Brain Tumor Res Treat.  2023 Jan;11(1):73-78. 10.14791/btrt.2022.0042.

Breast Cancer to Meningioma: A Rare Case of Tumor-to-Tumor Metastasis

• Joe WH
• Lee CY
• Kim CH
• Ko YS
• Kim SP
• Kwon SM

• KMID: 2539322
• DOI: http://doi.org/10.14791/btrt.2022.0042

Abstract

Tumor-to-tumor metastasis (TTM) is defined as the hematogenous metastasis within a primary host tumor from a donor neoplasm. Since there is insufficient evidence regarding the pathophysiology, clinical course, and management of TTM, there are no precise guidelines for its management. A 73-yearold female patient diagnosed with breast cancer was found to have convexity meningioma. Since the size of tumor and peritumoral brain edema increased during follow-up period, the meningioma was treated with surgical resection. Postoperatively, histopathologic examination confirmed metastasis of invasive ductal carcinoma within a secretory meningioma. The final diagnosis was TTM of breast cancer in meningioma. Here, we report a rare case of intra-meningioma metastasis and a review of literature to provide a better understanding of this rare phenomenon.

Keyword

Meningioma; Tumor-to-tumor metastasis; Breast cancer

Figure

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  Fig. 1 Brain MRI in a 73-year-old female patient shows strongly enhancing 3.4-cm parasagittal meningioma (A) with mild peritumoral edema on axial T2-weighted MRI (B).

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  Fig. 2 Follow-up MRI 16 months later shows increased tumor size (A) and peritumoral edema (B).

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  Fig. 3 Intraoperative surgical view showing complete removal of the tumor with the adjacent superior sagittal sinus and falx.

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  Fig. 4 Histopathologic findings of the meningioma components show sheets of meningothelial cells (A) and pseudo-psammomatous bodies inside a gland-like space (B) with immunopositivity for somatostatin receptor 2a (C) and carcinoembryonic antigen, cytokeratin (inlet) in the pseudo-psammomatous bodies (D). A and B: H&E stain, original magnification, ×200; C and D: Immunohistochemistry, original magnification, ×200.

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  Fig. 5 Histopathologic findings of the carcinoma components show nuclear immunoreactivity of GATA binding protein 3 (A) and estrogen receptor (B), membranous positivity of E-cadherin (C), focal cytoplasmic positivity of gross cystic disease fluid protein 15 (D), and negative immunoreactivity of progesterone receptor, which are consistent with breast ductal carcinoma (E). A-E: Immunohistochemistry, original magnification, ×200.

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