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Intracranial Malignant Meningioma With Multiple Spinal Metastases—A Case Report and Literature Review: Case Report

Chuang, Hao-Che, MD; Lee, Han-Chung, MD; Cho, Der-Yang, MD

doi: 10.1097/01.brs.0000245952.71265.9b
Case Reports
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Study Design. Case report.

Objective. To report a case and review the literature on intracranial malignant meningioma with metastasis to the spine.

Summary of Background Data. Because so few cases have been recognized and reported, the radiologic and pathologic assessment, pathway of metastasis, and the concepts of surgical resection and other palliative management of this disease are still controversial.

Methods. Abig lobulated mass in the left frontal lobe containing calcifications and tumor bleeding was resected. Pathologic findings indicated malignant meningioma due to bone destruction and dura invasion grossly, and tumor cellular atypism with mitotic activity and massive tumornecrosis microscopically. Radiotherapy followed, and brain computed tomography revealed no definite evidence of recurrence. Three months later, spinal magnetic resonance imaging revealed multiple bone metastasis in lower T-L-S1, and pathologic fracture of L1 with compression of the dural sac and spinal cord. Surgical resection was done for decompression, fixation, and pathologic proof.

Results. Both pathologic and immunohistochemical survey found evidence consistent with malignant meningioma with spinal metastasis. Advanced treatment was refused, and the patient died.

Conclusion. Spinal magnetic resonance imaging should be performed because of the high spinal metastatic rate, especially when spinal symptoms and signs are present. Immunohistochemical study has an important role in the differential diagnosis of primary or metastatic intracranial neoplasms.

Because so few cases of intracranial malignant meningioma with metastasis to the spine have been recognized and reported, the radiologic and pathologic assessment, pathway of metastasis, and the concepts of surgical resection and other palliative management of this disease are still controversial. We report a case.

From the Department of Neurosurgery, China Medical University Hospital, Taiwan, Republic of China.

Acknowledgment date: March 2, 2006. First revision date: May 3, 2006. Acceptance date: May 3, 2006.

The manuscript submitted does not contain information about medical device(s)/drug(s).

No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Address correspondence and reprint requests to Der-Yang Cho, MD, Associated professor, Department of Neurosurgery, China Medical University Hospital, No. 2 Yu-Der Road, Tai-chung, Taiwan, Republic of China; E-mail: d5057@www.cmuh.org.tw

© 2006 Lippincott Williams & Wilkins, Inc.