[Intraosseous meningioma associated with lung cancer: a case of multiple neoplasms]

Intraosseous tumor was found in a 63 year old male patient with lung cancer during metastatic work-up study. Plain skull X-ray film showed a large osteolytic lesion in the left temporo-parietal bone. Bone and Ga scintigrams revealed an increased activity in this lesion. CT scan demonstrated an isodense lentiform configuration, which was homogeneously enhanced with contrast medium. It was iso-intense in T1, and high-intense in T2 and proton weighted MR images. The tumor was removed en bloc with surrounding normal bone. The attached dura was markedly thickened, but there was no tumor infiltration. Histological diagnosis was transitional meningioma with psammoma body. Postoperatively he was transferred back to Okinawa Hospital and right lower lobectomy was performed for the lung tumor. Histological diagnosis was well-differentiated adenocarcinoma. We examined immunohistochemically p53 protein expression, but p53 immunoactivity was observed in neither tumor. Multiple neoplasms associated with brain tumor are relatively rare, but the incidence will increase in the future as the diagnostic work-up develops. Pathological diagnosis will give us the decisive opportunity for proper treatment. It is to be stressed that, in multiple neoplasms, care should be taken to avoid misdiagnosis of metastasis.