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Metastases to meningioma-review and meta-analysis
Naama Turner1, Andrew H Kaye2,3, Iddo Paldor4,5
1The Neurosurgery Department, Rambam (Maimonides) Medical Center, 2 Ha'aliya Street, 3109601, Haifa, Israel. naama.turner@mail.huji.ac.il.
Purpose:
Meningiomas are a common tumor within the cranial cavity. They may be a target for metastatic spread of cancer elsewhere in the body. We analyzed all the data in the literature about tumor-to-meningioma metastasis (TTMM).
Methods:
We performed a meta-analysis using the PRISMA checklist to locate all cases of TTMM in the PubMed and Medline databases. We collected patient and cancer parameters, meningioma parameters, and clinical factors.
Results:
We located 124 articles, describing 152 cases of patients with TTMM. The mean (± SD) age of all patients was 62.21 ± 10.8 years, with even distribution above and below the mean. Of the cases, 65.9% were reported in women. The most common cancer origins of TTMM were breast and lung carcinoma, followed by kidney, prostate, and GI tract carcinoma. Cancer status is not a good marker of TTMM when managing a meningioma. In 36.69% of cases, TTMM was the presentation of an unknown cancer. In nearly 60% of the known cases, cancer was considered in remission for at least 1 year. Meningioma parameters are unhelpful when considering a TTMM. The distribution of meningioma location is similar to other series of meningioma reported in the literature. Meningioma grade is similar to meningiomas without TTMM. In 57.89%, the patient presented with a focal deficit. Presenting factors were seizures, elevated ICP, and others. Over 95% of cases were symptomatic at presentation.
Conclusion:
TTMM should be suspected in cases of meningioma in a patient with background cancer, regardless of meningioma parameters or cancer status.
Insights
Meningiomas can be a site for cancer metastasis. Tumor-to-meningioma metastasis (TTMM) often presents as the first sign of an unknown cancer, even when the primary cancer is in remission.
Area of Science:
- Neuro-oncology
- Oncology
- Pathology
Background:
- Meningiomas are common primary tumors of the cranial cavity.
- These tumors can be a site for metastatic spread from cancers elsewhere in the body, a phenomenon known as tumor-to-meningioma metastasis (TTMM).
Purpose of the Study:
- To analyze and synthesize existing literature data on tumor-to-meningioma metastasis (TTMM).
- To identify patient, cancer, and meningioma parameters associated with TTMM.
Main Methods:
- A comprehensive meta-analysis was conducted using PRISMA guidelines.
- Data were extracted from PubMed and Medline databases, focusing on identified cases of TTMM.
- Patient demographics, cancer origins, meningioma characteristics, and clinical presentations were collected and analyzed.
Main Results:
- 152 cases of TTMM were identified from 124 articles, with a mean patient age of 62.2 years; 65.9% were female.
- The most frequent primary cancers metastasizing to meningiomas were breast and lung carcinomas.
- In 36.69% of cases, TTMM was the initial presentation of an undiagnosed cancer, and in nearly 60% of known cases, the primary cancer was in remission.
Conclusions:
- TTMM should be suspected in patients with meningiomas, particularly those with a history of cancer.
- Meningioma characteristics and the status of the primary cancer are not reliable indicators for suspecting TTMM.
- Clinical presentation, often with focal deficits, and the presence of an underlying malignancy are key factors.
