Background: Intrameningioma metastasis is a rare differential diagnosis. The clinical implications of these lesions are poorly understood. We screened our database to identify all patients who had been undergone surgery between January 2000 and December 2018 and had been diagnosed with intrameningioma metastasis. Medical charts and radiographic images were reviewed. Brain edema was related to tumor size on preoperative T2-weighted magnetic resonance imaging and classified as little (i.e., less than the tumor size), moderate (i.e., less than triple the size of the tumor), and extensive (i.e., more than triple the size of the tumor).
Case descriptions: We identified 7 patients (3 men and 4 women) with a median age of 61 years (range, 33-63 years). A systemic cancer had been diagnosed preoperatively in all patients (lung adenocarcinoma, n = 5; breast adenocarcinoma, n = 1; pancreas adenocarcinoma, n = 1). Mean time interval between diagnosis of the systemic cancer and the intracranial dural mass was 32 months (SD 23.05). The preoperative working diagnosis was meningioma in 5 patients, and metastasis in 2 patients. All patients were symptomatic at the time of diagnosis with a short history of headache (n = 2), nausea (n = 1), and dizziness (n = 1), and 5 patients harbored neurologic deficits, including hemiparesis (n = 2), hemihypesthesia (n = 2), and paresthesia (n = 1). Preoperative images showed brain edema in all patients (extensive, n = 4; moderate, n = 3).
Conclusions: Intrameningioma metastases show an aggressive clinical behavior prompting early surgical intervention. Clinicians should be aware of this rare entity when counseling patients.
Keywords: Intrameningioma metastasis; Meningioma; Tumor-to-tumor metastasis.
Copyright © 2019 Elsevier Inc. All rights reserved.