Extraneural metastases from cranial meningioma: a case report

Abstract

Extracranial metastases from brain meningiomas is a rare, but well-documented entity. Metastases occur mostly in the lungs, pleura and liver, but may also affect lymph nodes and bones. We report here on a patient who was treated for an atypical brain meningioma with multiple surgeries and multiple sessions of stereotactic radiosurgery with good control of his brain disease. Thirteen years after diagnosis, he developed bilateral large sacroiliac and abdominal metastases.

Figure 1

(A) H&E stain on the intracranial specimen resected in 2007 showing high cellularity and sheets of meningothelial cells with a mitotic activity of 4 per 10 high power fields with foci of necrosis (center and lower right). (B) Ki-67 immunostaining with the MIB-1 antibody showing a labeling index of around 15%.

Figure 2

(A) Axial MRI images showing bilateral sacroiliac heterogeneously enhancing masses. (B) Abdominal CT scan showing large bilateral renal metastases.