J Korean Neurosurg Soc.  2013 Jan;53(1):43-45. 10.3340/jkns.2013.53.1.43.

Non Small Cell Carcinoma Metastasis to Meningioma

• Kim KH
• Hong EK
• Lee SH
• Yoo H

• KMID: 2066984
• DOI: http://doi.org/10.3340/jkns.2013.53.1.43

Abstract

"Tumor-to-tumor" metastasis is a rare event; meningioma has been reported as the most common primary intracranial tumor to harbor cancer metastases. Several hypotheses have been previously proposed to explain this occurrence, but the exact mechanism by which these metastases develop into meningiomas is not yet understood. Magnetic resonance imaging and spectroscopy have been valuable diagnostic tools, but preoperative diagnosis of metastasis to meningioma remains highly difficult. We present a case report of a metastasis of non-small cell lung cancer into an intracranial meningioma.

Keyword

Metastasis; Meningioma; Lung cancer; Non-small cell; Tumor-to-tumor; Harbor cancer

MeSH Terms

Carcinoma, Non-Small-Cell Lung
Carcinoma, Small Cell
Lung Neoplasms
Magnetic Resonance Imaging
Meningioma
Neoplasm Metastasis
Spectrum Analysis

Figure

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  Fig. 1 Preoperative images. A : Chest PA imaging. B : Chest CT imaging reveals a right upper lobe mass (upper). PET imaging shows hypermetabolic lesion in the right upper lobe (lower). CT : computed tomography, PET : positron emission tomography.

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  Fig. 2 Brain MR imaging (at present). The right frontal mass is iso- or hyperintense on the T2 weighted image and enhanced on the T2 weighted image. A calcification lesion is observed inside the mass on the CT scan image. MR : magnetic resonance.

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  Fig. 3 Brain MR, and PET images show the increased size of the dural based mass (after 10 months). The size of the mass has suddenly increased. There are two round figures inside the mass which were not observed before compared to Fig. 1. The mass is hypointense on T2 weighted image, and heterogenously enhanced on T1 enhancing image. PET : positron emission tomography.

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  Fig. 4 Incidental finding of left anterior communicating aneurysm.

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  Fig. 5 Microscopic images. A : The fibrous meningioma with overlying dura of no carcinoma-bearing area (H-E, ×40). B : Higher magnification shows a streaming arrangement of elongated spindle cells resembling fibroblasts and psammomatous calcifications (H-E, ×200). C : In carcinoma-bearing areas, cancer glands are irregularly scattered in fibrous meningioma (H-E, ×200). D : Immunohistochemical staining for TTF-1 shows strong nuclear positivity in glandular structures (×100).

Reference

1. Aghi M, Kiehl TR, Brisman JL. Breast adenocarcinoma metastatic to epidural cervical spine meningioma : case report and review of the literature. J Neurooncol. 2005; 75:149–155. PMID: 16132512.

2. Fried BM. Metastatic inoculation of a meningioma by cancer cells from a bronchiogenic carcinoma. Am J Pathol. 1930; 6:47–52. PMID: 19969886.

3. Honma K, Hara K, Sawai T. Tumour-to-tumour metastasis. A report of two unusual autopsy cases. Virchows Arch A Pathol Anat Histopathol. 1989; 416:153–157. PMID: 2512743.

4. Lee A, Wallace C, Rewcastle B, Sutherland G. Metastases to meningioma. AJNR Am J Neuroradiol. 1998; 19:1120–1122. PMID: 9672023.

5. Pamphlett R. Carcinoma metastasis to meningioma. J Neurol Neurosurg Psychiatry. 1984; 47:561–563. PMID: 6330308.

6. Schmitt HP. Metastases of malignant neoplasms to intracranial tumours : the "tumour-in-a-tumour" phenomenon. Virchows Arch A Pathol Anat Histopathol. 1984; 405:155–160. PMID: 6438898.

7. Smith TW, Wang SY, Schoene WC. Malignant carcinoid tumor metastatic to a meningioma. Cancer. 1981; 47:1872–1877. PMID: 7226082.

8. Tally PW, Laws ER Jr, Scheithauer BW. Metastases of central nervous system neoplasms. Case report. J Neurosurg. 1988; 68:811–816. PMID: 3282041.

9. Van Zandijcke M, Casselman J. MR imaging of a metastasis in a meningioma. Acta Neurol Belg. 1996; 96:329–331. PMID: 9008785.

10. Watanabe T, Fujisawa H, Hasegawa M, Arakawa Y, Yamashita J, Ueda F, et al. Metastasis of breast cancer to intracranial meningioma : case report. Am J Clin Oncol. 2002; 25:414–417. PMID: 12151976.

11. Wolintz AH, Mastri A. Metastasis of carcinoma of lung to sphenoid ridge meningioma. N Y State J Med. 1970; 70:2592–2598. PMID: 5272944.