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Matsuzaki R, Fuchinoue Y, Mikai M, Nakada C, Uchino K, Terazono S, Harada M, Kondo K, Harada N, Sugo N. Metastasis infiltrating tumor to meningioma: a case report. J Med Case Rep 2024; 18:40. [PMID: 38303083 PMCID: PMC10835941 DOI: 10.1186/s13256-024-04349-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 12/30/2023] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND There have been many reports of tumor-to-tumor metastasis, in which cancer metastasizes directly into meningiomas. However, metastasis infiltrating tumors in which cancer metastasizes around meningiomas are rare. Therefore, we report a case of metastasis originating from lung cancer that infiltrated meningioma. CASE PRESENTATION A 79-year-old Japanese woman underwent head magnetic resonance imaging for brain metastasis screening before lung cancer surgery. At that time, asymptomatic meningioma of the left frontal region was accidentally found. Magnetic resonance imaging 6 months later revealed a lesion suspected to be a metastatic brain tumor close to the meningioma. Brain tumor resection was performed, and histopathological diagnosis was meningioma and metastatic brain tumor. Metastatic cancer had invaded the meningioma at the boundary between the brain tumor and metastasis. CONCLUSIONS A sudden change in imaging findings on routine examination of meningiomas in patients with lung carcinoma may indicate a metastatic brain tumor. The form of cancer metastasis to meningioma is not limited to tumor-to-tumor metastasis, but also includes metastasis infiltrating tumors near the meningioma.
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Affiliation(s)
- Ryo Matsuzaki
- Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, 6-11-1, Omori-Nishi, Ota-Ku, Tokyo, 143-8541, Japan.
| | - Yutaka Fuchinoue
- Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, 6-11-1, Omori-Nishi, Ota-Ku, Tokyo, 143-8541, Japan
| | - Masataka Mikai
- Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, 6-11-1, Omori-Nishi, Ota-Ku, Tokyo, 143-8541, Japan
| | - Chie Nakada
- Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, 6-11-1, Omori-Nishi, Ota-Ku, Tokyo, 143-8541, Japan
| | - Kei Uchino
- Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, 6-11-1, Omori-Nishi, Ota-Ku, Tokyo, 143-8541, Japan
| | - Sayaka Terazono
- Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, 6-11-1, Omori-Nishi, Ota-Ku, Tokyo, 143-8541, Japan
| | - Masashi Harada
- Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, 6-11-1, Omori-Nishi, Ota-Ku, Tokyo, 143-8541, Japan
| | - Kosuke Kondo
- Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, 6-11-1, Omori-Nishi, Ota-Ku, Tokyo, 143-8541, Japan
| | - Naoyuki Harada
- Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, 6-11-1, Omori-Nishi, Ota-Ku, Tokyo, 143-8541, Japan
| | - Nobuo Sugo
- Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, 6-11-1, Omori-Nishi, Ota-Ku, Tokyo, 143-8541, Japan
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Hota SK, Mishra S, Dash S, Samantaray S, Mallik RN. Intracranial tumor-to-tumor metastasis in an elderly female: An unusual case report. J Cancer Res Ther 2023; 19:1480-1482. [PMID: 37787337 DOI: 10.4103/jcrt.jcrt_1033_21] [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] [Indexed: 10/04/2023]
Abstract
Tumor-to-tumor metastasis is an extremely rare event, with only 150 reported cases in the literature. Meningioma, renal carcinoma, and tumors of the thyroid are the commonest sites of metastasis. Lung, breast, and GI-tract cancers are the most common types that undergo metastasis. Meningioma is the most common intracranial tumor as recipient of the tumor-to-tumor metastasis. Although breast carcinoma is the most common tumor to metastasize, adenocarcinoma from other organs can also spread to meningiomas, like the ovary and upper gastrointestinal (GI). We report a case of adenocarcinoma metastasis to meningioma with the possibility of primary involvement of the ovary or upper GI. A 77-year-old female patient presented to neurosurgery with episodes of multiple seizures and loss of consciousness. An MRI suggested a left frontotemporal meningioma. The patient underwent craniotomy with mass dissection. Microscopic examinations showed a dual tumor containing both components of meningioma with a metastatic adenocarcinomatous component. The tumor cells were positive for cytokeratin (CK7). Thus, the final diagnosis was made as meningothelial meningiomas (WHO grade I) with metastatic mucinous adenocarcinoma, possible primaries of the ovary or upper GI tract. The patient could not be followed up as we lost the patient a few days after surgery.
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Affiliation(s)
- Subhransu Kumar Hota
- Department of Pathology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Subhasis Mishra
- Department of Pathology, S.C.B. Medical College, Cuttack, Odisha, India
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Georgiou LA, Wright JH, Markel TO, Sims PJ. Small-cell lung cancer metastasis to a meningioma: Case report and review of the literature. Radiol Case Rep 2023; 18:1452-1456. [PMID: 36798062 PMCID: PMC9925871 DOI: 10.1016/j.radcr.2023.01.040] [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: 12/29/2022] [Revised: 01/07/2023] [Accepted: 01/09/2023] [Indexed: 02/04/2023] Open
Abstract
Tumor-to-tumor metastasis is a rare event with meningioma as the recipient tumor accounting for 20% of the reported cases. The most common primary cancers showing this phenomenon are lung and breast cancer. Most lung cancers metastasizing to a meningioma are due to lung adenocarcinoma with the literature containing only 3 prior reports of small-cell lung cancer showing this pattern of spread. Herein, we present the case of a 67-year-old-patient with small-cell lung cancer that developed a metastasis to a meningioma.
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Affiliation(s)
- Loukas A. Georgiou
- Kentucky College of Osteopathic Medicine, 147 Sycamore St., Pikeville, KY 41501, USA
- Corresponding author.
| | - Jeremiah H. Wright
- Department of Radiology, Jackson-Madison County General Hospital, Jackson, TN, USA
| | - Thomas O. Markel
- Department of Radiology, Radia Inc., Legacy Salmon Creek Medical Center, Vancouver, WA, USA
| | - Paul J. Sims
- Department of Pathology, Jackson-Madison County General Hospital, Jackson, TN, USA
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Papadakis BK, Vorrias E, Bräutigam K, Chochlidakis N, Koutsopoulos A, Mavroudis D, Vakis A, Tsitsipanis C. Intrameningioma metastasis: A case-based literature review. J Clin Neurosci 2021; 93:168-173. [PMID: 34656242 DOI: 10.1016/j.jocn.2021.08.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 08/30/2021] [Accepted: 08/31/2021] [Indexed: 11/16/2022]
Abstract
A tumor-to-tumor metastasis inside a meningioma is a rare phenomenon. Malignant neoplasms of the breast and lung are the most common primary tumors. Other sites of origin include prostate, renal and gastric neoplasms. The included case files were retrieved from the medical records of the University Hospital of Crete, Greece. A review of the literature was conducted in March 2020 via PubMed. Relevant search results were few. We report a case of a 66-year-old female, with known Small Cell Lung Cancer, who presented with left-sided hemiparesis. The Magnetic Resonance Imaging scan revealed a right frontal extra-axial mass. The patient underwent a craniotomy and a gross total removal of the tumor. Histological examination of the excised mass revealed metastatic adenocarcinoma deposits inside a meningioma: tumor-to-tumor metastasis. Reviewing the available literature, it has been hypothesized that the following factors play a role in the pathophysiology of this phenomenon: progesterone and estrogen receptors, cell-to-cell adhesion molecules, rich vascularization, favorable metabolic, micro-and immunological environment. Meningiomas seem to be the most common type of intracranial neoplasm to host a metastasis. There is a difference between tumor-to-tumor metastasis and collision tumors. The former implies a recipient role of the host tumor, and the latter refers to a co-localization of two different tumors that grow into one another, both being in the same organ. Tumor-to-tumor brain metastasis is a well-described phenomenon but with unclear pathophysiology. Deeper knowledge could be beneficial for its management.
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Affiliation(s)
| | - Eleftherios Vorrias
- Department of Medical Oncology, General University Hospital of Heraklion, 71500 Voutes Heraklion, Greece
| | - Konstantin Bräutigam
- Institute of Pathology, University of Bern, Murtenstrasse 31, 3008 Bern, Switzerland
| | - Nikolaos Chochlidakis
- Department of Neurosurgery, General University Hospital of Heraklion, 71500 Voutes Heraklion, Greece
| | - Anastasios Koutsopoulos
- School of Medicine, University of Crete, Panepistimiou 71500, Heraklion, Greece; Department of Pathology, General University Hospital of Heraklion, 71500 Voutes Heraklion, Greece
| | - Dimitrios Mavroudis
- School of Medicine, University of Crete, Panepistimiou 71500, Heraklion, Greece; Department of Medical Oncology, General University Hospital of Heraklion, 71500 Voutes Heraklion, Greece
| | - Antonis Vakis
- School of Medicine, University of Crete, Panepistimiou 71500, Heraklion, Greece; Department of Neurosurgery, General University Hospital of Heraklion, 71500 Voutes Heraklion, Greece
| | - Christos Tsitsipanis
- Department of Neurosurgery, General University Hospital of Heraklion, 71500 Voutes Heraklion, Greece
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5
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Metastases to meningioma-review and meta-analysis. Acta Neurochir (Wien) 2021; 163:699-709. [PMID: 33389125 DOI: 10.1007/s00701-020-04661-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 11/26/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE Meningiomas are a common tumor within the cranial cavity. They may be a target for metastatic spread of cancer elsewhere in the body. We analyzed all the data in the literature about tumor-to-meningioma metastasis (TTMM). METHODS We performed a meta-analysis using the PRISMA checklist to locate all cases of TTMM in the PubMed and Medline databases. We collected patient and cancer parameters, meningioma parameters, and clinical factors. RESULTS We located 124 articles, describing 152 cases of patients with TTMM. The mean (± SD) age of all patients was 62.21 ± 10.8 years, with even distribution above and below the mean. Of the cases, 65.9% were reported in women. The most common cancer origins of TTMM were breast and lung carcinoma, followed by kidney, prostate, and GI tract carcinoma. Cancer status is not a good marker of TTMM when managing a meningioma. In 36.69% of cases, TTMM was the presentation of an unknown cancer. In nearly 60% of the known cases, cancer was considered in remission for at least 1 year. Meningioma parameters are unhelpful when considering a TTMM. The distribution of meningioma location is similar to other series of meningioma reported in the literature. Meningioma grade is similar to meningiomas without TTMM. In 57.89%, the patient presented with a focal deficit. Presenting factors were seizures, elevated ICP, and others. Over 95% of cases were symptomatic at presentation. CONCLUSION TTMM should be suspected in cases of meningioma in a patient with background cancer, regardless of meningioma parameters or cancer status.
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Tan C, Tan H, Low S. A case report of atypia in angiomatous microcystic meningioma: A mimicker and masker of intratumoral metastasis in a patient with no known systemic malignancy. GLIOMA 2021. [DOI: 10.4103/glioma.glioma_31_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Clézardin P, Coleman R, Puppo M, Ottewell P, Bonnelye E, Paycha F, Confavreux CB, Holen I. Bone metastasis: mechanisms, therapies, and biomarkers. Physiol Rev 2020; 101:797-855. [PMID: 33356915 DOI: 10.1152/physrev.00012.2019] [Citation(s) in RCA: 144] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Skeletal metastases are frequent complications of many cancers, causing bone complications (fractures, bone pain, disability) that negatively affect the patient's quality of life. Here, we first discuss the burden of skeletal complications in cancer bone metastasis. We then describe the pathophysiology of bone metastasis. Bone metastasis is a multistage process: long before the development of clinically detectable metastases, circulating tumor cells settle and enter a dormant state in normal vascular and endosteal niches present in the bone marrow, which provide immediate attachment and shelter, and only become active years later as they proliferate and alter the functions of bone-resorbing (osteoclasts) and bone-forming (osteoblasts) cells, promoting skeletal destruction. The molecular mechanisms involved in mediating each of these steps are described, and we also explain how tumor cells interact with a myriad of interconnected cell populations in the bone marrow, including a rich vascular network, immune cells, adipocytes, and nerves. We discuss metabolic programs that tumor cells could engage with to specifically grow in bone. We also describe the progress and future directions of existing bone-targeted agents and report emerging therapies that have arisen from recent advances in our understanding of the pathophysiology of bone metastases. Finally, we discuss the value of bone turnover biomarkers in detection and monitoring of progression and therapeutic effects in patients with bone metastasis.
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Affiliation(s)
- Philippe Clézardin
- INSERM, Research Unit UMR_S1033, LyOS, Faculty of Medicine Lyon-Est, University of Lyon 1, Lyon, France.,Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom
| | - Rob Coleman
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom
| | - Margherita Puppo
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom
| | - Penelope Ottewell
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom
| | - Edith Bonnelye
- INSERM, Research Unit UMR_S1033, LyOS, Faculty of Medicine Lyon-Est, University of Lyon 1, Lyon, France
| | - Frédéric Paycha
- Service de Médecine Nucléaire, Hôpital Lariboisière, Paris, France
| | - Cyrille B Confavreux
- INSERM, Research Unit UMR_S1033, LyOS, Faculty of Medicine Lyon-Est, University of Lyon 1, Lyon, France.,Service de Rhumatologie Sud, CEMOS-Centre Expert des Métastases Osseuses, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Ingunn Holen
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom
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Hu T, Wang R, Song Y, Yu J, Guo Z, Han S. Metastasis of pulmonary adenocarcinoma to right occipital parafalcine meningioma: A case report and literature review. Medicine (Baltimore) 2020; 99:e23028. [PMID: 33126391 PMCID: PMC7598821 DOI: 10.1097/md.0000000000023028] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Tumor-to-tumor metastasis is a rare clinical phenomenon. Although meningioma is the most common intracranial recipient of cancer metastasis, only a few cases have been reported. We present a case of metastasis of lung adenocarcinoma into intracranial meningioma and review the published literature. PATIENT CONCERNS A 70-year-old woman was admitted to our hospital for a 1-month history of headache and pain in her lower extremities. DIAGNOSIS Brain and lumbar vertebral magnetic resonance imaging showed an intracranial space-occupying lesion in the right occipital region and spinal canal stenosis. Pulmonary computed tomography showed an irregular mass in the right upper lobe of the lung. The postoperative histological examination demonstrated adenocarcinoma metastasis to meningioma. INTERVENTION The patient underwent right occipital craniotomy for tumor removal and lumbar spinal canal decompression. OUTCOMES There were no initial abnormal conditions after the operation. However, the patient died suddenly 7 days after surgery. LESSONS Tumor-to-meningioma metastasis is a rare but important phenomenon. According to previous reports, it is associated with rapid onset of symptoms and a poor prognosis. Histological examination is of great importance in diagnosis. The history and process of malignant carcinoma should be closely monitored.
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Affiliation(s)
- Tianhao Hu
- Department of Neurosurgery, The First Hospital of China Medical University
| | - Run Wang
- Department of Neurosurgery, The First Hospital of China Medical University
| | - Yifu Song
- Department of Neurosurgery, The First Hospital of China Medical University
| | - Juanhan Yu
- Department of Pathology, China Medical University, Shenyang, China
| | - Zongze Guo
- Department of Neurosurgery, The First Hospital of China Medical University
| | - Sheng Han
- Department of Neurosurgery, The First Hospital of China Medical University
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Mansour S, Luther E, Echeverry N, McCarthy D, Eichberg DG, Shah A, Matus A, Chen S, Gultekin SH, Ivan M, Morcos J. Rare Tumor-to-Tumor Metastases Involving Lung Adenocarcinoma to Petroclival Meningiomas. World Neurosurg 2020; 144:125-135. [PMID: 32730974 DOI: 10.1016/j.wneu.2020.07.140] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 07/19/2020] [Accepted: 07/21/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Lung carcinoma metastasizing to a skull base meningioma remains an extremely rare phenomenon, with only 3 studies reported. Furthermore, no documented cases have been reported in the petroclival region. Thus, we have presented the first 2 cases of tumor-to-tumor metastasis (TTM) in which a petroclival lesion, initially thought to be purely meningioma, was also found to contain metastatic lung adenocarcinoma. CASE DESCRIPTION We present the cases of 2 patients with a known history of lung adenocarcinoma and stable petroclival meningioma who had presented with new-onset neurologic deficits. Repeat imaging studies for both patients found an increased lesion size and peritumoral enhancement; thus, both patients underwent emergent craniotomy for complete lesion resection. Intraoperatively, both lesions had zones of markedly different tumoral texture. On histologic analysis, both lesions showed metastatic lung adenocarcinoma contained within the primary petroclival meningioma. CONCLUSION Skull base TTM is a rare entity for which no specific management guidelines have been created. Therefore, even if the imaging characteristics suggest a more benign process, skull base TTM should remain high on the differential diagnosis for patients with a known primary cancer and new-onset, rapidly progressive, neurologic deficits. Close clinical follow-up with short-interval repeat imaging in this subset of patients might prevent misdiagnosis and facilitate prompt treatment.
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Affiliation(s)
- Samuel Mansour
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida, USA.
| | - Evan Luther
- Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Nikolas Echeverry
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida, USA
| | - David McCarthy
- Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Daniel G Eichberg
- Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Ashish Shah
- Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Alejandro Matus
- Department of Neurological Surgery, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, USA
| | - Stephanie Chen
- Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Sakir Humayun Gultekin
- Department of Pathology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Michael Ivan
- Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Jacques Morcos
- Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida, USA
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Dietterle J, Frydrychowicz C, Müller W, Hoffmann KT, Jähne K, Meixensberger J. Tumor-to-Tumor Metastasis of Multiple Meningiomas and Clear Cell Renal Cell Carcinoma Metastasis as First Clinical Appearance of Kidney Cancer: A Case Report and Analysis. J Neurol Surg Rep 2020; 81:e10-e14. [PMID: 32257763 PMCID: PMC7108953 DOI: 10.1055/s-0040-1708846] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 09/28/2019] [Indexed: 01/10/2023] Open
Abstract
Background Meningioma accounts for more than 35% of all diagnosed brain tumors of the central nervous system and, moreover, it is the most common benign recipient of tumor-to-tumor metastasis. Several cases with tumor-to-meningioma metastasis by breast, lung, and intestinal cancer have been described before. Case description The case of a patient with a longstanding history of multiple meningiomas ( n = 4) that suddenly became symptomatic and progressive in size is presented. Following extirpation of the two largest meningiomas, a histological examination revealed two separate tumor-to-meningioma metastases of clear cell renal cell carcinoma that was undiagnosed before. Post-surgical computed tomography scan then confirmed tumor-suspect lesions in both kidneys. After recovery and rehabilitation, adjuvant radio-chemo-therapy was applied according to protocols for kidney cancer. No other tumor-to-tumor-suspect event occurred since then for the remaining two meningiomas. Conclusion Review of literature and our case strengthens the idea of meningioma as a favorable premetastatic niche. Considering that the patient lived with a stable disease for many years, a sudden progress of tumor size in association with neurological deterioration was highly suspected for malign involvement, including the possibility of tumor-to-tumor metastasis. Physicians should be aware about this phenomenon and treat patients accordingly to the underlying disease.
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Affiliation(s)
- Johannes Dietterle
- Department of Neurosurgery, University Hospital Leipzig, Leipzig, Germany
| | - Clara Frydrychowicz
- Section of Neuropathology, Department of Diagnostic Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Wolf Müller
- Section of Neuropathology, Department of Diagnostic Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Karl-Titus Hoffmann
- Section of Neuroradiology, Department of Diagnostic Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Katja Jähne
- Department of Neurosurgery, University Hospital Leipzig, Leipzig, Germany
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Liu N, Guli QR, Ming XC, Zhou HT, Cui YJ, Zhang D, Liu Y. Tumor-to-tumor metastasis: lung adenocarcinoma metastasizing to intracranial benign meningioma as a first clinical manifestation, with literature review. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2018; 11:2852-2858. [PMID: 31938406 PMCID: PMC6958249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 02/10/2018] [Indexed: 06/10/2023]
Abstract
We report a case of lung adenocarcinoma metastasizing to intracranial meningioma as a first clinical manifestation. Surgeons should be aware of this rare lesion. A 70-year-old Chinese woman was admitted to our hospital with a complaint of progressive left hemiparesis, predominantly of the upper extremity, for 20 days. Computed tomography (CT) revealed a mass on the right side of the right occipital cerebral falx. The subsequent magnetic resonance imaging (MRI) showed an oval mass with equal intensity on T1 weighted imaging (WI) and heterogeneous equal intensity on T2 WI. Within the tumor, a low T1 signal lesion was moderately enhanced after enhanced scanning with a relative boundary. Neuroimaging indicated a meningioma and the patient underwent a total mass resection. Formalin-embedded sections demonstrated two histologically distinct tumors (meningioma and adenocarcinoma) simultaneously in the same lesion without an intermediate transitional zone. Meanwhile, immunohistochemical (IHC) staining showed two distinctly different immunophenotypes in these two tumors and indicated that the component of adenocarcinoma might be a metastasis from a primary lung cancer. Therefore, a subsequent pulmonary CT scan was performed and found a mass at the tip of the upper lobe of the right lung. Fine-needle aspiration biopsy demonstrated an adenocarcinoma. The primary lung adenocarcinoma shared similar histologic morphology with that of the intracranial metastatic site. The final diagnosis waslung adenocarcinoma metastasizing to intracranial benign meningioma. The patient died of heart failure 2 weeks after surgery.
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Affiliation(s)
- Nan Liu
- Department of Pathology, The First Affiliated Hospital and College of Basic Medical Sciences, China Medical UniversityShenyang 110001, China
- Institute of Pathology and Pathophysiology, China Medical UniversityShenyang, China
| | - Qie-Re Guli
- Department of Pathology, The People’s Hospital of Tacheng RegionTacheng, China
| | - Xiao-Cui Ming
- Department of Pathology, The People’s Hospital of Tacheng RegionTacheng, China
| | - Hai-Tao Zhou
- Department of Pathology, The People’s Hospital of Tacheng RegionTacheng, China
| | - Yong-Jie Cui
- Department of Pathology, The People’s Hospital of Tacheng RegionTacheng, China
| | - Di Zhang
- Department of Pathology, The First Affiliated Hospital and College of Basic Medical Sciences, China Medical UniversityShenyang 110001, China
- Institute of Pathology and Pathophysiology, China Medical UniversityShenyang, China
| | - Yang Liu
- Department of Pathology, The First Affiliated Hospital and College of Basic Medical Sciences, China Medical UniversityShenyang 110001, China
- Institute of Pathology and Pathophysiology, China Medical UniversityShenyang, China
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12
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Syed S, Karambizi DI, Baker A, Groh DM, Toms SA. A Comparative Report on Intracranial Tumor-to-Tumor Metastasis and Collision Tumors. World Neurosurg 2018; 116:454-463.e2. [PMID: 29704691 DOI: 10.1016/j.wneu.2018.04.109] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 04/16/2018] [Accepted: 04/17/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND The incidence of 2 distinct tumor types occupying the same anatomic location is rarely observed and may be accounted for by 2 separate mechanisms: tumor-to-tumor metastasis and collision tumors, where 2 adjacent tumors invade one another. These rare phenomena arise from distinct mechanisms, which may affect their preoperative recognition, surgical approach, and postoperative care. We review 2 cases, highlighting their identification and perioperative management. CASE DESCRIPTIONS In case 1, a 71-year-old patient with a history of sphenoid wing meningioma presented with headache, nausea, and vomiting and was found to have a mass with meningioma and glioblastoma (GBM) characteristics. In case 2, a 61-year-old man with worsening dysmetria in the setting of unintentional weight loss presented with multiple masses in the pelvis, abdomen, lung, and brain. The brain masses were classified as meningioma with intratumoral metastatic adenocarcinoma foci. CONCLUSIONS Preoperative recognition of collision tumor and tumor-to-tumor metastasis is imperative for surgical planning, including selecting regions for tissue biopsy and goals of care. Meticulous evaluation of history and imaging and thorough pathologic analysis allow for effective diagnosis and optimal patient outcomes.
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Affiliation(s)
- Sohail Syed
- Department of Neurosurgery, Brown University, Providence, Rhode Island, USA
| | - David I Karambizi
- Warren Alpert Medical School of Brown University, Brown University, Providence, Rhode Island, USA
| | - Amanda Baker
- Department of Radiology, Brown University, Providence, Rhode Island, USA
| | - Darren M Groh
- Department of Neuropathology, Brown University, Providence, Rhode Island, USA
| | - Steven A Toms
- Department of Neurosurgery, Brown University, Providence, Rhode Island, USA; Normal Prince Neurosciences Institute, Brown University, Providence, Rhode Island, USA; Warren Alpert Medical School of Brown University, Brown University, Providence, Rhode Island, USA.
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13
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Pham JT, Kim RC, Nguyen A, Bota D, Kong XT, Vadera S, Hsu F, Carrillo JA. Intracranial meningioma with carcinoma tumor-to-tumor metastasis: two case reports. CNS Oncol 2018; 7:CNS09. [PMID: 29698064 PMCID: PMC5977278 DOI: 10.2217/cns-2017-0022] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Accepted: 12/04/2017] [Indexed: 12/11/2022] Open
Abstract
Meningiomas have been implicated as the most common primary intracranial tumor to contain tumor-to-tumor metastasis. In the following two case reports, we describe cases of adenocarcinoma and breast carcinoma that metastasized into an intracranial meningioma. The first patient was a 64-year-old man presenting to the emergency department with seizures and loss of consciousness. After a left frontal mass resection, pathology reported a heterogeneous mass consisting of a meningioma and a metastatic adenocarcinoma component. The second patient was a 63-year-old woman presenting with significant vision problems and unstable gait. After a right frontal mass resection, pathology reported a heterogeneous mass consisting of a meningioma and a metastatic breast carcinoma component. Possible explanations for the development of the tumor-to-tumor metastasis are described.
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Affiliation(s)
- Jason T Pham
- Department of Neurology, University of California, Irvine Medical Center, Orange, CA 92868, USA
| | - Ronald C Kim
- Department of Neuropathology, University of California, Irvine Medical Center, Orange, CA 92868, USA
| | - Anna Nguyen
- Department of Neuropathology, University of California, Irvine Medical Center, Orange, CA 92868, USA
| | - Daniela Bota
- Department of Neurology, University of California, Irvine Medical Center, Orange, CA 92868, USA
| | - Xiao-Tang Kong
- Department of Neurology, University of California, Irvine Medical Center, Orange, CA 92868, USA
| | - Sumeet Vadera
- Department of Neurological Surgery, University of California, Irvine Medical Center, Orange, CA 92868, USA
| | - Frank Hsu
- Department of Neurological Surgery, University of California, Irvine Medical Center, Orange, CA 92868, USA
| | - Jose A Carrillo
- Department of Neurology, University of California, Irvine Medical Center, Orange, CA 92868, USA
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14
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Kim J, Kim MM, Starkey LJ. A Primer on Secondary Brain Neoplasms: The Essentials. Semin Roentgenol 2018; 53:101-111. [PMID: 29405951 DOI: 10.1053/j.ro.2017.11.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- John Kim
- Department of Radiology, University of Michigan, Ann Arbor, MI.
| | - Michelle M Kim
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
| | - Leslie Jay Starkey
- Department of Radiology, St. Luke's International Hospital, Tokyo, Japan
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15
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Hua L, Luan S, Li H, Zhu H, Tang H, Liu H, Chen X, Bozinov O, Xie Q, Gong Y. Angiomatous Meningiomas Have a Very Benign Outcome Despite Frequent Peritumoral Edema at Onset. World Neurosurg 2017; 108:465-473. [PMID: 28844928 DOI: 10.1016/j.wneu.2017.08.096] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 08/13/2017] [Accepted: 08/14/2017] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Angiomatous meningioma (AM) is a rare subtype of meningioma characterized by highly vascular tumor tissue comprising predominantly variable sized hyalinized blood vessels. The aim of this study is to evaluate the clinical radiologic features of AM and the long-term prognosis in a single neurosurgical center. METHODS A total of 93 patients who underwent surgical resection of AMs between 2003 and 2008 were enrolled for analysis. Clinical information, treatment, and radiologic images were collected and analyzed; follow-up was carried out as well. Expression of estrogen receptor, progesterone receptor, and vascular endothelial growth factor was analyzed by immunohistochemistry. RESULTS Forty-eight females and 45 males were identified. Forty-four patients (47.31%) manifested as hypersignal in T1-weighted imaging sequences and 68 (73.12%) as hypersignal in T2-weighted imaging, and a characteristic ringlike signal was observed in 28 patients (30.11%). Eighty-one cases (87.10%) showed different degrees of peritumor brain edema and it was significantly correlated with the vascular endothelial growth factor expression (P < 0.001). Simpson I resection was achieved in 63 patients (67.74%), grade II in 27 patients (29.03%), and grade III in 3 patients (3.23%). The extent of resection was not associated with the postoperative neurologic function (P = 0.546). Only 4 patients experienced recurrences during the follow-up and these 4 patients were stable until the last follow-up. CONCLUSIONS AMs were a special subtype of meningioma with distinctive radiologic features. AMs manifest benign behavior with a satisfying outcome, which makes Simpson grade II resection an option.
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Affiliation(s)
- Lingyang Hua
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Shihai Luan
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Haixia Li
- Department of Pathology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Hongda Zhu
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Hailiang Tang
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Hanqiu Liu
- Department of Radiology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xiancheng Chen
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Oliver Bozinov
- Department of Neurosurgery, University Hospital Zürich, University of Zürich, Zürich, Switzerland
| | - Qing Xie
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
| | - Ye Gong
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China; Department of Critical Medicine, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
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16
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Johnson MD. Do mesothelin/MUC16 interactions facilitate adenocarcinoma metastases to intracranial meningiomas? Surg Neurol Int 2016; 7:S1049-S1052. [PMID: 28144481 PMCID: PMC5234303 DOI: 10.4103/2152-7806.196367] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 10/11/2016] [Indexed: 11/16/2022] Open
Abstract
Background: Meningiomas have been shown to express mesothelin, a high affinity binding site for MUC16, a transmembrane protein on adenocarcinoma cells. The mechanisms underlying adenocarcinoma metastases to meningiomas may provide insight into tumor-to-tumor metastases and adenocarcinoma metastases to leptomeningeal cells. Methods: Two meningiomas containing metastases from adenocarcinomas were identified and evaluated immunohistochemically for the expression and localization of mesothelin and MUC16. Results: Both meningiomas show extensive mesothelin immunoreactivity, and the adenocarcinomas metastatic to the meningiomas show mesothelin and MUC16 immunoreactivity at the interface with meningioma. Conclusions: Interactions between MUC16 and/or mesothelin on the cell membrane of adenocarcinoma cells with mesothelin on meningioma cells may facilitate adenocarcinoma metastases to meningiomas and possibly the leptomeninges.
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Affiliation(s)
- Mahlon D Johnson
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, New York, India
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