Primary ectopic atypical meningioma in the renal hilum: a case report

Primary pulmonary meningioma presenting as a pulmonary ground glass nodule: a case report and review of the literature

BACKGROUND

A primary pulmonary meningioma is an extremely rare entity. Primary pulmonary meningiomas manifested with a ground glass nodule are a very rare occurrence in clinical practice.

CASE PRESENTATION

In this study, we report a case of a primary pulmonary meningioma with atypical computed tomography features. A 59-year-old Han Chinese female came to our hospital for treatment and reported that her physical examination revealed a ground glass nodule in the right lung for over 3 months. The histologic result revealed a primary pulmonary meningioma. The patient underwent a thoracoscopic lung wedge resection of the right upper lobe for a ground glass nodule. After 1 year of follow-up, the patient is still alive without evidence of metastasis or recurrence.

CONCLUSIONS

Primary pulmonary meningiomas could have a variety of radiological findings. As there are no specific radiologic features for the diagnosis of primary pulmonary meningiomas, complete resection of the lesion is required for both diagnosis and treatment. It is necessary to note the imaging features of primary pulmonary meningiomas, presenting as a ground glass nodule; this rare tumor should be considered in differential diagnoses.

Malignant perineurioma derived from the retroperitoneum with an aggressive clinical course: a case report

BACKGROUND

Malignant perineurioma is a rare malignant counterpart of perineurioma derived from perineural cells. Resection is the primary option for the treatment of malignant perineuriomas; however, patients often develop recurrence after resection, and effective treatment for advanced or recurrent lesions needs to be established. This report describes a 51-year-old female with a rare malignant perineurioma in the retroperitoneum, which contributing valuable insights to the literature.

CASE PRESENTATION

The patient presented with abdominal distension and the imaging work-up revealed a huge hemorrhagic tumor in the retroperitoneum and obstruction of inferior vena cava by the tumor. The patient underwent surgery retrieving the tumor combined with left hemiliver and retrohepatic vena cava, which confirmed the diagnosis of a malignant perineurioma based on histopathological and immunohistochemical examination. Cancer gene panel testing identified mutations in NF2. Radiotherapy was administered for peritoneal dissemination 2 months after surgery, and the patient died from disease progression 6 months after surgery.

CONCLUSIONS

This rare case highlights the challenges in managing retroperitoneal malignant perineuriomas. The aggressive characteristics and limited treatment options for advanced malignant perineuriomas underscore the need for understanding the pathogenesis and developing effective systemic therapies. The identification of an NF2 mutation provides significant insights into potential therapeutic target.

Primary extracranial meningioma of the pelvis discovered on screening pelvic examination

Many conditions that affect a woman's health can be evaluated through the pelvic examination. Early detection and treatment of a range of gynaecologic and non-gynaecological conditions, including unusual pelvic masses, may decrease a woman's morbidity and mortality. Here, we have a female patient in her early 20s who was found to have a mass on her first screening pelvic examination. Subsequent imaging followed by surgical resection were performed with the final diagnosis of a pelvic meningioma. Routine pelvic examinations in asymptomatic women may be more useful than merely screening for cervical cancer and sexually transmitted infections. Once detected, the differential diagnosis of a pelvic mass may include aetiologies outside of the gynaecological organ system.

Liver Metastasis from Typical Meningioma

BACKGROUND

Extracranial metastases from atypical meningioma are not usually found; they are sometimes found in lung, bone or scalp, but atypical meningioma in the liver is extremely rare.

CASE DESCRIPTION

We report a case of a 55-year-old patient with atypical meningioma, treated with surgical resection in 2005, who accepted a second surgical resection in 2015 by the same surgeon, caused by a liver metastasis 4 years after the second surgical resection.

CONCLUSIONS

We have analyzed the cytological findings of a metastastic meningioma with particular focus on pathological and immunohistochemical assessment. These results could improve the knowledge of surgeons about meningioma types and guide them to solve clinical incidents.

Malignant primary pulmonary meningioma with bone metastasis

Primary pulmonary meningioma is extremely rare and only <45 cases have been reported since its first report by Kemnitz and Heinrich (Meningioma of lung: first report with light and electronmicroscopic findings. Ultrastruct. Pathol. 1982;3:359-65). Among these cases, only five cases were malignant or atypical. A 67-year-old female with primary pulmonary meningioma underwent thoracoscopic pulmonary wedge resection of the left lower lobe a year before. She had been aware of left thigh pain for 9 months, then she was referred to our division. Positron emission tomography-computed tomography suspected multiple bone metastasis including frontal bone, mandible, left scapula, rib, vertebra, pubis, left femur and sternum. We performed a needle biopsy of the sternum. Histopathological diagnosis was metastasis of primary pulmonary meningioma, World Health Organization grade III. We treated her with denosumab and radiation therapy targeting the left femur. Two months after the treatment, the pain had decreased and she could walk with no cane. No case of malignant extracranial meningioma with bone metastasis have been reported.

A Patient with a Benign and a Malignant Primary Pulmonary Meningioma: An Evaluation with 18F Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography and Computed Tomography with Iodinated Contrast

An 80-year-old male with a previous history of thymoma and kidney cancer underwent a ¹⁸F fluorodeoxyglucose (FDG) positron emission tomography (PET)/contrast-enhanced computed tomography (CT) scan: two pulmonary nodules were discovered, both characterized by an increased glucose uptake. Of them, only one showed mild contrast enhancement. Both nodules were surgically resected: the first nodule was a benign meningioma and the second one was a malignant meningioma. This case study shows that malignancy of meningioma in the lung is not correlated with ¹⁸F FDG uptake and the contrast enhancement, thus suggesting that PET/CT may represent a suboptimal imaging modality for the evaluation of these lesions.

Primary pulmonary meningioma: an unusual cause of a nodule with strong and homogeneous enhancement

We report a case of a 61-year-old female with atypical chest pain. The chest CT scan revealed a well-circumscribed large intrapulmonary nodule that showed vigorous and homogeneous contrast enhancement. The nodule was diagnosed as a meningioma after surgery. Metastatic meningioma was excluded by brain and spine MRI scans. Primary pulmonary meningioma usually appears as a solitary well-defined round or lobulated nodule with variable enhancement on CT; this case is unique because of the intense and homogeneous enhancement. Although rare, primary pulmonary meningioma should be considered in the differential diagnosis of a well-defined pulmonary nodule with dense and homogeneous enhancement.