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Isolated extracranial intraosseous metastasis of an intracranial meningioma following bevacizumab therapy: Case report and review of the literature

 Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA

Correspondence Address:
Debraj Mukherjee,
Department of Neurosurgery, Cedars-Sinai Medical Center, 8631 W. 3rd Street, Suite 800E, Los Angeles, CA 90048
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Source of Support: None, Conflict of Interest: None

Meningiomas account for a significant proportion of all primary intracranial tumors; distant metastasis is quite rare. We report a patient with resected, atypical meningioma. The patient's clinical course over 5 years included two craniotomies, a course of radiation, and a shortened course of bevacizumab. Only 5 months after starting bevacizumab, the patient developed an isolated left clavicular pathological fracture attributable to metastatic anaplastic meningioma. This constitutes the first report of meningioma with isolated extracranial intraosseous metastasis in the modern English literature and highlights concerns associated with the use of anti-angiogenic agents in promoting more invasive tumor phenotypes upon disease recurrence.

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