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Valente Aguiar P, Gonçalves M, Vaz R, Linhares P. A rare case of meningioma recurrence on a titanium mesh cranioplasty. Br J Neurosurg 2024; 38:1027-1030. [PMID: 34726561 DOI: 10.1080/02688697.2021.1995592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 10/14/2021] [Indexed: 10/19/2022]
Abstract
Cranioplasty with titanium mesh provides a stable and cosmetically sound option for the correction of extensive skull bone defects following trauma or tumour surgery with osseous involvement. Meningiomas are for the most part benign lesions that are amenable to surgical cure, however lesions with extradural extension pose additional challenges not only due to increased technical difficulty in achieving gross total resection but also because of distinct biological behaviour. We describe the case of a 43-years-old woman that had been submitted to gross total resection of a WHO grade I falcine and superior sagittal sinus secretory meningioma with extradural and bone extension and cranioplasty with a titanium mesh who had a recurrence 4 years later as two tumour masses on top of the titanium mesh with no adjacent soft tissue invasion, and without dural involvement. To our knowledge, this is the first reported case of meningioma growth on top of titanium cranioplasty material. Seeded or incompletely removed tumoral cells might have exploited the biocompatibility of titanium to promote tumour regrowth.
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Affiliation(s)
- Pedro Valente Aguiar
- Neurosurgery Department, Centro Hospitalar Universitário São João, Porto, Portugal
- Faculty of Medicine, University of Porto, Porto, Portugal
| | - Manuel Gonçalves
- Neurosurgery Department, Centro Hospitalar Universitário São João, Porto, Portugal
- Faculty of Medicine, University of Porto, Porto, Portugal
| | - Rui Vaz
- Neurosurgery Department, Centro Hospitalar Universitário São João, Porto, Portugal
- Faculty of Medicine, University of Porto, Porto, Portugal
- Neurosciences Centre, Hospital CUF, Porto, Portugal
| | - Paulo Linhares
- Neurosurgery Department, Centro Hospitalar Universitário São João, Porto, Portugal
- Faculty of Medicine, University of Porto, Porto, Portugal
- Neurosciences Centre, Hospital CUF, Porto, Portugal
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2
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Javed S, Khan A, Khalid A, Scalia G, Umana GE, Mahmood A, Yaqoob E, Pahwa B, Chaurasia B. Scalp metastasis from atypical meningioma: A case report and literature review. Clin Case Rep 2024; 12:e8789. [PMID: 38681044 PMCID: PMC11053248 DOI: 10.1002/ccr3.8789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 01/17/2024] [Accepted: 03/20/2024] [Indexed: 05/01/2024] Open
Abstract
Key Clinical Message Scalp metastasis from atypical meningioma, though rare, underscores the importance of meticulous surgical techniques to prevent tumor cell implantation. Early detection and comprehensive management, including surgery and adjuvant therapy, are crucial for optimal outcomes. Abstract Meningiomas are tumors of the meninges that originate in the arachnoid layer from arachnoid cap cells. Atypical meningiomas, classified as WHO grade 2 tumors, tend to metastasize and recur if not surgically managed properly. Scalp metastasis is a rare occurrence that presents as a subcutaneous elevation. A 33-year-old patient presented with a complaint of a constant, dull pressure headache persisting for the past 12 months, exacerbated by exertion, along with seizures and neuropsychiatric symptoms. The patient had no significant medical history but had undergone surgery 4 years ago for a WHO grade 2 meningioma. The current brain MRI revealed a dural tail sign, along with masses on both the left and right sides of the frontal lobe, extending to involve the skin on the forehead and scalp. The patient underwent surgical resection and adjuvant radiation therapy. At the 12-month follow-up, no neurological deterioration or tumor recurrence was observed. A literature review on scalp metastasis in patients with atypical meningioma was also conducted, including eight articles published up to September 2023. The mechanism of metastasis development appears to be consistent in all eight reported cases, involving the implantation of tumor cells during resection. Therefore, there is a critical need for meticulous intra- and post-operative surgical techniques to prevent such implantation.
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Affiliation(s)
- Saad Javed
- Department of NeurosurgeryRawalpindi Medical UniversityRawalpindiPakistan
| | - Amina Khan
- Department of NeurosurgeryRawalpindi Medical University RawalpindiRawalpindiPakistan
| | - Ayesha Khalid
- Department of NeurosurgeryRawalpindi Medical University RawalpindiRawalpindiPakistan
| | - Gianluca Scalia
- Neurosurgery Unit, Department of Head and Neck SurgeryGaribaldi HospitalCataniaItaly
| | | | - Ashraf Mahmood
- Department of NeurosurgeryRawalpindi Medical University RawalpindiRawalpindiPakistan
| | - Eesha Yaqoob
- Department of Public HealthHealth Services Academy, Ministry of National Health Services Regulations and Coordination, Government of PakistanIslamabadPakistan
| | - Bhavya Pahwa
- University College of Medical Sciences and GTB HospitalDelhiIndia
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Hachicha A, Ghedira K, Bouhoula A, Bouali S, Zehani A. Recurrent subcutaneous metastasis of a convexity meningioma: a case report and literature review. Int J Neurosci 2023:1-5. [PMID: 37929581 DOI: 10.1080/00207454.2023.2279499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 10/31/2023] [Indexed: 11/07/2023]
Abstract
Subcutaneous metastasis in the operative route after intracranial meningioma resection is extremely rare. Here we describe the case of a 69-year-old male who was operated on in our department for a convexity meningioma that spread a few years after surgery in the soft tissues next to the craniotomy site. Twenty-one other cases have been found in the medical literature. In this article, we discuss mechanisms of growth, presentation and management of subcutaneous meningiomas.
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Affiliation(s)
- Anis Hachicha
- Neurosurgery Department, Gabes University Hospital, Gabes, Tunisia
- Department of Medicine of Sfax, Institutul National de Metrologie, București, Romania
| | - Khalil Ghedira
- Department of Medicine of Tunis, Tunisia
- Neurosurgery Department, Mongi Ben Hamida National Institute of Neurology, Tunis,Tunisia
| | | | - Sofiene Bouali
- Department of Medicine of Tunis, Tunisia
- Neurosurgery Department, Mongi Ben Hamida National Institute of Neurology, Tunis,Tunisia
| | - Alia Zehani
- Neurosurgery Department, Mongi Ben Hamida National Institute of Neurology, Tunis,Tunisia
- Department of Pathology, Rabta Hospital, Tunis, Tunisia
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Chen A, Hall M, Liu W, Arps D. Atypical presentation of cutaneous meningioma. J Cutan Pathol 2023; 50:110-112. [PMID: 35996326 DOI: 10.1111/cup.14316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 08/17/2022] [Accepted: 08/18/2022] [Indexed: 01/24/2023]
Abstract
Cutaneous meningiomas are rare tumors of ectopic meningeal tissue in the dermis or subcutis and are most commonly located on the scalp and around the eyes, ears, nose, and mouth. We present a case of cutaneous meningioma with an unusual presentation on the upper arm, but with positivity for epithelial membrane antigen to support the diagnosis of meningioma. Lack of pancytokeratin AE1/3 and p63 allowed us to rule out a keratinocytic tumor, such as squamous cell carcinoma and basal cell carcinoma. The absence of smooth muscle actin, FXIIIa, CD163, and CD34 allowed us to rule out a leiomyoma, dermatofibroma, and vascular neoplasm respectively. Weak staining of S100 allowed us to rule out a perineuroma. The purpose of this case report is to increase awareness of a rare presentation of cutaneous meningioma not located within the scalp/face region. This may broaden its inclusion within differential diagnoses of neoplasms of uncertain behavior and encourage correct clinical diagnosis, thus improving treatment outcomes.
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Affiliation(s)
- Anthony Chen
- West Virginia University School of Medicine in Morgantown, Morgantown, West Virginia, USA
| | - Mary Hall
- Mon Health Medical Center, Morgantown, West Virginia, USA
| | - Wenhua Liu
- Consolidated Pathology Consultants, Lake Forest, Illinois, USA
| | - David Arps
- Consolidated Pathology Consultants, Lake Forest, Illinois, USA
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5
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Anderson JD, Anderson JB, Alhatem A, Walter A, Langston L. Type III Cutaneous Atypical Meningioma of the Scalp. J Cutan Pathol 2022; 49:565-569. [PMID: 35001422 DOI: 10.1111/cup.14200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 12/19/2021] [Accepted: 01/07/2022] [Indexed: 11/28/2022]
Abstract
Cutaneous meningiomas can be a diagnostic challenge, as they are not only found very rarely in extracranial sites, including the skin, but also because of the histopathologic overlap with several other spindle cell tumors. Cutaneous meningiomas are divided into type I (congenital), type II (ectopic) and type III (via a direct extension) lesions. We present a rare case of atypical meningioma of the skin in a 71-year-old female. A patient presented with a painful and enlarging lesion on the left central frontal scalp. Biopsy showed bone and soft tissue with involvement of a spindle cell neoplasm, consisting of whorled nests with atypical features, including variably increased mitotic index, areas of hypercellularity, and sheeted architecture. The overall findings were consistent with an atypical meningioma (WHO grade 2). Atypical meningiomas constitute only 5 - 15% of all meningiomas. A skull MRI was later performed, which demonstrated a left frontal tumor consistent with an atypical meningioma that had eroded through the skull. Dermatopathologists should consider cutaneous meningioma as a differential diagnosis of spindle cell neoplasms of the skin and subcutaneous tissue in head and neck. This article is protected by copyright. All rights reserved.
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Affiliation(s)
| | | | - Albert Alhatem
- Department of Dermatology, Saint Louis University School of Medicine, St. Louis, MO
| | - Anne Walter
- Dermatology & Skin Surgery Specialists, Scottsdale, AZ
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Elarjani T, Alhuthayl M, Hassounah M. Massive Secondary Cutaneous Meningioma with Extension to the Face. Surg Neurol Int 2020; 11:209. [PMID: 32874712 PMCID: PMC7451192 DOI: 10.25259/sni_290_2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 07/08/2020] [Indexed: 11/23/2022] Open
Abstract
Background: Cutaneous meningioma is a very uncommon pathologic entity that can be divided into primary and secondary types. Secondary cutaneous meningioma arises from an intracranial meningioma through metastasis, seeding during surgery, or direct bone invasion. There are limited published case reports correlating the development of cutaneous meningioma to high-grade convexity meningioma. Case Description: A 63-year-old man underwent total resection of a right frontal convexity meningioma, World Health Organization Grade I in 2001. He presented in 2016 with a small frontal cutaneous mass over the craniotomy site. Computed tomography showed extracranial and intracranial components of the meningioma. The patient declined surgical intervention and lost to follow. One and half years later, he underwent resection of the growing ulcerating cutaneous component in an outside hospital. The pathological diagnosis was Grade 3 meningioma. Six months later, he presented to us with a massive cutaneous meningioma and large intracranial component. Surgical resection and multidisciplinary management were planned. The patient was very hesitant to have surgery but settled for receiving radiation. Seven months after radiation, he presented with a decreased level of consciousness and skin necrosis with maggot infestation. His code status was changed to “do not attempt resuscitation,” and he died 3 days later in December 2019. Conclusion: Large intracranial meningiomas with massive transosseous extension to the scalp pose a significant challenge to the treating team. Proper planning and a multidisciplinary approach are essential. However, prognosis remains generally poor.
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Affiliation(s)
- Turki Elarjani
- Division of Neurosurgery, Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Meshari Alhuthayl
- Division of Neurosurgery, Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Maher Hassounah
- Division of Neurosurgery, Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
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Ling M, Acharya J, Patel V. Anaplastic meningioma seeding of the abdominal wall following calvarial bone flap preservation. Radiol Case Rep 2020; 15:683-687. [PMID: 32382362 PMCID: PMC7198915 DOI: 10.1016/j.radcr.2020.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 03/02/2020] [Accepted: 03/03/2020] [Indexed: 11/12/2022] Open
Abstract
Meningiomas are common intracranial tumors that rarely metastasize. We present a highly unusual case of a 42-year-old man with direct seeding of meningioma to the abdominal wall. The patient had a history of multiple operations for a recurrent intracranial meningioma with decompressive craniectomy and preservation of the calvarial bone flap by implantation into the subcutaneous layer of the anterior abdominal wall. Following removal of the bone flap, a new abdominal wall mass was identified, consistent with iatrogenic implantation of anaplastic meningioma.
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Liu Y, Li J, Duan Y, Ye Y, Xiao L, Mao R. Subcutaneous Metastasis of Atypical Meningioma: Case Report and Literature Review. World Neurosurg 2020; 138:182-186. [PMID: 32145423 DOI: 10.1016/j.wneu.2020.02.128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 02/20/2020] [Accepted: 02/21/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND Meningioma, a neoplasm of the meninges, is usually a benign localized tumor. Extraneural metastasis is an extremely rare complication of meningiomas, and only a few cases have been reported to date. The present study reports a case of scalp metastasis of an atypical meningioma and discusses the types of atypical meningiomas and their management options. CASE DESCRIPTION A 69-year-old man presented with scalp metastasis of an atypical meningioma. Six years after the right frontoparietal meningioma lesion was completely resected, an isolated subcutaneous metastasis developed at the right frontal region of the scalp, originating at the scar left by the first surgery. Postoperative histologic examination of the subcutaneous tumor revealed the features of an atypical meningioma. CONCLUSIONS This study highlights that resection of meningiomas is still associated with a risk of iatrogenic metastasis. Surgeons should carefully wash out the operative field and change surgical tools frequently to avoid the potential risk of metastasis.
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Affiliation(s)
- Yikui Liu
- Department of Neurosurgery, Huadong Hospital, Fudan University, Shanghai, China
| | - Jian Li
- Department of Neurosurgery, Huadong Hospital, Fudan University, Shanghai, China
| | - Yu Duan
- Department of Neurosurgery, Huadong Hospital, Fudan University, Shanghai, China
| | - Yao Ye
- Department of Pathology, Huadong Hospital, Fudan University, Shanghai, China
| | - Li Xiao
- Department of Pathology, Huadong Hospital, Fudan University, Shanghai, China
| | - Renling Mao
- Department of Neurosurgery, Huadong Hospital, Fudan University, Shanghai, China.
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Kok DL, Hendry S, Alvarez B. Iatrogenic subcutaneous metastasis from WHO Grade I intracranial meningioma. J Clin Neurosci 2018; 58:224-225. [PMID: 30253907 DOI: 10.1016/j.jocn.2018.09.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Revised: 07/07/2018] [Accepted: 09/10/2018] [Indexed: 11/17/2022]
Abstract
Meningiomas are the most frequent primary brain tumours and are often managed with surgical excision. We present the case of a young woman with the unusual phenomenon of iatrogenic subcutaneous seeding from an intracranial meningioma. We discuss the risk factors, possible mechanisms and management of this.
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Affiliation(s)
- David L Kok
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia; Melbourne Medical School, The University of Melbourne, Victoria, Australia.
| | - Shona Hendry
- Department of Anatomical Pathology, St Vincent's Hospital Melbourne, Australia; Department of Pathology, The University of Melbourne, Victoria, Australia
| | - Beatriz Alvarez
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, Spain
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Kirkman MA, Pickles JC, Fairchild AR, Avery A, Pietsch T, Jacques TS, Aquilina K. Early Wound Site Seeding in a Patient with Central Nervous System High-Grade Neuroepithelial Tumor with BCOR Alteration. World Neurosurg 2018; 116:279-284. [PMID: 29859355 DOI: 10.1016/j.wneu.2018.05.158] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 05/21/2018] [Accepted: 05/23/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Advances in molecular profiling have facilitated the emergence of newly defined entities of central nervous system (CNS) tumor, including CNS high-grade neuroepithelial tumor with BCOR alteration (CNS HGNET-BCOR). Relatively little is known about the clinical behavior of these newly characterized tumors. CASE DESCRIPTION We describe a pediatric male patient with CNS HGNET-BCOR, who developed seeding of the tumor into the site of the surgical wound within months of surgery and who underwent resection of a residual posterior fossa tumor. CONCLUSIONS This case emphasizes 3 important points. First, CNS HGNET-BCOR can be aggressive tumors that necessitate close clinical and radiologic surveillance. Second, surveillance imaging in such cases should incorporate the surgical incision site into the field of view, and this should be closely scrutinized to ensure the timely detection of wound site seeding. Third, wound site seeding may still occur despite the use of meticulous surgical techniques.
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Affiliation(s)
- Matthew A Kirkman
- Department of Neurosurgery, Great Ormond Street Hospital, London, United Kingdom; Victor Horsley Department of Neurosurgery, The National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom
| | - Jessica C Pickles
- Department of Histopathology, Great Ormond Street Hospital, London, United Kingdom; Developmental Biology and Cancer Programme, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Amy R Fairchild
- Department of Histopathology, Great Ormond Street Hospital, London, United Kingdom; Developmental Biology and Cancer Programme, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Aimee Avery
- Department of Histopathology, Great Ormond Street Hospital, London, United Kingdom; Developmental Biology and Cancer Programme, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Torsten Pietsch
- Department of Neuropathology and Brain Tumor Reference Center, University of Bonn Medical Center, Bonn, Germany
| | - Thomas S Jacques
- Department of Histopathology, Great Ormond Street Hospital, London, United Kingdom; Developmental Biology and Cancer Programme, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Kristian Aquilina
- Department of Neurosurgery, Great Ormond Street Hospital, London, United Kingdom.
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Isolated Ectopic Cutaneous Atypical Meningioma of the Scalp: Another Mimicker of Primary Adnexal Tumor. Am J Dermatopathol 2017; 39:545-547. [DOI: 10.1097/dad.0000000000000821] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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12
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Sharieff W, Mulroy L, Weeks A, Mansoor S, Pahil R, Islam MU. Scalp Seeding Post Craniotomy and Radiosurgery for Solitary Brain Metastasis: A Case Report and Systematic Review. Cureus 2017; 9:e1083. [PMID: 28405533 PMCID: PMC5384848 DOI: 10.7759/cureus.1083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2016] [Accepted: 03/07/2017] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Radiosurgery is being increasingly used post craniotomy for brain metastasis, instead of whole-brain radiation. We report a case of scalp metastasis following craniotomy and radiosurgery, along with a systematic review of the literature. METHODS Our patient was a 70-year-old male who presented with a scalp metastasis, two years after craniotomy and radiosurgery, for a solitary brain metastasis from esophageal carcinoma. Using Medline® (United States National Library of Medicine, Bethesda, MD), we performed a systematic review of the literature to identify cases of isolated scalp metastases following craniotomy for brain lesions. RESULTS The scalp metastasis was in close proximity to the craniotomy site. Workup did not show any other site of active disease. Biopsy confirmed it to be a metastasis from esophageal carcinoma. The literature review did not yield any case of isolated scalp metastasis following craniotomy and whole-brain radiotherapy or radiosurgery. However, it yielded six cases of isolated scalp metastases following craniotomy for primary brain tumors. CONCLUSION Isolated scalp metastasis has not been reported following craniotomy and whole-brain radiotherapy for brain metastases. Our patient likely had surgical seeding during craniotomy. These surgically implanted cells could not be ablated because the radiosurgery treatment volume does not cover the surgical tract. Further research is needed to identify risk factors for surgical seeding.
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Affiliation(s)
- Waseem Sharieff
- Department of Radiation Oncology, Dalhousie University, Cape Breton Cancer Centre, Sydney NS
| | - Liam Mulroy
- Radiation Oncology, Dalhousie University, Cape Breton Cancer Centre, Sydney NS
| | - Adrienne Weeks
- Neurosurgery, Capital Health District Authority, Dalhousie University
| | - Samina Mansoor
- Pathology, Capital Health District Authority, Dalhousie University
| | - Rajbir Pahil
- Oncology, Dalhousie University, Cape Breton Cancer Centre, Sydney NS
| | - Muhammad U Islam
- Radiology, Dalhousie University, Cape Breton Cancer Centre, Sydney NS
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13
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Singh R, Ryan C, Chohan MO, Tisnado J, Hadjigeorgiou GF, Bilsky MH. Intracranial meningioma with vertebral or intraspinal metastasis: report of 2 cases and review of the literature. J Neurosurg Spine 2016; 25:775-781. [DOI: 10.3171/2016.5.spine151457] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Extracranial meningioma metastases (EMM) occur in 0.1% of intracranial meningioma patients and are more commonly seen in those with atypical and anaplastic histologies. While the lungs and pleura are the most common site of EMM, intraspinal and vertebral EMM also occur and are not well described in the literature. Although the presence of EMM can worsen prognosis, no standard of care has been established for EMM management.
All patients treated for recurrent atypical/anaplastic meningiomas between January 1985 and July 2014 at Memorial Sloan Kettering Cancer Center were screened for intraspinal and vertebral EMM. Of these patients, 2 were identified as having recurrent meningioma complicated by vertebral or intraspinal EMM. A review of the literature was also conducted. The PubMed database was screened for intraspinal and vertebral EMM cases reported in the literature from 1985 to 2015. Nineteen articles were identified from the literature and included 24 individual cases with a total of 34 vertebral or intraspinal EMM. Forty-two percent (10/24) of patients with vertebral or intraspinal EMM had WHO Grade I tumors. Furthermore, 25% (6/24) of vertebral and intraspinal EMM occurred after the primary tumor but prior to any recurrence.
This paper highlights that vertebral and intraspinal EMM can occur in patients with WHO Grade I meningiomas and can occur before tumor recurrence. This challenges the notion that EMM are seen primarily in high-grade atypical and anaplastic meningiomas.
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Affiliation(s)
| | | | - Muhammad O. Chohan
- Departments of 1Neurosurgery and
- 2Department of Neurosurgery, University of New Mexico Comprehensive Cancer Center, Albuquerque, New Mexico; and
| | - Jamie Tisnado
- 3Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
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14
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Woo LH, Soo YW, Sup CD. Seeding of Meningeal Sarcoma Along a Surgical Trajectory on the Scalp. Brain Tumor Res Treat 2016; 4:160-163. [PMID: 27867931 PMCID: PMC5114191 DOI: 10.14791/btrt.2016.4.2.160] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Revised: 09/28/2016] [Accepted: 10/10/2016] [Indexed: 11/20/2022] Open
Abstract
Primary sarcomas of the central nervous system are rare. These tumors is rapid growth often produces mass effect on the brain. Diagnosis is rendered pathologically after resection. Surgical resection is the mainstay treatment and need the adjuvant therapy. We report a 44-year-old female with a meningeal sarcoma of frontal meninges. She complained headache for 2 months and palpable forehead mass for 3 weeks. Brain MRI demonstrated a soft tissue mass sized as 5.3×3.7×3.1 cm with well-defined osteolysis on the midline of the frontal bone. The mass attached to anterior falx without infiltration into the brain parenchyme. The tumor had extracranial and extraaxial extension with bone destruction. The tumor was totally removed with craniectomy and she had an adjuvant radiotherapy. However, an isolated subcutaneous metastasis developed at the both preauricular area of the scalp, originating from the scar which was remained the first surgery. After complete removal of this metastasis, she had an adjuvant radiotherapy in other hospital. However, she expired after six months after first surgery. We believe that the occurrence of tumor seeding at the site of incision in the scalp is related to using the fluid for irrigation after tumor resection and the same surgical instruments for the removal of the brain tumor.
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Affiliation(s)
- Lho Hyoung Woo
- Department of Neurosurgery, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea
| | - Yoon Wan Soo
- Department of Neurosurgery, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea
| | - Chung Dong Sup
- Department of Neurosurgery, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea
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15
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Ranjani S, Mehdi I, Sreenath C, Palassery R. Subcutaneous metastasis secondary to surgical tract seeding in a child with medulloblastoma - A case report. PEDIATRIC HEMATOLOGY ONCOLOGY JOURNAL 2016. [DOI: 10.1016/j.phoj.2017.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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16
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Ashmore DL, Clancy R, Chumas PD. Recurrent meningioma of the scalp after 13 years. BMJ Case Rep 2016; 2016:bcr-2016-215418. [PMID: 27389725 DOI: 10.1136/bcr-2016-215418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Meningiomas represent some of the most common types of tumour of the central nervous system. They are considered benign, with ∼1 in 1000 known to metastasise. We report a case of recurrent meningioma of the scalp 13 years following craniotomy to treat the primary. The recurrent tumour of the scalp was eventually excised 5 years later and the defect closed with an anterolateral thigh free flap in a joint procedure between the neurosurgeons and plastic surgeons. Histology of the scalp lesion confirmed a WHO grade I meningioma. Although a number of explanations for recurrent scalp meningiomas exist, the precise role of isolated genetic defects in scalp meningiomas is incomplete. The scalp meningioma in this case consisted of a complex karyotype suggestive of more aggressive disease. This case emphasises that cytogenetics may play a greater role in identifying more aggressive tumours than histology alone.
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Affiliation(s)
| | | | - Paul D Chumas
- Department of Neurosurgery, Leeds General Infirmary, Leeds, UK
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