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Atypical meningioma with nodal metastasis: A case report
S J Y Chew1, C Rajesvaran2, X Woo3
1University Malaysia Sarawak, Department of Pathology, Malaysia. chewjink@gmail.com.
Introduction:
Meningiomas are common and usually benign central nervous system neoplasms. These neoplasms are graded into three groups which differ in biological behaviour. Atypical meningioma is an intermediate grade (Grade 2) tumour that is rarely associated with metastases compared to higher grade (Grade 3) meningiomas.
Case Report:
A 68-year-old lady with a history of multiple craniotomies and hemifacial resections for meningothelial meningioma currently underwent orbital exenteration, tumour debulking and cervical nodal excision for tumour recurrence. Histopathological examination of the tumour showed atypical meningioma, with cervical nodal metastasis.
Discussion:
This case report presents a rare finding of lymph node metastasis associated with atypical meningioma. The previous history of surgical resection is a known risk factor for metastasis for low to intermediate grade meningioma. Tumour biology and histology are predictors of metastasis. Haematogenous dissemination is the commonest route of metastasis. No standardised management protocol has been developed and the prognosis remains unknown.
Insights
This case report details a rare instance of atypical meningioma metastasizing to lymph nodes. Previous surgeries and tumor characteristics are key factors in meningioma metastasis risk.
Area of Science:
- Neurology
- Oncology
- Pathology
Background:
- Meningiomas are common central nervous system tumors, graded by behavior.
- Atypical meningioma (Grade 2) is intermediate, rarely metastasizing compared to Grade 3.
- Understanding metastasis patterns is crucial for patient outcomes.
Observation:
- A 68-year-old patient with a history of meningioma surgery experienced recurrence.
- The patient underwent orbital exenteration, debulking, and cervical nodal excision.
- Histopathology confirmed atypical meningioma with cervical lymph node metastasis.
Findings:
- This case highlights a rare lymph node metastasis of atypical meningioma.
- Prior surgical resection is a risk factor for meningioma metastasis.
- Tumor biology and histology predict metastatic potential.
Implications:
- This finding underscores the importance of considering metastasis in atypical meningiomas.
- Further research is needed to establish standardized management protocols.
- Prognosis for atypical meningioma with lymph node metastasis requires further investigation.
