Metastatic Meningioma with Systemic Involvement: Discussion of Molecular, Genomic, and Radiological Features

Area of Science:

• Neuro-oncology
• Genomic Medicine
• Cancer Metastasis Research

Background:

• Meningiomas are typically benign cranial or spinal tumors.
• Systemic metastasis is rare (<1%) but poses a significant clinical challenge.

Purpose of the Study:

• To add data on meningioma metastasis.
• To explore early molecular profiling for identifying metastatic risk.
• To inform surveillance and treatment strategies for meningioma patients.

Main Methods:

• Retrospective review of 2,888 meningioma patients (2012-2024).
• Analysis of clinical data, histopathology, genomic details, and treatment outcomes.
• Focus on patients who developed metastatic features.

Main Results:

• Five patients (0.17%) developed metastases (scalp, parotid, vertebra, liver, lungs, neck).
• Metastases occurred in one Grade 2 and four Grade 3 meningiomas.
• Identified mutations include MTAP, BRCA-1-associated protein-1, CDKN2A/B, and H3K27me3.
• Survival decreased significantly post-metastasis (107 months to 24 months).

Conclusions:

• Extra-CNS metastatic meningiomas present diagnostic and therapeutic challenges.
• High-grade meningiomas are more prone to metastasis.
• Multidisciplinary care and close follow-up are crucial for high-grade or recurrent meningiomas with specific mutations.