough systemic evaluation.
- Prompt detection of distant metastases is vital for effective management of meningioma.
- This case highlights the importance of comprehensive staging in specific meningioma presentations.
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