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Extensive pulmonary metastases 13 years after initial resection of intracranial meningioma

1 Department of Neurosurgery, Waikato Hospital, Hamilton, New Zealand
2 Department of Radiation Oncology, Waikato Hospital, Hamilton, New Zealand
3 Department of Pathology, Waikato Hospital, Hamilton, New Zealand

Correspondence Address:
Samuel Rajadurai,
Department of Neurosurgery, Waikato Hospital, Hamilton
New Zealand
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ajns.AJNS_191_18

Background: Extracranial metastasis from intracranial meningioma is a very rare condition. A current literature review reveals that only few cases are documented with extensive pulmonary involvement >10 years after initial intracranial meningioma resection. Diagnosis of pulmonary meningioma is often confirmed by computed tomography chest-guided core biopsies. The prognosis of extensive metastatic pulmonary meningioma, however, is unknown and there is no gold standard treatment option. Case Description: We present a case of multiple pulmonary meningioma metastases developing 13 years after initial resection of left occipital parafalcine World Health Organization Grade I intracranial meningioma. Conclusion: There are no established guidelines for the optimal management or surveillance of extensive pulmonary metastatic meningioma. In patients with high-grade meningioma and multiple cannonball pulmonary lesions, metastatic meningioma should be considered as part of the differential diagnosis. Metastatic meningioma may occur even a decade after initial tumour resection.

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