Recurrent Intracranial Meningioma with Pulmonary Metastases: A Case Report

Case Report

Austin Oncol Case Rep. 2022; 5(1): 1015.

Recurrent Intracranial Meningioma with Pulmonary Metastases: A Case Report

Rim A, Alia M*, Lina K and Chiraz N

Department of Radiation Therapy, Salah Azaiz Institute, Tunis, Tunisia

*Corresponding author: Mousli Alia, University Tunis El Manar, Campus Universitaire Farhat Hached, B.P. n° 94 - ROMMANA, Tunis 1068, Tunisia

Received: December 24, 2021; Accepted: January 21, 2022; Published: January 28, 2022


We report a 40-year-old female diagnosed with histological grade III meningioma of OMS 2016 in the right side of the temporo-parietal region of skull vault. After a partial resection of the primary site, she rapidly developed unusual multiple metastasis in the pulmonary parenchyma. The patient received adjuvant radiotherapy on the residual volume with palliative decompressive intent due to the gross tumor volume. A review of the literature revealed well documented cases of benign meningiomas that metastasized in an interval of up to 10-12 years after primary tumor resection. This case illustrates that meningiomas Grade III WHO with progression disease of the primary tumor have the potential to develop hematogenous rapid metastases, emphasize the role of multimodal management and the role of genetic behavior to predict such evolution.

Keywords: Meningioma; Pulmonary metastases; Radiotherapy; Palliative


Meningiomas represent 14-19% of all primary intracranial neoplasms [1]. They are slow-growing typically benign intracranial tumors that develop from the arachnoid membrane. After total resection, meningiomas represent a low rate of recurrence [2]. Numerous risk factors of recurrence were described in the literature such as histological grade, subtotal resection, young age, brain infiltration, and high proliferative rate [2]. Reportedly, 2-10% of meningiomas exhibit aggressive behaviour and the prevalence of distant metastases is estimated to 0.1-1% of all meningioma patients. [3]. Extracranial meningioma metastases have been reported to occur mostly in the lungs (61%), followed by the liver, lymph nodes, and bone [3].

We report a case of multiple pulmonary meningioma metastases developing after initial resection of right temporo-parietal World Health Organization Grade III intracranial meningioma

Case Presentation

Miss Y.N is a 40-year-old woman, with no past medical and family history. A right cranial vault swelling appeared in May 2020 related to an ipsilateral temporo-parietal exteriorized mass with necrosis without any neurological symptoms. A Brain Magnetic Resonance Imaging (MRI) revealed osteolytic tissue process of the right temporo-parietal vault measuring 10cm in the greatest axis with intracranial invasion and ventricular junction’s compression. It showed a hydrocephalus of the temporal horn with deviation of the midline reaching the right transverse venous sinus (Figure 1). It was incompletely surgically removed with peripheral bone and dura infiltration. A cranioplasty with PALACOS® cement was made.