Rapid dedifferentiating meningioma with repeated multifocal recurrences and pulmonary metastases

A 62-year-old woman presented with a convexity meningioma which, after primary surgery, was histopathologically graded as grade II. There followed three more operations due to repeated rapid local recurrences. After each of these three operations histology revealed dedifferentiated grade III tumors. At third recurrence moreover, other multiple tumor masses in the vicinity of the primary tumor site and in the lung were found. These had the same histological appearance as the local recurrences. The patient died 30 months after primary surgery from respiratory failure due to the multiple lung metastases.